by iphindia | Nov 23, 2015 | Blog, Latest Updates
Dr. Arun Jithendra, Dr. Praveen Aivalli and Dr. Samantha Lobbo, attended a four day regional course on Good Health Research Practice (GHRP) by the Regional Training Center, Universitas Gadjah Mada, Yogyakarta, Indonesia from July 27th – 30th, 2015.
The regional course on Good Health Research Practice was jointly organized by the TDR, (the Special program for Research and Training in Tropical diseases) and Regional Training Center Universitas Gadjah Mada, Indonesia. The course had participants with diverse backgrounds from countries such as Bangladesh, Nepal, Indonesia and India. The facilitators for the course were Varalakshmi Elango and Patricia Henley from TDR; Yodi Mahendradhata and Riris Andono Ahmad from Regional Training Center, Universitas Gadjah Mada (UGM).
The aim of the course was to guide the participants towards having a standardized research protocol that could be used in newer avenues of public health research like implementation research. The course was spread over 4 days with modules comprising of lectures, discussions and group activities. The following topics were covered as the part of the course:
- Principles of research ethics and quality
- Study planning and management
- Informed consent
- Tools for data collection
- Tools for study conduct and quality assurance
- Study sites and study team
- Organization breakdown structure and Delegation log
- Study site checklist
- Data management
- Quality system
- Evaluating the research
- Reporting and Dissemination
The uniqueness of the course lay in the fact that each team were asked to bring their own research protocol. Each group went through each topic of the course viewing it through the lens of their own research protocol. This led to an enriching experience of self-reflection, identifying gaps if any, discuss solution to plug these gaps which we could then implement in our respective projects. The lectures were made interactive by case vignettes during each session which encouraged to bring about different viewpoints that further enhanced the understanding of each topic. Presentations of each protocol helped us understand the varying contexts in which each team was working and helped us realize that there is no single fit solution for even similar problems that could exist in different contexts. Overall the course was a good first step to start looking towards developing standards in newer areas of public health research which could potentially improve the quality of the research being carried out.
by iphindia | Nov 17, 2015 | Blog, Latest Updates
According to the Diabetes Atlas 2006, the number of people with diabetes in India is currently around 40.9 million and is expected to rise to 69.9 million by 2025. Similarly, 118 million people were estimated to have high blood pressure in the year 2000, which is expected to go up to 213 million in 2025.
To address this situation, the Indian government launched the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease, and Stroke (NPCDCS) to 364 districts and Tumkur is one of them.
I want to share my experience of working in Tumkur, one of the rural districts of Karnataka, as part of a research project aiming to strengthen care for hypertension and diabetes in two primary health centers (PHCs) with using available sources.
Link to Bheemaray V M blog’s on BMJ:- Click Here
by iphindia | Aug 21, 2015 | Blog, ePHM-Advance, Latest Updates, Short Course
The term Medical Devices, as defined in the Food and Drugs Act, covers a wide range of health or medical instruments used in the treatment, mitigation, diagnosis or prevention of a disease or abnormal physical condition. Medical devices are useful for easy diagnostics and effective instruments acting as a catalyst for treatment of many diseases.
Nowadays, rural medical devices are a boost to develop and developing countries around the world. CAMTECH, USA and Harvard Medical School are two examples who provide platform for many students to develop medical devices. CAMTech’s mission is to accelerate medical technology innovation to improve health outcomes in low and middle-income countries (LMICs). The CAMTech India Jugaad-a-thin brings together some of the world’s brightest minds to develop innovative health technologies.
In India, Moreover, NGO’s like SEWA Rural (Gujarat) are extensively working on mobile healthcare through SMS system and smart phones. Nowadays, many mobile sensor based healthcare I-Phone and android applications have come up which can detect the pulse heart rate etc. Diabetes, Alzheimer’s management apps have recently come up in play store. Students of Faridabad-based Manav Rachna College of Engineering have built an automated portable digital device which collects blood and urine samples to detect diseases like diabetes, anaemia and jaundice. Similarly, Hyderabad-based 20-year-old Asar Dhandala has developed Just Born, a Windows app that highlights the issue of female foeticide in India through a game. Similarly, a few IIT-Madras students managed to develop an automated screening tool to detect diabetic retinopathy. The software analyses the image of fundus (interior eye portion) and identifies the regions affected by the disease. Fractal has also developed Virtual Brailler, a device for the visually impaired that converts text to braille. The low-cost revolutionary product proved to be accessible to several millions who earlier depended on the tangible braille books or resorted to text-to-speech methods.
