Tag: health

Open hospitals in State: CM to investors

Source: dailypioneer.com

Riding on the recent health indicators portraying growth and betterment in the health services in the State, Chief Minister Raghubar Das today appealed to investors to help improve health facilities in Jharkhand by means of opening hospitals, especially in rural areas. The CM said that the government will provide subsidy and all facilities to the investors for the purpose.

Addressing people during the inaugural ceremony of Healthcare Summit Jharkhand-2019 here on Thursday the CM said that if any investor builds a hospital in a rural area, the government will give them 75 per cent subsidy on land value for the purchase, 50 per cent in the block headquarters and 25 per cent in the urban area. The investment (single door) will be through a single channel, he said.

“Jharkhand was ranked third in the NITI Aayog’s State index for incremental growth. It is the result of continuous growth of State in the field of health since 2014. In the year 2000, the maternal mortality rate in Jharkhand was 400 per lakh, which decreased to 165 per lakh, infant mortality rate was 72 per thousand, which decreased to 29 per thousand, institutional deliveries which were only 13.50 per cent which increased to 80 per cent and complete vaccination was 9 per cent which increased to 87 per cent. Jharkhand ranks third in providing OPD service in hospitals across the country. These facts indicate that the State is on the path of reform in the field of health,” said the CM.

Das said that till September 25, 2 crore 85 lakh people of the State will be covered by Golden Card under Ayushman Bharat Yojna. As many as 57 lakh families of Jharkhand will have benefit of this scheme. Golden cards have been made available to 39,13,000 families. A total of 2,26,000 beneficiaries have been taken advantage of the scheme. An amount of Rs 206 crores has been spent for this. To provide maximum benefit of the scheme to the poor, a 300-bed hospital has been arranged in Jamshedpur, where only patients coming under the Ayushman Bharat scheme will be treated. The State has 429 private and 219 government hospitals listed under the scheme. The government will also waive the fee being taken for the golden card in the Pragya Kendras from August 16, 2019, for the poor,” added he.

The CM said on death anniversary of Atal Bihari Vajpayee, Atal Clinic will be opened in every ward.

Das said that the people of the state are getting 108 ambulance facilities. About 5,000 calls are being received every day. The treatment of 8,000 patients is being ensured by 108 ambulances. This service is more effective in tribal areas. Through CSR also, the government is providing the facility of bike ambulance to the poor in remote areas.

Health Minister Ramchandra Chandravanshi said that the government is working towards providing better health facilities. “We are committed to ensure that people get health care up to their doorstep. On September 25, 57 lakh families will be given a Golden Card. The government has added 32 lakh additional families in Ayushman Bharat Yojna. In the last 10 months, 2 crore 19 lakh patients have been treated under the scheme. The present government has established a medical college to provide healthcare,” he said.

All you want to know about malnutrition in India

Source: thehindu.com

Moderate Acute malnutrition (MAM): Children aged between six months and 59 months who are between the -2 and -3 standard deviation for weight for height (wasting) score.

Severe Acute Malnutrition (SAM): Children aged between six months and 59 months and have a weight for height (wasting) score 3 standard deviations below the median, have a mid-upper-arm circumference less than 115 mm, or the presence of bilateral edema.

Severe Chronic Malnutrition (SCM): Calculated with the Z-score defined as a height-for-age index less than –3 standard deviations from the mean weight of a reference population of children of the same height and/or having edema.

Stunting: Calculation is based on height-for-age. It is is associated with an underdeveloped brain, poor learning capacity, and increased nutrition-related diseases.

Wasting: Calculated by weight-for-height. It is associated with decreased fat mass. Also known as wasting syndrome, it causes muscle and fat tissue to waste away.

Underweight: Calculated by the weight-for-age formula. It is a body weight considered to be too low to be healthy. It can reflect both stunting and wasting.

Key highlights of the report

The highest levels of stunting and underweight are found in Jharkhand, Bihar, Uttar Pradesh, Madhya Pradesh, Gujarat and Maharashtra.

At the national level, among social groups, the prevalence of stunting is highest amongst children from the Scheduled Tribes (43.6 percent), followed by Scheduled Castes (42.5 percent) and Other Backwards Castes (38.6 percent).

The prevalence of stunting in children from ST in Rajasthan, Odisha and Meghalaya is high while stunting in children from both ST and SC is high in Maharashtra, Chhattisgarh and Karnataka.

Prevalence of wasting is highest in Jharkhand (29.0%) and above the national average in eight more States (Haryana, Goa, Rajasthan, Chhattisgarh, Maharashtra, Madhya Pradesh, Karnataka and Gujarat) and three UTs (Puducherry, Daman and Diu and Dadra and Nagar Haveli).

Prevalence of underweight is also highest in Jharkhand (47.8%) and is above the National average in seven more States (Maharashtra, Rajasthan, Chhattisgarh, Gujarat, Uttar Pradesh, Madhya Pradesh and Bihar) and one UT (Dadra and Nagar Haveli).

