Punjab Archives - InnoHEALTH magazine

Specific health situation of Indian states

InnoHEALTH Magazine — Thu, 03 May 2018 09:14:37 +0000

Importance of understanding the specific health situation of each state

Understanding the health and disease trends in groups of states at a similar level of development or epidemiological transition is an important intermediate step in teasing apart the heterogeneity of disease and risk factor epidemiology in India. However, effective action to improve health must finally be based on the specific health situation of each state. This point is elucidated by significant variations in the burden from leading diseases and risk factors in 2016 between the following pairs of states that have physical proximity and are at similar levels of development and epidemiological transition.

The major EAG states of Madhya Pradesh and Uttar Pradesh both have a relatively lower level of development indicators and are at a similar less advanced epidemiological transition stage. However, Uttar Pradesh had 50% higher disease burden per person from chronic obstructive pulmonary disease, 54% higher burden from tuberculosis, and 30% higher burden from diarrheal diseases, whereas Madhya Pradesh had 76% higher disease burden per person from stroke.

The cardiovascular risks were generally higher in Madhya Pradesh, and the unsafe water and sanitation risk was relatively higher in Uttar Pradesh. The two North-East India states of Manipur and Tripura are both at a lower-middle stage of epidemiological transition but have quite different disease burden rates from specific leading diseases.

Tripura had 49% higher per person burden from ischaemic heart disease, 52% higher from stroke, 64% higher from chronic obstructive pulmonary disease, 159% higher from iron-deficiency anaemia, 59% higher from lower respiratory infections, and 56% higher from neonatal disorders.

Manipur, on the other hand, had 88% higher per person burden from tuberculosis and 38% higher from road injuries. Regarding the level of risks, child and maternal malnutrition, air pollution, and several of the cardiovascular risks were higher in Tripura.

The two adjoining north Indian states of Himachal Pradesh and Punjab both have a relatively higher level of development indicators and are at a similar more advanced epidemiological transition stage. However, there were striking differences between them in the level of burden from specific leading diseases.

Punjab had 157% higher per person burden from diabetes, 134% higher burden from ischaemic heart disease, 49% higher burden from stroke, and 56% higher burden from road injuries.

On the other hand, Himachal Pradesh had 63% higher per person burden from chronic obstructive pulmonary disease. Consistent with these findings, Punjab had substantially higher levels of cardiovascular risks than Himachal Pradesh.

The Executive summary says these examples highlight why it is necessary to understand the specific disease burden trends in each state, over and above the useful broad insights provided by trends common for groups of states at similar levels of epidemiological transition, if health action has to be planned for the specific context of each state.

The chances of achieving the overall health targets set by India would be much higher if the biggest health problems and risks in each state are tackled on priority than with a more generic approach that does not take into account the specific disease burden trends in each state.

Application of the state-level disease burden findings and future work. The findings in this report of the India State-level Disease Burden Initiative can be used for planning of state health budgets, prioritisation of interventions relevant to each state, informing the government’s Health Assurance Mission in each state, monitoring of health-related Sustainable Development Goals targets in each state, assessing impact of large-scale interventions based on time trends of disease burden, and forecasting population health under various scenarios in each state.

Future plans of the India State-level Disease Burden Initiative include annual updates of the estimates based on newly available data, and more disaggregated findings such as the rural-urban estimates planned for next year and sub-state level estimates subsequently when adequate data become available.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post Specific health situation of Indian states appeared first on InnoHEALTH magazine.

Lifestyle diseases: A threat to backward states

InnoHEALTH Magazine — Wed, 02 May 2018 08:13:02 +0000

Lifestyle diseases like chronic respiratory and heart diseases are killing more people in India than communicable ailments like Tuberculosis (TB) or Diarrhea in every states, including most backward belts, says the India State-Level Disease Burden Initiative’s Report.

Among the leading non-communicable diseases, the largest disease burden or Disability-Adjusted Life Year (DALY) rate increase from the period of 1990 to 2016 was observed for diabetes at 80 per cent, and ischaemic heart disease at 34 per cent.