Mobile phone based Glucometers have now come into the market which helps the patient to check the level of glucose on cell phones and send the results to doctors directly. Public Health Foundation of India, Affordable Health Technologies division has designed Swasthya Slate, a system that allows an Android tablet/phone to deliver 33 medical diagnostics using a single kit. It has been validated in field tests in Punjab and Andhra Pradesh and is currently being used internationally in Peru and Timor-Leste. The overall framework of the Swasthya Slate operations involves diagnostic devices interfaced to a Bluetooth unit. An affordable diagnostic device has been taken and readings have been digitized. These digitized values are sent to an Android tablet, wirelessly. In the tablet, a free-to-use application called Swasthya Slate allows the healthcare worker to take demographic details as well as the clinical information of the patient. (https://www.phfi.org/our-activities/affordable-health-technologies).
Covering a wide range of products, from simple bandages to the most sophisticated life-support products, the medical devices sector plays a crucial role in the diagnosis, prevention, monitoring, and treatment of diseases and the improvement of the quality of life of people suffering from disabilities.
Over 70% of India’s population lives in a rural setting. Hence, it goes without saying that providing adequate health care to this group is of paramount importance. In order for that, we need an improved and reorganised healthcare delivery system. The delivery system tasks include motivating women to give birth in hospitals, bringing children to immunization clinics, encouraging family planning (e.g. surgical sterilization), treating basic illness and injury with first aid, keeping demographic records, and improving village sanitation. But their most important contribution is to serve as a key communication mechanism between the healthcare system and rural populations.
Mobile phone ownership in India is growing rapidly, six million new mobile subscriptions are added each month and one in five Indian’s will own a phone by the end of 2007. By the end of 2008, three-quarters of India’s population will be covered by a mobile network. Many of these new “mobile citizens” live in poorer and more rural areas with scarce infrastructure and facilities, high illiteracy levels, low PC and internet penetration. Primary Health Care Services using Mobile Devices ensures improved access to primary health care and its gate-keeping function leads to less hospitalisation, and less chance of patients being subjected to inappropriate health interventions.
Amongst the many ICT options available to govt to improve the efficiency& effectiveness of its delivery process of primary health care, mobile & wireless technologies offer some exciting opportunities for a low cost, high reach service. There is strong evidence that mobile technologies could be instrumental in addressing slow response rates of govt to citizen requests, poor access to services, particularly for low-income and marginalised populations in underserviced rural areas. The use of mobile devices by health care professionals (HCPs) has transformed many aspects of clinical practice.
Hardik Panchal was a student of e-learning course in Public Health Management(ePHM) conducted by Institute of Public Health, Bangalore, India.
Disclaimer: IPH blogs provide a platform for ePHM students to share their reflections on different public health topics. The views expressed here are solely those of the authors and not necessarily represent the views of IPH.
by iphindia | Aug 12, 2015 | Blog, ePHM-Advance, Latest Updates, Short Course
Health has long been defined as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity ’. This clearly implies the need for promoting ‘holistic’ well-being and comprehensive healthcare that enables people to increase control over improving their own health. This process entails raising health awareness, enabling informed choice, disease prevention and control. Action in health promotion requires that efforts move beyond the boundaries of an absolute biomedical approach, towards one that takes into account the wider determinants of health including social, economic, political, cultural and ecological factors.
Incorporating health promotion mechanisms at every level of our health system is essential. In this blog, I share a few reflections derived from my experiences with health promotion and disease control activity.
