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India won’t meet National Health Policy 2017 targets: Ex-health secretary

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New Delhi, April 15: Health has never been a national priority and it is one reason why we have the highest number of women dying during childbirth and under-five mortality rates, former Union Health Secretary K. Sujatha Rao wrote in her recently-published book “Do We Care? Indias Health System”.

Drawing on two decades of work in public health, Rao favours increasing the health budget, greater use of technology and providing leadership and good governance for better healthcare. In an email interview with IndiaSpend, Rao said that with the level of under-funding for health and crowding in of ambitious targets, India will not meet the National Health Policy 2017 targets. Excerpts:

Q: Public health spending is 1.16 per cent of GDP while the World Health Organisation (WHO) recommends spending five per cent of GDP. National Health Policy 2017 talks about increasing the spending to 2.5 per cent by 2025 but we haven’t met the 2010 target of two per cent of GDP. Why does India’s public health funding remain low?

A: Public health spend is low for three reasons: First, lack of political will and the absence of political philosophy that places an individual’s health, well-being and education as being central to the development process. Our mindset is still wired to fly-overs and fast trains. Second, the absence of accompanying reforms in the direction of decentralisation, flexibility and greater accountability to enable quicker absorption of funds and utilisation. Thirdly, on the macro-level, we are not collecting enough taxes and have competing demands and liabilities that have constricted space for increasing resources for health.

Q: Most of the health targets mentioned in National Health Policy 2017 are the same as in 2002, which were supposed to be met in 2010. Most targets have been repackaged with new deadlines. What went wrong, and how do we ensure that we meet the 2017 targets?

A: We will not meet these targets either… not with the level of funding proposed and the crowding in of too many ambitious targets, indicating an absence of prioritisation. I see no shift in strategy that could accelerate the process for achieving the targets within the time-frame suggested. Our public health systems are too weak to fulfil the many demands being placed on it.

Q: How important is it to regulate the private consultation system that caters to 75 per cent of the country’s health needs, as a 2016 Brookings India report showed?

A: Since the 1980s, with the gradual emergence of the economic crisis, India had no option but to allow the entry of the commercialised private sector. The structural adjustment following the IMF loan in 1993 accelerated the process due to severe budget cuts.

Health, unlike other sectors, is fraught with market failures such as the asymmetry of information. These characteristics put limitations on the ability of markets to arbitrate equitably necessitating state intervention. Regulations are critical to protect patient interests and ensure that patient vulnerability is not exploited by the provider… or, as we now see, by the hospital managements.

Q: Talking about the cut in health budgets in the 12th Plan (2015-17), you have said: “…reduced public spending on health and pushing of public-private partnership (PPP) is a dangerous cocktail”. Yet, the National Health Policy 2017 talks about partnerships with the private sector to “address specific gaps in public services”. Should India focus on strengthening the public sector than on PPPs?

A: PPPs work when the risk is shared. They fail when it is a one-sided game with all benefits taken by one partner and all risks borne by one. PPPs in the health sector seem to be more like the latter case.

Secondly, purchasing of health services is based on a contract that is a legal document. So, when you have restricted budgets and contractual obligations, spending priorities get dictated by the legal commitments and not what is in the immediate interest of the people.

Thirdly, the “gap” is more a huge hole. Private sector is the dominant provider. So, if there has to be a real PPP based on a level playing field, the public sector has to be strengthened.

Q: You have mentioned the lack of public discourse and involvement on health in demanding accountability from policy makers. What are the factors responsible for it, and how do we change it?

A: Lack of understanding or perhaps a belief that illness is our fault. Besides, in a very poor country still struggling for basics, health is not a priority — access to water, food and basic incomes to survive are.

By Swagata Yadavar (IANS/Indiaspend) 

Health

Maternal blood sugar likely to affect baby’s heart

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New York, Dec 16: Women with high blood sugar early in pregnancy may raise their baby’s risk of developing a congenital heart defect, according to a study.

While it has been long known that diabetes in pregnancy raises the odds for congenital heart defects in babies.

