श्री सिद्धार्थ श्रीनिवासन, सीईओ, लुपिन डिजिटल हेल्थ (LDH), तकनीक के माध्यम से रोगियों के बेहतर परिणाम सुनिश्चित करने पर केंद्रित डिजिटल थेरेप्यूटिक्स पहलों का नेतृत्व कर रहे हैं। टेक-ड्रिवन व्यवसायों को बड़े पैमाने पर आगे बढ़ाने का अनुभव रखने वाले वे इससे पहले एक दशक तक टाटा समूह से जुड़े रहे। उन्होंने एस.पी. जैन से पीजीडीएम और वीएनआईटी से बी.टेक की डिग्री प्राप्त की है। डॉ. सौम्या सिंह, क्रिएटिव एडिटर, उनसे स्वास्थ्य सेवा में डिजिटल थेरेप्यूटिक्स की भूमिका पर बातचीत कर रही हैं।

भारत में शहरी और ग्रामीण क्षेत्रों में डिजिटल थेरेप्यूटिक्स किस प्रकार स्वास्थ्य सेवाओं को बदल रहे हैं?

डिजिटल थेरेप्यूटिक्स भारत में स्वास्थ्य सेवाओं के परिदृश्य को तेजी से बदल रहे हैं।

• शहरी क्षेत्रों में टेलीहेल्थ और मोबाइल हेल्थ सॉल्यूशन्स का व्यापक रूप से उपयोग हो रहा है।
• ग्रामीण क्षेत्रों में भी धीरे-धीरे टेलीहेल्थ और डिजिटल थेरेप्यूटिक्स का अपनापन बढ़ रहा है, क्योंकि लोग विशेषज्ञ डॉक्टरों की सेवाओं तक पहुँच बनाना चाहते हैं।

अब ध्यान संक्रामक रोगों से हटकर गैर-संक्रामक रोगों (NCDs) पर केंद्रित हो गया है, जिनमें कार्डियोमेटाबोलिक बीमारियाँ (जैसे उच्च रक्तचाप और मधुमेह) शामिल हैं। इन स्थितियों से भारत की बड़ी आबादी प्रभावित है, और डिजिटल थेरेप्यूटिक्स इन्हें नियंत्रित करने में महत्वपूर्ण भूमिका निभा सकते हैं।

इसके अलावा, श्वसन रोग, महिला स्वास्थ्य, कैंसर, नवजात शिशु देखभाल और मानसिक स्वास्थ्य जैसे क्षेत्रों में भी उल्लेखनीय प्रगति हो रही है।

कार्डियोलॉजी (हृदय रोग विज्ञान) में डिजिटल थेरेप्यूटिक्स की क्या भूमिका है?

हृदय रोगों में डिजिटल थेरेप्यूटिक्स तीन प्रमुख पहलुओं में मददगार हैं:

• सक्रिय निगरानी (Active Monitoring): मरीज अपने लक्षण और महत्वपूर्ण संकेत (Vitals) वास्तविक समय में साझा कर सकते हैं, जिससे सही समय पर हस्तक्षेप संभव होता है।
• अनुपालन (Adherence): यह सुनिश्चित करता है कि मरीज नियमित रूप से दवा लें और समय-समय पर चेकअप करवाएँ।
• जागरूकता और पुनर्वास (Awareness & Rehabilitation): मरीजों को जीवनशैली सुधारने और रिकवरी में व्यापक सहायता प्रदान की जाती है।

डिजिटल थेरेप्यूटिक्स प्लेटफ़ॉर्म में डेटा गोपनीयता और सुरक्षा कैसे सुनिश्चित की जाती है?

• कानूनों का पालन: भारत में डिजिटल पर्सनल डेटा प्रोटेक्शन बिल और अमेरिका में HIPAA जैसे नियम।
• सूचना सुरक्षा प्रणाली: ISO 27001 जैसे मानकों के अनुसार।
• नियमित ऑडिट और जाँच।
• डेटा एन्क्रिप्शन और सीमित एक्सेस।
• सुरक्षित क्लाउड सेवा प्रदाताओं के साथ साझेदारी।
• मरीजों को अपने डेटा पर नियंत्रण: वे चाहें तो जानकारी एक्सेस या डिलीट कर सकते हैं।

AI एकीकरण डिजिटल थेरेप्यूटिक्स की प्रभावशीलता कैसे बढ़ा रहा है?