Food and malnutrition in the country

Over the last 20 years, total food grain production in India increased from 198 million tonnes to 269 million tonnes. Despite increase in food production, the rate of malnutrition in India remains very high.

In the food basket, it turns out that in both urban and rural areas, the share of expenditure on cereal and cereal substitutes has declined between 1972-73 and 2011-12, from 57% to 25% in rural areas and from 36% to 19% in urban areas.

The energy and protein intake from cereals has decreased in both rural and urban India, largely because of increased consumption of other food items such as milk and dairy products, oils and fat and relatively unhealthy food such as fast food, processed food, and sugary beverages.

The consumption of unhealthy energy and protein sources is much higher in urban areas.

Double burden of malnutrition

For several decades India was dealing with only one form of malnutrition– undernutrition. In the last decade, the double burden which includes both over- and undernutrition, is becoming more prominent and poses a new challenge for India.

From 2005 to 2016, prevalence of low (< 18.5 kg/m2) body mass index (BMI) in Indian women decreased from 36% to 23% and from 34% to 20% among Indian men.

During the same period, the prevalence of overweight/obesity (BMI > 30 kg/m2) increased from 13% to 21% among women and from 9% to 19% in men.

Children born to women with low BMI are more likely to be stunted, wasted, and underweight compared to children born to women with normal or high BMI.

AES in Bihar: Poor anganwadi centres failed to deliver

Source: downtoearth.org.in

Imagine a dilapidated room, with no plaster on the walls and any doors, window panes — this is what an anganwadi centre (AWC) in Bihar’s Talimpur village in East Champaran district looks like. More, the building has neither a toilet, hand washing facility nor drinking water.

“I have to carry chairs, utensils and other essentials for making food, charts for teaching children, and my registers everyday to and fro from home,” says the sevika (the main service provider) of the AWC in Talimpur village’s Madhuban block told DTE.

Most AWCs in Muzaffarpur, East Champaran (Motihari) and Sitamarhi districts that Down To Earth (DTE) visited, appears to be in similar appalling condition.

The state has recently witnessed a massive outbreak of Acute Encephalitis Syndrome (AES), which claimed lives of more than 130 children. Malnourishment has widely been pegged as the causal factor for AES.

The state also has the highest case of malnourished children (43.9 per cent) in India.

The Anganwadi scheme was started as a rural child care programme in 1975 as part of the Integrated Child Development Services (ICDS) programme. The centres are responsible for providing food and nutrition to children and also pregnant women.

An AWC has a sevika and sahaiyka (the helper who prepares food). The menu is fixed — khichdi, kheer, halwa, rasiav (a sweet local dish to be given on particular days of the week). Typically, an AWC, registers 40 children (3-5 years) for food.

It registers another 40 (0-3 years), eight pregnant and eight lactating mothers to provide take-home-ration (THR). The THR consist of 2.5 kg rice, 2.5 kg dal and some soybean to each of the beneficiaries.

But, many centres get children and mothers more than they could afford. As a result, many do not get registered and remain under nourished.

This is despite the 2006 Supreme Court order directing anganwadi services to be universalised.

“There are many more but I can’t register all of them as the numbers are fixed. Therefore I also have to face wrath of parents whose kids I don’t register,” said Sahaiyka from Talimpur village, adding they try to take only one member (child/lactating or pregnant woman) from a family even if there are more eligible members so that more and more families can be covered.

Out of 2.96 lakh children registered in AWCs of the district’s villages, 27,000 are malnourished, according to a survey report sent by Muzaffarpur district programme manager of ICDS department. This was about those children who are registered. The level of malnourishment in children not registered is yet to be known, the report said.

Most of the deceased’s families that DTE visited said their child was not registered with any AWC.

“There is no AWC nearby. The one that is far did not register my child,” said a man from Muzaffarpur’s Marwan block, who lost his child due to AES. Parents in Sitamarhi and Motihari also narrated a similar story.

Moreover, many of sevikas have also not received their salaries as well as the budget allocated for their centres.

“The villagers come charging on me as to why I am denying food. But the fact remains if I am not getting money what can I do,” said the sevika from AWC in Runni Saidpur block of GIddha Phulwariya village in Sitamarhi district.

The last budget was received in the month of March, she said, teary-eyed. Till the next lot, she provides the children with biscuits from her own pocket on a daily basis.

“If we don’t do it, the children will stop coming and they would not turn up even when I would have the budget. Then I will be questioned by supervisor why children are not there. What would I do then when I would be slapped with notices,” the sahayika rued, adding that they have raised the concern to authorities, but to no avail.

The story is same across AWCs of all the three districts where DTE visited.

According to the recent national family health survey, only 37 per cent children got food from AWCs in Bihar. Incidentally, Bihar had second highest number of malnourished children after Uttar Pradesh till NFHS-3 But in last NFHS survey, it even surpassed Uttar Pradesh.

“Whatever you found in the anganwadi kendras of these villages is in fact of story of villages across Bihar. The story would not have been different, had you not visited the villages before the advent of AES,” said Shakeel, the Bihar coordinator of Jan Swasthya Abhiyan.