The new findings reveal that risk extends even to women without diabetes in their earliest part of pregnancy, when the foetal heart is forming.

“Most women who have a child with congenital heart disease are not diabetic,” said James Priest, assistant professor at the Stanford University in California.

The results showed that the risk of giving birth to a child with a congenital heart defect was elevated by 8 per cent for every increase of 10 milligrams per deciliter in blood glucose levels in the early stages of pregnancy.

“We found that in women who don’t already have diabetes or develop diabetes during pregnancy, we can still measure risk for having a child with congenital heart disease by looking at their glucose values during the first trimester of pregnancy,” Priest added.

For the study, published in The Journal of Paediatrics, the team examined medical records from 19,107 pairs of mothers and their babies born between 2009 and 2015, which included details of the mothers’ prenatal care, including blood test results and any cardiac diagnoses made for the babies during pregnancy or after birth.

The study may be helpful to measure blood glucose early in pregnancy in all pregnant women to help determine which individuals are at greater risk for having a baby with a heart defect.

“Knowing about defects prenatally improves outcomes because mothers can receive specialised care that increases their babies’ chances of being healthier after birth,” Priest added.

IANS

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Radiation from smartphones may up miscarriage risk: Study

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New York, Dec 14: Pregnant women’s exposure to non-ionising radiation from smartphones, Bluetooth devices and laptops may more than double the risk of miscarriage, a study has showed.

Non-ionising radiation — radiation that produces enough energy to move around atoms in a molecule, but not enough to remove electrons completely — from magnetic fields is produced when electric devices are in use and electricity is flowing.

It can be generated by a number of environmental sources, including electric appliances, power lines and transformers, wireless devices and wireless networks.

While the health hazards from ionising radiation are well-established and include radiation sickness, cancer and genetic damage, the evidence of health risks to humans from non-ionising radiation remains limited, said De-Kun Li, a reproductive and perinatal epidemiologist at the Kaiser Permanente — a US-based health care firm.

For the study, published in the journal Scientific Reports, the team asked for 913 pregnant women over age 18 to wear a small (a bit larger than a deck of cards) magnetic-field monitoring device for 24 hours.

After controlling for multiple other factors, women who were exposed to higher magnetic fields levels had 2.72 times the risk of miscarriage than those with lower magnetic fields exposure.

The increased risk of miscarriage associated with high magnetic fields was consistently observed regardless of the sources of high magnetic fields. The association was much stronger if magnetic fields was measured on a typical day of participants’ pregnancies.

The finding also demonstrated that accurate measurement of magnetic field exposure is vital for examining magnetic field health effects.

“This study provides evidence from a human population that magnetic field non-ionising radiation could have adverse biological impacts on human health,” Li noted.

“We hope that the finding from this study will stimulate much-needed additional studies into the potential environmental hazards to human health, including the health of pregnant women,” he said.

IANS
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Use of Smartphone before sleep may make your kid obese: Study

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New York, Dec 10: Beware if your children have a habit of playing games on smartphones before sleeping, he or she may face an increased risk of becoming obese, warns a study.

It was discovered kids who used digital devices such as watching TV or playing games on smartphones before going to bed got an average of 30 minutes less sleep in comparison to those who did not.

This lack of proper sleep not only caused fatigue and attention problems in school, but also disrupted their eating habits. This leads to higher body mass indexes (BMI), news agency IANS reported.

“We saw technology before bed being associated with less sleep and higher BMIs,”stated Caitlyn Fuller, researcher at the Pennsylvania State University in the US.

“We also saw this technology use being associated with more fatigue in the morning, which circling back, is another risk factor for higher BMIs. So we’re seeing a loop pattern forming,” Fuller further asserted.

The study, published in the journal Global Pediatric Health, examined the sleep and technology habits of 234 children, between the age of eight to 17 years.

As per the suggestions from the American Academy of Pediatrics (AAP), parents should set some limitations regarding the use of technology, like requiring their kids to put away their devices during meal times and keeping phones out of bedrooms at night.

WeForNews 

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