• प्रीडिक्टिव मॉडल्स: संभावित स्वास्थ्य समस्याओं का पहले से अनुमान।
• नेचुरल लैंग्वेज प्रोसेसिंग: चैटबॉट्स और वर्चुअल असिस्टेंट्स मरीजों के सवालों का जवाब देते हैं।
• क्लिनिकल डिसीजन सपोर्ट: डॉक्टरों को मरीज की जानकारी का सारांश और व्यक्तिगत इलाज योजनाएँ सुझाना।
• जोखिम मूल्यांकन (Risk Assessment): री-अडमिशन या जटिलताओं की संभावना का अनुमान।
• कंप्यूटर विज़न: स्मार्टफोन इमेज से बीमारियों का आकलन।

आने वाले 5–10 वर्षों में कौन-सी नई तकनीकें डिजिटल थेरेप्यूटिक्स पर सबसे बड़ा प्रभाव डालेंगी?

• वेयरेबल्स (Wearables): स्मार्टवॉच और अन्य उपकरणों का व्यापक उपयोग।
• गैर-आक्रामक मॉनिटरिंग: बिना सुई या कफ के ब्लड प्रेशर और ग्लूकोज की निगरानी।
• AI-आधारित बिहेवियरल मॉडल्स: बेहतर अनुपालन सुनिश्चित करने हेतु।
• कंप्यूटर विज़न: व्यायाम की सही तकनीक पर वास्तविक समय फीडबैक।
• ऑगमेंटेड रियलिटी (AR): मरीज शिक्षा और सर्जिकल प्लानिंग में उपयोग।

भारत और वैश्विक स्तर पर डिजिटल थेरेप्यूटिक्स बाजार का भविष्य कैसा है?

• भारत में: AI-आधारित हेल्थकेयर बाजार तेजी से विस्तार कर रहा है।
• वैश्विक स्तर पर: वेयरेबल्स का बाजार उल्लेखनीय रूप से बढ़ने की संभावना है।
• वर्तमान में स्वास्थ्य सुविधाओं में डिजिटल थेरेप्यूटिक्स का उपयोग अभी भी कम है, जिससे वृद्धि की अपार संभावना है।

हृदय रोगों की देखभाल में डिजिटल थेरेप्यूटिक्स का दृष्टिकोण क्या है?

विशेषज्ञ टीम (केयर मैनेजर, न्यूट्रिशनिस्ट, व्यायाम विशेषज्ञ)।

• मरीज, डॉक्टर और देखभालकर्ताओं के लिए ऐप इकोसिस्टम।
• मान्यता प्राप्त चिकित्सा उपकरणों का एकीकरण।
• पोस्ट-प्रोसीजर से लेकर क्रॉनिक कार्डियक कंडीशन्स तक की देखभाल।
• एविडेंस-बेस्ड केयर: नवीनतम क्लिनिकल गाइडलाइन्स पर आधारित।

डिजिटल थेरेप्यूटिक्स स्वास्थ्य सेवाओं को अधिक सुलभ और किफायती कैसे बनाते हैं?

• दूरस्थ परामर्श और मॉनिटरिंग, अस्पताल जाने की आवश्यकता कम।
• विशेषज्ञों तक पहुँच, खासकर डॉक्टरों की कमी वाले क्षेत्रों में।
• यात्रा और आवास जैसे छिपे हुए खर्चों में कमी।
• नियमित देखभाल के बीच निरंतर समर्थन, जिससे जटिलताओं से बचाव।
• AI और तकनीक के ज़रिए बड़े पैमाने पर व्यक्तिगत देखभाल।
• मरीजों को आत्म-प्रबंधन के लिए ज्ञान और उपकरण उपलब्ध।

The post स्वास्थ्य सेवा में बदलाव: भारत और वैश्विक स्तर पर डिजिटल थेरेप्यूटिक्स की भूमिका appeared first on InnoHEALTH magazine.

Menopause, a natural physiological transition marking the end of a woman’s reproductive years, typically occurs between the ages of 45 and 55. While commonly associated with hormonal shifts and fertility cessation, its broader health implications are often underestimated. One of the most overlooked aspects is the intersection between menopause and the risk of non-communicable diseases (NCDs)—a growing concern that deserves urgent attention from clinicians, policymakers, and public health stakeholders.