In 2016, three of the five leading individual causes of disease burden in India were non-communicable, with ischaemic heart disease and chronic obstructive pulmonary disease as the top two causes and stroke as the fifth leading cause. The range of disease burden or DALY rate among the states in 2016 was nine-fold for ischaemic heart disease, four-fold for chronic obstructive pulmonary disease, and six-fold for stroke, and fourfold for diabetes across the country.

The key metric used in the study is DALYs, which is the sum of the number of years of life lost due to premature death and a weighted measure of the years lived with disability due to a disease or injury. The use of DALYs to track disease burden is recommended by India’s National Health Policy of 2017.

While ischaemic heart disease and diabetes generally had higher DALY rates in states that are at a more advanced epidemiological transition stage toward non-communicable diseases, the DALY rates of chronic obstructive pulmonary disease were generally higher in the Empowered Action Group (EAG) states that are at a relatively less advanced epidemiological transition stage.

[vc_single_image image=”3888″ img_size=”500×300″ alignment=”center” onclick=”link_image”]

[vc_single_image image=”3889″ img_size=”500×300″ alignment=”center” onclick=”link_image”]

The report shows that communicable diseases constitute almost two-thirds of the disease burden in India from a little over a third in 1990. Despite the transition, which is associated with development, malnutrition remains the single top risk for health loss.

All states have thus made what’s called the ‘epidemiological transition’ there remain wide variations in their disease profiles with some having made that transition as early as 1986, and others as recently as 2010.

The first group to make the transition in 1986 included Kerala, Tamil Nadu, Goa, Himachal Pradesh and Punjab. The last group to do so, accounting for the highest number of people (588 million), made the transition almost a quarter of a century later, in 2010. This group included Bihar, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Jharkhand, Rajasthan and Odisha. India as a country made the transition in 2003.

The Report’s executive summary says with almost one-fifth of the world’s population living in India, the health status and the drivers of health loss are expected to vary between different parts of the country and between the states.

Accordingly, effective efforts to improve population health in each state require systematic knowledge of the local health status and trends. While state-level trends for some important health indicators have been available in India, a comprehensive assessment of the diseases causing the most premature deaths and disability in each state, the risk factors responsible for this burden, and their time trends have not been available in a single standardised framework.

The Report finds that the Health status improving, but major inequalities between states Life expectancy at birth improved in India from 59.7 years in 1990 to 70.3 years in 2016 for females, and from 58.3 years to 66.9 years for males.

There were, however, continuing inequalities between states, with a range of 66.8 years in Uttar Pradesh to 78.7 years in Kerala for females, and from 63.6 years in Assam to 73.8 years in Kerala for males in 2016.

The per person disease burden measured as DALYs rate dropped by 36% from 1990 to 2016 in India, after adjusting for the changes in the population age structure during this period. But there was an almost two-fold difference in this disease burden rate between the states in 2016, with Assam, Uttar Pradesh, and Chhattisgarh having the highest rates, and Kerala and Goa the lowest rates.

While the disease burden rate in India has improved since 1990, it was 72% higher per person than in Sri Lanka or China in 2016. The under-5 mortality rate has reduced substantially from 1990 in all states, but there was a four-fold difference in this rate between the highest in Assam and Uttar Pradesh as compared with the lowest in Kerala in 2016, highlighting the vast health inequalities between the states.

Large differences between states in the changing disease profile of the total disease burden in India measured as DALYs, 61% was due to communicable, maternal, neonatal, and nutritional diseases (termed infectious and associated diseases in this summary for simplicity) in 1990, which dropped to 33% in 2016. There was a corresponding increase in the contribution of non-communicable diseases from 30% of the total disease burden in 1990 to 55% in 2016, and of injuries 18 %.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post Lifestyle diseases: A threat to backward states appeared first on InnoHEALTH magazine.

Digital India Healthy India

InnoHEALTH Magazine — Fri, 27 Apr 2018 06:34:46 +0000

New India, Digital India, Make India, Innovate India in making a ‘Healthy’ India

[vc_single_image image=”3771″ img_size=”500×300″ alignment=”center” style=”vc_box_shadow_border” onclick=”link_image”]

India is a country of diversity with 1.3 billion population of which 70 per cent resides in villages and have access to 30 per cent of medical assets of the country. Poverty is a significant issue of the country, despite having one of the fastest-growing economies in the world, clocked at an economic growth of 7.6 per cent in 2015. It is estimated that 23.6 per cent of Indian population, or about 276 million people, live below $1.25 per day.

