Reduction in MR and MMR

Universal access to essentials like women

and child health, water, sanitation, immunisation
Prevention and control of communicable and
non-communicable diseases
ntegrated primary care
Population stabilisation incl gender balance
Revitalise local health traditions
Health promotion
NationaI RuraI HeaIth Mission NationaI RuraI HeaIth Mission
amp|e ev|oenoe ol a oyslunor|ona|, non-
perlorm|n puo||o nea|rn sysrem. .Tne
s|ruar|on var|es aoross rne oounrry ano
|n some parrs ol rne oounrry |r lunor|ons
very ue||. l rn|nk on an averae, |r ooes
nor lunor|on ue|| ano rnere are some
parrs unere |r |s rea||y lunor|on|n
|noreo|o|y oao|y
Montek 3ingh Ahluwalia
0y Chairman, Planning Commission
Established in 1981 in Mumbai
Now, a Ieader in ndian Referral Laboratory Market, processing over 5
miIIion samples per year and its 25
th
year of existence
The fastest growing pathology chain in ndia with 10 state of the art
clinical laboratories across the country
The only ndian pathology chain with a direct internationaI presence in
Dubai- UAE, Mahe -Seychelles, Colombo Sri Lanka, Bahrain
Presence in 125 towns and cities with more than 250 collections centers
across the country catering to more than 3000 laboratories, hospitals,
nursing homes and more than 10,000 consultants all across ndia.
ExcIusive aIIiance with two 1500 bedded hospitals for conducting
Clinical Trails and Research - Sri Ramachandra MedicaI CoIIege and
Research Institute (Deemed University) Chennai and M.S. Ramaiah
MedicaI CoIIege and Research Institute (A joint venture for SMO)
1983
F|rsl super-spec|a|ly corporale
rosp|la| |r lrd|a
Apo||o losp|la|s, Crerra|
8tarted w|th 150 eds; today has
700+ beds
3VALL 3TEP T0wAR03 A 8l0 3VALL 3TEP T0wAR03 A 8l0
REv0LuTl0N REv0LuTl0N
0Wred rosp|la|s, Assoc|ale rosp|la|s
ard over 3 c||r|cs
0ver 8 oeds, 11 Card|ac lrsl|lules,
0rco|ogy lrsl|lules
MedicaI Tourism to India MedicaI Tourism to India
Currently worth $333 million, additional revenue
of $2.2 billion expected by 2012
c150,000 "medical tourists in 2003
Potential to attract 1 million tourists per annum -
US$ 5 billion
A Heart Surgery in the US costs US$ 30,000
while it costs US$ 6,000. Bone marrow transplant
in the US costs US$ 2, 50,000 while it is US$
26,000 in ndia, C points out
ndia is unique as it offers holistic medicinal
services, with yoga, meditation, ayurveda,
allopathy, and other systems of medicines
NationaI Workshop on HeaIth
Insurance: 24 Sep 2005
Central State Corporate Personal Total
Primary care 4.3 5.6 0.8 48 58.7
npatient 0.9 8.4 2.5 27 38.8
Non service 0.9 1.6 na na 2.5
TOTAL 6.1 15.6 3.3 75 100
0octor, do you think l need an MRl?" 0octor, do you think l need an MRl?"
Self-reported assessment of medical
practices
spects of Practice
Fee-splitting practices
Over-prescription of drugs
Over-prescription of diagnostics
nadequate sterilization of medical equipment
nadequate measures of disposal of waste
nadequate fulfilment of standards
nappropriate use of medical technology
Breakdown of trust in doctor-patient relationship
nadequate information given to patients
Lack of accessibility during emergencies
Prevelance - High
24
25
14
12
31
5
4
14
15
12
The Baby Doom The Baby Doom
by by
Kavery Nambisan Kavery Nambisan
The couple sitting opposite me in the
clinic are young and wealthy. She is
three months into her third pregnancy
and wants to know the sex of the
unborn baby. Their two bright-eyed
daughters aged four and two are
playing outside. I explain. It is against
the law; the number of girls in our
country is dwindling; all-girl families
are often high achievers. The
husband's patience begins to wear
thin. They leave my clinic with the
frown of those who will not come back
to me. I find out later that the woman
"miscarried" in Bangalore.
!ubIic Empowment
A doctor can be held liable under the
Consumer !rotection Act, 1986, for
deficiency of service.
Disciplinary action can also be brought
against them under the ndian Medical
Council (Professional conduct, Etiquette
and Ethics) Regulations, 2002
Objectives Objectives
Context: general and health
Emerging health care trends
Critique of above
Suggestions for the way forward
Emerging trends in heaIth care in Emerging trends in heaIth care in
India India
!overty and SociaI Opportunity !overty and SociaI Opportunity
el ever a rurdred 8arga|ores ard
lyderaoads W||| rol, or lre|r oWr, so|ve lrd|a's
lerac|ous poverly ard deep-sealed |requa||ly.
Tre very poor |r lrd|a gel a sra|| - ard
oas|ca||y |rd|recl - srare ol lre ca|e lral
|rlorral|or lecrro|ogy ard re|aled
deve|oprerls gererale. Tre rerova| ol
exlrere poverly, ca||s lor rore parl|c|palory
groWlr or a W|de oas|s, Wr|cr |s rol easy lo
acr|eve across lre sare oarr|ers ol ||||leracy, |||
rea|lr, urcorp|eled |ard relorrs ard olrer
sources ol severe soc|ela| |requa||ly. Tre
process ol ecoror|c advarce carrol oe
d|vorced lror lre cu|l|val|or ard errarcererl
ol soc|a| opporlur|l|es over a oroad lrorl.
India Shinning
"ndia is shining ok for the glossy magazines,
but if you just go outside Bangalore you will see
that everything about ndia shining is refuted .
[n the villages] alcoholism is rife and femaie
infacticide and crime are rising. You have to
bribe to get electricity, water. Yes, the middle
and upper classes are taking off, but the 700
million who are left behind, all they see is gloom
and darkness and despair. They are born to fulfil
their destiny and have to live this way and die
this way. The only thing that shines for them is
the sun, and it is hot and unbearable and too
many of them die of heatstroke.
HeaIth Care in India: summary HeaIth Care in India: summary
assessment assessment
Safety
Timeliness
Effectiveness
Efficiency
Equitable
Patient Centeredness
asic health care is a privilege not a right
HeaIth Care in India: summary HeaIth Care in India: summary
assessment assessment
&T...
Reasons to be optimistic
Defining Trends Defining Trends
ndian Economy is GLOBALSNG
ndian Politics is REGONALSNG
ndian Society is LOCALSNG
These are mutually reinforcing and positive trends
...
0ojecl|ves 0ojecl|ves
Context: general and health
Emerging health care trends
Critique of above
Suggestions for the way forward
Areas for coIIaboration Areas for coIIaboration
(hat s n t or e) Test
Philanthropy
Money
Curiousity
Need
Need
8upp|y
SuppIy
India India
8pa|n 8pa|n
Areas for coIIaboration Areas for coIIaboration
ntellectual capital:
policymaking/insurance/management/T
Workforce: Clinical and non-clinical
Goods/manufacturing: Equipment/Medicines
nfrastructure: Population base for R & D/PH
system