HEALTH PROMOTION AND DISEASE CONTROL
I have in the past, had the opportunity to closely observe and be a part of health promotion programmes dealing with cancer awareness, prevention and care. While I had the opportunity to work within the Cancer Screening Programmes in the UK, it was clear that the programmes had been carefully designed, strategized, piloted and rolled out in an evidence-based manner. Understanding the disease, its anatomical symptoms and more so its aetiology at a molecular level, and the social factors influencing its development, held centre focus in the design and implementation of the population-wide disease control programmes. In Bangalore, I had the opportunity to set up a hospital-based cancer registry programme as part of the wider national programme. Being hospital- based, it was the first time that the ‘patient’ was brought into focus in my work with cancer, and in the process; the seriousness, complexity and reality of the disease with its wider issues governing all aspects of disease awareness, prevention or cure became more apparent and significant.
Simultaneously, my background in Immunology began to re-iterate the significant role our human immune system plays in linking the impacts of our environment with our health outcomes. The Government of India has made efforts to incorporate health promotion into the health system through various intervention-based disease control programmes. Such programmes are important in the short term; however their predominant vertical, biomedical (drug-based) approach is futile for sustained disease control. They fail to consider the wider social determinants of health (SDH) that govern individual and population immunity. One such vertical intervention is the DOTS–TB Control.
Programme introduced under the NRHM.
Tuberculosis (TB) remains a major national and global health problem and is no longer only a disease of the poor; but rather a disease of compromised immunity. Various factors like financial poverty, undernourishment, small, overcrowded and unhygienic living conditions, lack of health awareness and poor health / medical practices; all culminate, to directly or indirectly impact on human immunity and influence susceptibility to TB. The evolution of multidrug-resistant TB strains greatly challenges the efficacy of anti-TB drugs. Furthermore, Directly Observed Treatment, Short Course (DOTS) despite its advantages, fails to address the basic principles of autonomy, appropriateness, accessibility and acceptability; essential for successful adherence and compliance to such a disease control strategy. Responsibility to one’s own health and the sense of personal agency is crucial in positively influencing the SDH and thereby health outcomes.
Recent media campaigns promote the importance of TB diagnosis and uninterrupted treatment via the DOTS programme. While this is a powerful effort in health promotion, it fails to convey the very significance of nutrition and a healthy immunity in TB prevention and control.
HEALTH PROMOTION AND THE INDIAN HEALTH SYSTEM
Health promotion is complex and requires adequate reflection, effort and resources. We are fortunate as a country to have the aptitude and the means to build a massive and effective health promotion campaign as a part of our existing public health system. A successful example of disease control through health promotion activities (education and prevention strategies) and multi-sectoral efforts (including The Ministry of Rural Development, Govt. of India, State Public Health Engineering Departments, and the Rajiv Gandhi National Drinking Water Mission (Rural Water Supply) in India; is the Guinea Worm Eradication Programme. Health promotion has the potential to move beyond the NRHM’s vertical interventions through cross sectoral engagement (sectors that influence the daily lives of the public and their health). Addressing the SDH through such an approach would ensure that important disease–contributing factors like micronutrient deficiencies are addressed even via the food industry, for example.
Health protection through immunity building and addressing the SDH from within the Public Health system and across sectors, to introduce well-planned horizontal efforts together with vertical interventions is a way forward.
Janelle de Sa was a student of e-learning course in Public Health Management(ePHM ) conducted by Institute of Public Health, Bangalore, India.
Disclaimer: IPH blogs provide a platform for e-PHM students to share their reflections on different public health topics. The views expressed here are solely those of the authors and not necessarily represent the views of IPH.
![BPM-DPM training on Admin procedures]()
by iphindia | Jan 10, 2012 | Latest Updates
Dr. PK Srinivas, Lead Consultant NHRM, was invited to facilitate a session on ‘Administrative procedures’ on 4/1/2012 for the district and block program managers of Tumkur.
The session was an open discussion on the concerns and problems related to administration. While primarily focusing on challenges in administration, the session also dealt with issues such as enhancing interpersonal communication, creating visibility and value for one’s role and improving working relation between all health staff in respective health care facilities.
Dr. PK Srinivas, a motivational speaker, encouraged participants to raise questions and clarify issues that hindered their routine work processes. He predominantly spoke drawing examples from his own diverse multi faceted experience in the field of health.
According to the 
Incorporating health promotion mechanisms at every level of our health system is essential. In this blog, I share a few reflections derived from my experiences with health promotion and disease control activity.