“Besides the central government’s scheme, the state also has a couple of them. But the result is to be seen on the ground,” Shakeel added.

EXCLUSIVE: Will put heart, soul into fighting Bihar encephalitis outbreak, says Health Minister Harsh Vardhan

Source:-indiatoday.in

In an exclusive interview with Rajdeep Sardesai, Union Health Minister Harsh Vardhan admitted that a lot needs to be done to combat the encephalitis outbreak in Bihar. He, however, assured that he is personally monitoring the situation in the state even as the death toll from encephalitis deaths reached 128 in Muzaffarpur.

As the death toll in the encephalitis outbreak in Bihar continues to rise, Union health minister Harsh Vardhan admitted that many improvements need to be made to India’s health system.

In an exclusive interview with Rajdeep Sardesai, Harsh Vardhan said, “There is certainly a need for a lot of improvement in the health system of the country. In the past five years, we have been trying to do our best to systematically strengthen the system in the country but I think there is a lot to be done.”

The death toll due to Acute Encephalitis Syndrome (AES) rose to 128 in Bihar’s Muzaffarpur district on Wednesday. Amid growing criticism over governmental inaction, Health Minister Harsh Vardhan had issued directions for immediately sending a high-level team to Muzaffarpur to set up a state-of-the-art multi-disciplinary research centre in the wake of these deaths.

Harsh Vardhan also said five virological labs will be set up in different districts in the state. The districts can be decided in consultation with the state government and can be funded through the National Health Mission (NHM), he said.

In one of the decisions taken during his visit, Vardhan instructed to set up a 100-bed paediatric ICU at SKMCH. Also, in the adjoining districts, 10-bed paediatric ICUs will be set up with support from the Centre, so that such cases can be given better and exclusive treatment and there is no unnecessary load on the facilities available at Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur.

He had made similar suggestions when the Narendra Modi government first came to power in 2014.

When asked about why the Modi government failed to deliver on its 2014 promises, the health minister give a list of work that was in progress. “Let me tell you, super speciality building in the college will be ready by year-end. It will be dedicated to people of Muzaffarpur and those from adjoining districts. I myself visited the site this weekend. As far as the pediatric ICU is concerned, I had suggested there should be exclusive pediatric ICU separate from the main hospital setup but they created ICU within the hospital.”

WATCH FULL INTERVIEW WITH DR HARSH VARDHAN HERE:

Harsh Vardhan said his 2014 suggestions were not fully implemented as he was health minister for only four-five months then. The Union minister agreed things need to be improved further, “We need to ensure 100 per cent immunisation of children, we are proactively bringing many children into the net of immunisation but India being a large country we need to go ahead at a fast manner. You have seen the initial impact of Ayushmann Bharat. We have the ambitious plan to build 1.5 lakh health and wellness centres at primary level, out of which 18,000 have been created.”

However, Harsh Vardhan admitted that expenditure on health in India needs to increase. “There is an ambitious plan to increase the health budget to 2.5 per cent (from the current 1.5 per cent) of the total Union budget. Personally, as a doctor, I wish I could get much more,” said Harsh Vardhan.

The spread of encephalitis in Bihar has been attributed to malnutrition. Unripe litchi fruit contains a high concentration of the toxin called MCPG which triggers hypoglycemia if consumed by a child with a malnourished body. Therein lies the answer to the question: why only the poorest of the poor and mostly those living in Muzaffarpur and adjoining districts are suffering from the disease.

Harsh Vardhan said that the Modi government has diagnosed the problems in the system and hopes to eradicate them by 2022. “When we took over in 2014, under the leadership of PM Modi we tried to diagnose each and every problem in the country. A lot has been done and a lot needs to be done and we are very hopeful that in the new India that we are talking about in 2022, you will see a lot of perceptible and measurable changes in the country,” said Harsh Vardhan.

However, the minister was not able to give a clear answer on whether the NDA government in Bihar or CM Nitish Kumar should be held accountable for the encephalitis outbreak. “You have to appreciate that this disease has not been eradicated anywhere in the world. It is endemic to this part of the country. This is not happening only here,” he said.

When questioned on how the UP government had managed to control the encephalitis outbreak in the state but Bihar had failed, Harsh Vardhan said that he was doing his best to improve the situation and was monitoring it closely. “I can only tell you that we are trying to do our best. I have sent one of my joint secretaries there [to Muzaffarpur], have sent all possible help — paediatricians, virologists, epidemiologists. From our side, we have ensured that whatever gap exists is filled. I was only four-five days old in this ministry, but I sent a high-powered team there. Every day I am monitoring things on an hourly basis and the teams are reporting to me directly.”

Finally, when asked if he could give a guarantee that such a grim scenario would not be seen in Bihar next year, Harsh Vardhan said, “I can only give you one guarantee that Dr Harsh Vardhan will personally monitor the implementation of all the suggestions that he gave in 2019. I will do my best and I will put my heart and soul into it.”