Hormonal Changes: A Silent Catalyst for NCDs

The onset of menopause brings a significant decline in estrogen levels. This hormone, while primarily linked to reproductive health, also plays a crucial protective role in regulating cardiovascular, metabolic, skeletal, and immune systems. Its gradual withdrawal sets off a cascade of physiological changes, many of which contribute to an increased risk of developing chronic conditions.

Cardiovascular Disease: A Rising Threat Post-Menopause

Estrogen supports vascular health by enhancing nitric oxide production, which promotes blood vessel flexibility. It also maintains a favorable lipid profile, keeping LDL (bad cholesterol) low and HDL (good cholesterol) high. When estrogen declines, these protections fade, leading to arterial stiffness, plaque buildup, and rising blood pressure—factors that significantly elevate the risk of coronary artery disease and stroke. Indeed, within a decade after menopause, cardiovascular risk in women sees a steep upward trajectory.

Metabolic Shifts and Bone Vulnerability

Estrogen improves insulin sensitivity and helps maintain stable blood glucose levels. Its absence contributes to increased abdominal fat, insulin resistance, and elevated blood sugar, all of which are precursors to type 2 diabetes. Additionally, estrogen is vital for bone health, as it slows down the breakdown of bone tissue. After menopause, accelerated bone loss can lead to osteoporosis and fragility fractures, particularly in the spine, hips, and wrists.

Mental Health: A Hidden Dimension

The psychological effects of menopause are often underestimated but are no less significant. Estrogen influences the brain’s neurotransmitters—serotonin,dopamine,and norepinephrine—essential for emotional regulation and cognitive performance. As hormone levels drop, many women experience:
– Increased susceptibility to depression and anxiety
– Mood fluctuations and reduced stress resilience
– Difficulty sleeping and diminished cognitive clarity

These symptoms are often exacerbated by external stressors such as caregiving responsibilities, career changes, and evolving family dynamics, potentially leading to decreased self-esteem and emotional burnout.

An Emerging Concern: Cognitive Decline

Recent scientific inquiries have started to draw connections between menopause and an increased risk of neurodegenerative diseases, including Alzheimer’s. Estrogen’s role in protecting brain cells from oxidative stress and inflammation is only beginning to be fully understood, but its implications highlight the importance of proactive cognitive health strategies during midlife.

A Missed Public Health Opportunity

Despite the established link between menopause and the increased risk for several NCDs—including cardiovascular disease, diabetes, osteoporosis, and mental health disorders—this life stage remains largely absent from mainstream public health programming. Menopause is rarely addressed as a distinct health milestone requiring preventive care, leaving many women unaware of the risks and without access to timely interventions.

This gap reflects broader gender disparities in healthcare and reveals a pressing need for systemic change. Integrating menopause into the public health narrative offers a pivotal opportunity to reduce the long-term burden of chronic illness and promote healthy aging.

Towards a Gender-Responsive Health Agenda

Public health strategies must begin to see menopause not as a private medical issue but as a societal health turning point. This requires:
– Risk-based screenings for hypertension, diabetes, dyslipidemia, and bone density
– Culturally appropriate counselling on lifestyle changes, physical activity, and nutrition
– Access to mental health services, tailored to midlife emotional and cognitive challenges
– Educational initiatives that empower women with knowledge about their changing bodies and health risks

A lifespan approach to women’s health, beyond the reproductive years, can help build more equitable and effective health systems.

Menopause is far more than the end of menstruation—it is a critical inflection point in a woman’s health journey. By recognizing the strong link between menopause and non-communicable diseases, we can shift from reactive treatment to proactive prevention. It’s time we brought menopause to the forefront of public health discourse and created supportive ecosystems that enable women to thrive—not just survive—through this transition and beyond.

Author’s biography

Dr. Shazina Saeed is a physician-scientist with expertise in clinical genetics and public health, currently serving as Assistant Professor and PhD Coordinator at Amity University, Noida.

The post Menopause and NonCommunicable Diseases: The Overlooked Nexus appeared first on InnoHEALTH magazine.

India too is urbanizing rapidly, in alignment with the global trend. As per the Census of India, the population in urban areas has increased from 286.1 million in 2001 to 377.1 million in 2011 (projected 483 million, in 2022).

