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Parliamentary panel red-flags government’s ambitious healthcare scheme

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New Delhi, March 13: The Modi government has released less than half of the budgeted allocation for health insurance of poor families in fiscal 2017-18, even as it promised to step up coverage with the proposed launch of what is called the world’s largest government healthcare programme.

The revenue allocation of Rs 975 crore for the Rashtriya Swasthya Bima Yojana (RSBY) was reduced to Rs 565 crore and, as the year progressed, the actual release was just Rs 450 crore — less than half of the budget estimate, according to a parliamentary panel’s report.

“Funds as a central share of premium under RSBY of approximately Rs 450 crore were only released for such states that submitted their proposal during the year 2017-18,” said the Parliamentary Standing Committee on Health and Family Welfare in its report.

As for the reason for reducing the budgeted allocation, the panel quoted the Department of Health and Family Welfare, saying: “This ministry had moved a proposal for another scheme with an enhanced cover of Rs 1 lakh per family.

“However, this proposal is still pending with the cabinet. Therefore, such states that were waiting for the new scheme to be launched did not submit any proposal and meanwhile stopped implementation of RSBY.”

Even the amount of Rs 25 crore allocated for capital purposes in 2017-18 for setting up office premises for the proposed scheme with an enhanced cover of Rs 1 lakh remained unutilised during the period as the cabinet approval for the scheme remained pending. The money was surrendered.

The RSBY provided a limited coverage of only Rs 30,000 and there was a proposal to increase it to Rs 1 lakh. While the government had difficulties in implementing the healthcare scheme, it announced the launch a bigger healthcare programme in its Union Budget for 2018-19 last month.

The proposed National Health Protection Scheme (NHPS), which would subsume RSBY, would cover 10 crore poor and vulnerable families, and the coverage is further enhanced to Rs 5 lakh per family per year.

However, the Parliamentary Standing Committee has warned of possible failures.

The committee reported that the enrolment in RSBY was quite low. “Only 57 percent of eligible are enrolled and less than 12 percent of the eligible persons got their hospitalisation covered through RSBY.”

Citing a comprehensive review of various studies on RSBY, the panel said that in a majority of states (eight out of 14) there was an increase in out-of-pocket expenditure related to RSBY, while only two of 14 studies showed a reduction in expenditure.

It further noted that many states have opted out of RSBY in favour of state-run schemes. “The government should form a committee to analyse the failures of RSBY and ensure that inadequacies plaguing the operation and implementation of RSBY are not repeated.”

The panel observed that the new scheme is just a modification of the earlier one as more than half of the target beneficiaries proposed to be covered under the NHPS were already covered under existing government-supported schemes.

“What would indeed have been a step forward is if it covered out-patient treatment as well, but that is lacking,” said the Parliamentary panel.

IANS

Health

Diabetes could contribute to infertility, warn experts

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New Delhi, Feb 16: Diabetes, commonly described as a “lifestyle disease”, can contribute to infertility in both women and men, warn health experts.

“Diabetes can cause infertility in both men and women. Both sexes are at equal risk of infertility,” S.K. Wangnoo, endocrinologist at Indraprastha Apollo Hospitals, told IANS.

Infertility affects up to 15 per cent of reproductive-aged couples worldwide. According to an estimate by the World Health Organization (WHO), the overall prevalence of primary infertility in India is between 3.9 per cent to 16.8 per cent.

“Diabetes in men damages DNA of the sperm and leads to reduced number of sperms and reduced motility of sperms which leads to infertility. Although having diabetes does not necessarily make men infertile, it could make them less fertile,” added Roopak Wadhwa, Consultant at Fortis Hospital, New Delhi.

On the other hand, diabetes in women is associated with polycystic ovary syndrome (PCOS) and other autoimmune diseases that can lead to infertility.

“Diabetes causes a lack of glucose control in the body which, in turn, can make the implantation of the fertile egg in the uterus difficult. Therefore, the chances of miscarriage in diabetic women increase between 30-60 per cent,” Wadhwa explained.

Another WHO report had stated that India had 69.2 million people living with diabetes in 2015.