Urbanization is one of the leading global demographic trends with a significant impact on the health and well-being of the population. As per World Health Organisation (WHO), more than 55% of the world’s population lives in urban areas, which is likely to increase to 68% by 2050. This scenario puts great demand on governments across the globe to address the varied vulnerabilities and issues affecting the health issues and health outcomes of urban populations. As most of the urban population growth will occur in developing countries, their governments have a unique opportunity to plan and guide urban development in a way that favourably affects the health and well-being of the urban population.  

India too is urbanizing rapidly, in alignment with the global trend. As per the Census of India, the population in urban areas has increased from 286.1 million in 2001 to 377.1 million in 2011 (projected 483 million, in 2022). The urban population constitutes 31% of the total population in India and is expected to increase to more than 550 million by 2030. 

The unprecedented growth of this scale comes with issues such as disparities, inadequate urban housing and infrastructure, overcrowding, insufficient urban amenities, etc. An increasing number of communicable and non-communicable diseases, malnutrition among children, insufficient water and sanitation facilities, etc., affect the health status of the urban population. According to the National Family Health Survey (NFHS 5), 18.5 percent of the urban population does not have access to an improved sanitation facility, and 1.4 percent do not have access to an improved drinking water source. 

The private sector undoubtedly makes significant contributions to fill the existing gaps in healthcare service provision; however, several issues plague the efficiency, equity and quality of their services.

Urban Health: Existing Policies and Programmes in India

India’s focus on the comprehensive development of the urban health system is a recent phenomenon. The Tenth Plan observed that “Unlike the rural health services, there have been no efforts to provide well-planned and organized primary, secondary and tertiary care services in geographically delineated urban areas. As a result, in many areas, primary health facilities are not available; some of the existing institutions are underutilized, while there is overcrowding in most of the secondary and tertiary centres”. Responding to this reality, the National Urban Health Mission (NUHM) was launched in 2013 under the overarching umbrella of the National Health Mission (NHM).

The launch of NUHM was a decisive step taken by the Government of India, acknowledging the heterogeneous nature of communities in urban areas, which resulted in unique vulnerabilities and requirements and initiated systematic development of urban health systems across the country. NUHM provides a comprehensive framework for setting up urban health systems in different contexts and defines institutional mechanisms at the national, state, and district levels for implementation.

Under the National Urban Health Mission, every municipal corporation and town panchayat becomes a unit of health planning. The Mission provides flexibility to states/UTs to choose the model which suits the needs and capacities of states to best address the healthcare needs of the urban population, especially the urban poor. The broad framework of programme implementation proposes rationalizing the available human resources, improving access through communitised risk pooling mechanisms, and enhancing participation of community in planning and management of the health care service delivery by ensuring a community link volunteer such as ASHA (Accredited Social Health Activist) or Link Worker from other programs like ICDS, etc.

Empowerment of the community through awareness generation, whereby they can demand services from the Health System, is also an important area of emphasis under the NUHM. Urban health systems have an edge over their rural counterparts in the availability of human resources for health, as the urban density of doctors is nearly four times that in rural areas and three times higher in the case of nurses. However, the outcome of NUHM has not been uniform across urban areas in the country. 

Although, the out-of-pocket expenditure (OOPE) as a percent of Total Health Expenditure has reduced from 64.2% in 2013-14 to 48.2% in 2018-19,  the average OOPE in government hospitals in urban areas is Rs. 326, while it is Rs. 1082 in private facilities. There also exist wide variations in OOPE across states in the country. The Government of India is implementing programmes such as the Free Drugs and Diagnostics initiative, PM-National Dialysis programme, etc., in rural and urban areas with the aim to reduce OOPE endured by families; However, It is imperative also to understand the context-specific direct and indirect costs which people in urban areas might have to spend like transportation to the health facility, loss of wages, etc., to understand the true extent of the financial burden endured while accessing healthcare services. 

The role of private healthcare providers in provisioning healthcare services in urban areas is another critical aspect which requires more focus. The private sector healthcare providers in urban areas consist of individual practitioners or small nursing homes that provide services focusing on curative care, in addition to medium-sized hospitals and large hospital chains targeting tertiary care. The private sector undoubtedly makes significant contributions to fill the existing gaps in healthcare service provision; however, several issues plague the efficiency, equity and quality of their services.