By 2030, nearly 98 million people in India may have Type-2 diabetes, according to a study published in the Lancet Diabetes and Endocrinology journal last year.

While diabetic patients can always try parenthood, the risk of passing on the sugar disease to the child is approximately 50 per cent high, Wangnoo stated.

“It can also cause intra-uterine growth retardation (IUGR) and congenital anomalies. IUGR is a condition where an unborn baby is smaller than it should be because it is not growing at a normal rate inside the womb,” Wadhwa added.

Furthermore, he noted that diabetic mothers are at high risk of premature deliveries, abortions and perinatal (during birth) complications.

High diabetes can be risky for both mother and child. The experts suggest that maintaining a good lifestyle, an ideal body weight, keeping sugars within target range, avoiding smoking and alcohol and excessive work related stress are some of the preventive measures.

Besides infertility, diabetes can also raise the risk of cardiovascular and lung disease, arthritis, osteoporosis. An estimated 3.4 million deaths are caused due to high blood sugar, according to the WHO.

The global health body also estimates that 80 per cent of diabetes deaths occur in low and middle-income countries and projects that such deaths will double between 2016 and 2030.

IANS

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Birth control pills could impair women’s ability to recognise emotion

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The study showed that healthy women who use birth control pills are poorer judges of subtle facial expressions than non-users. (Representative Photo)

London, Feb 12: Despite the widespread use of oral contraceptives (OCPs) by women, many are not aware that it may impair their ability to recognise others’ emotional expressions, which may have serious consequences in interpersonal contexts, suggests a new study.

The study showed that healthy women who use birth control pills are poorer judges of subtle facial expressions than non-users.

“More than 100 million women worldwide use oral contraceptives, but remarkably little is known about their effects on emotion, cognition and behaviour,” said senior author Alexander Lischke from the University of Greifswald in Germany.

“However, coincidental findings suggest that oral contraceptives impair the ability to recognise emotional expressions of others which could affect the way users initiate and maintain intimate relationships,” said Lischke.

To investigate the effects of OCPs on women’s emotion recognition, the researchers administered a special emotion recognition task to two similar groups of healthy women: 42 OCP users and 53 non-users.

The findings, published in Frontiers in Neuroscience, showed that OCP users were nearly 10 per cent less accurate on average than non-users in deciphering the most enigmatic emotional expressions.

Though the groups were equally good at recognising easy expressions, the OCP users were less likely to correctly identify difficult expressions, results showed.

The effect held for both positive and negative expressions, and regardless of the type of OCP or the menstrual cycle phase of non-users.

“Cyclic variations of estrogen and progesterone levels are known to affect women’s emotion recognition and influence activity and connections in associated brain regions. Since oral contraceptives work by suppressing estrogen and progesterone levels, it makes sense that oral contraceptives also affect women’s emotion recognition,” said Lischke.

There is a need for further studies that replicate and extend the findings of the present study before thinking about changing current guidelines regarding the prescription of OCPs, the study noted.

IANS

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The Delhi High Court seeks Delhi government response over bike ambulance controversy

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New Delhi, Feb 11 (IANS) The Delhi High Court on Monday asked the state government to file response to a plea alleging that trained paramedics are not deployed in bike ambulance service.

On February 7, the Central Accident and Trauma Services (CATS), an entity of the state government, launched a scheme of First Responder Vehicle, popularly known as bike ambulance service, to provide timely health assistance in traffic-congested areas and small lanes.

A bench of Chief Justice Rajendra Menon and Justice V. Kameswar Rao asked the Delhi government and CATS to file response on the plea seeking direction to deploy trained, young and energetic paramedics with requisite qualification and valid licence to drive two-wheelers.

The court has listed the matter for further hearing on May 2.

The court was hearing a plea filed by advocate Satakashi Verma and Kamlesh Kumar. In the plea, the advocates said that the scheme has been launched without doing due diligence with the help of untrained manpower, who are unfit to manage existing ambulance system due to lack of technical qualification.

The scheme was launched without deploying adequately qualified and trained paramedics, they added.

In their petition, they claimed that the existing staff of Assistant Ambulance Officer was found to be unfit for operation and maintenance of the bike ambulance service.

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