These include distributional inequalities of private providers in urban areas, a lack of uniform standards and protocols to which the private practitioners may adhere to, a need for quality assurance and cost control mechanisms for private providers, lack of implementation of the Clinical Establishment Act (CEA) in some states, leading to a regulatory vacuum, etc.

Although the 74^th Amendment of the Constitution places the healthcare system under local governance, its role in delivering healthcare in many states is almost negligible. In states like Kerala, decentralization under NUHM has resulted in the devolution of functions, funds, and functionaries to the ward level; some states in India have not reached this stage. Research shows that the weak capacity of ULBs is one of the major reasons for their sub-optimal involvement in planning and implementing health policies and programs.

It is in this context that the Government of India launched the Ayushman Bharat – Health and Wellness Centres (HWCs) in 2018, marking the shift of focus from selective to comprehensive primary healthcare. Under this program, the Government of India targets the conversion of 1.5 lakhs SHCs, PHCs, and UPHCs into Health and Wellness Centres by December 2022. Funds for converting UPHCs into UPHC-HWCs are also provided under recently launched schemes like Ayushman Bharat – Prime Minister’s Health Infrastructure Mission (PM-ABHIM) and the 15^th Finance Commission earmarked grants for local bodies. 

Universal Comprehensive Primary Health Care is planned to be provided through these Urban Health and Wellness Centres (Urban HWCs) and Polyclinics, in addition to dedicated funds for diagnostics in close collaboration with Urban Local Bodies. Another critical intervention is establishing cost-effective laboratory systems at the district level that provide rapid, reliable, and accurate test results, with defined upwards and downwards linkages.

These facilities will enable decentralized delivery of health care services closer to people, thereby increasing the reach of the public health system to the vulnerable and marginalized in urban areas. The Government of India is building the capacity of rural and urban local bodies to plan and implement the urban components envisaged under PM-ABHIM and the 15^th Finance Commission grants. This can bring revolutionary improvements in the governance of urban and rural health systems. 

A ‘one size fits all’ approach will not work for urban areas, as the requirements of residents residing in the same slum area may vary as they migrate to slums from different contexts and cultures.

Way Forward: 

Moving forward, the most crucial strategy to improve health outcomes in urban areas is understanding the dynamic and complex nature of health vulnerabilities experienced by the urban population. A ‘one size fits all’ approach will not work for urban areas, as the requirements of residents residing in the same slum area may vary as they migrate to slums from different contexts and cultures. In order to respond suitably and adequately to improve health outcomes, there is a need for a granular understanding of the vulnerable groups and the nature of their vulnerability. This strategy will pay huge dividends in improving the health of urban communities and will improve social inclusion. 

Strengthening communities’ involvement in the governance of urban health systems also requires enhanced focus. Community platforms like Mahila Arogya Samitis (MAS) in urban areas bring community members into the governance process through their participation in regular monitoring of health care services. This empowers communities to take ownership and hold the health system accountable for their needs. 

Strengthening convergence and collaboration between different departments in urban areas is another aspect that needs improvement. Implementation of vertical programs without integration into the existing health system results in duplication of efforts and resources and poses a sustainability issue. 

The ‘Framework of Implementation for NUHM’ emphasizes that the focus of the Mission is on the urban poor, which includes residents of listed and unlisted slums and vulnerable populations such as the homeless, rag-pickers, street children, rickshaw pullers, construction and brick and lime kiln workers, sex workers, and other temporary migrants. However, considering the efforts made by the government to ensure quality, affordability and availability of healthcare services in urban areas, it is time to move from the current targeted approach to a holistic approach. Additionally, following a targeted approach in the provision of services is not easy, given the dynamic and temporary nature of populations in urban areas.

With the exponential growth of the urban population, it is only rational to anticipate a parallel increase in the urban poor population in the coming years. The above mentioned approaches are not exhaustive; however, these could be used as a starting point in devising strategies. Effective knowledge-based health planning, implementation, monitoring, evaluation, and health governance are required at all levels to ensure equitable access, affordability, and quality of services provided at urban health facilities and to ensure equitable health outcomes in the dynamic and complex urban populations. 

The post Urban Health in India: Present and Future appeared first on InnoHEALTH magazine.