As Health is a state subject-there is lot of mismatch in states like Kerala and Punjab have best health indicators, while Uttar Pradesh is the poorest as per the NITI Aayog report. Indian government spends approx. 1.5 per cent of its GDP on health sector and mplans to make it 2.5 per cent which is much less than many developing countries while the USA has dedicated 16 per cent of its GDP. India is riddled with very basic public health issues leading to disease burden. Keeping this in mind, Prime Minister Narendra Modi has launched six initiatives: Open Defecation free country by 2019, Swachh Bharat Mission, National Health Policy 2017, Digital India with e-health, medical device manufacturing and door-to-door screening of chronic diseases.

[vc_single_image image=”3774″ img_size=”500×300″ alignment=”center” style=”vc_box_shadow_border” onclick=”link_image”]

The healthcare needs holistic approach which depends on multiple factors. The present government has taken many positive steps including launching of National Health Policy 2017 after the gap of 12 years. It has announced many initiatives like health insurance of people who cannot afford basic healthcare and upgrading of health infrastructure.

The regulation of medical devices have been brought out and is applicable w.e.f January 1, 2018 ending uncertainty of medical device manufacturers having global market of 220 billion US dollar. Challenges bring opportunities such as Indian healthcare market is around US$ 100 billion while it is expected to grow US$ 280 billion by 2020. The healthcare IT market is US$ one billion and is expected to grow 1.5 times by 2020. There is requirement of 7 lakh hospital beds which need investment opportunities of 25-30 billion US dollar. We need to bring innovations in hospital planning,devices, diagnostics, drugs and use of technology to reduce healthcare delivery cost and yet quality.

[vc_single_image image=”3779″ img_size=”500×300″ alignment=”center” style=”vc_box_shadow_border” onclick=”link_image”]

We failed targets of Health for All by 2000, National Rural Health Mission, and Millennium Development Goals and now launched Universal Health Coverage; its success would depend on providing healthcare facilities and strict accountability. We need to focus on primary health care and customise our healthcare delivery system by learning from experiences of other countries.

The concept of Diagnosis Related Group (DRG) making financial package for group of diseases which is known to patients, providers and third party payors should be considered by improving deficiency found in its execution by the USA.

The various schemes of present government are appreciable but success would depend on strict monitoring, corporate hospitals have high cost and many unethical practices are reported every day in media. Public hospitals to National Rural Health Mission have not delivered as required because of corruption, lack of resources and application of management practices. The need is not old wine in new bottle but strict control in implementation of various schemes launched.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 4 (October to December 2017) – http://amzn.to/2B2UMLw
InnoHEALTH Volume 3 Issue 1 (January to March 2018) – https://goo.gl/fksdQx
InnoHEALTH Volume 3 Issue 2 (April to June 2018) – https://goo.gl/grbtRo

Connect with InnovatioCuris on:
Facebook: https://www.facebook.com/innovatiocuris
Twitter: https://twitter.com/innovatiocuris
LinkedIn: https://www.linkedin.com/groups/7043791
Stay updated about IC, visit: www.innovatiocuris.com

The post Digital India Healthy India appeared first on InnoHEALTH magazine.

Smartcity development are heat islands

InnoHEALTH Magazine — Fri, 23 Mar 2018 06:02:34 +0000

The phenomenon of urban heat islands, in which concrete and built areas experience higher temperatures than surrounding rural areas, may get accentuated with rapid urbanization. This is the conclusion of a new study of urban areas selected for development of smart cities. The study, which covered 89 of 100 areas selected for development of smart cities, has found that agriculture and irrigation are two dominant drivers of urban heat islands or UHI in India. In addition, significant presence of atmospheric aerosols – mainly pollutants – over urban areas can influence UHI.

Moisture from irrigation canals and agriculture fields play a key role in keeping rural areas surrounding cities much cooler that urban areas, resulting cities becoming heat islands. In a heat island, temperature could be 1 to 6 degrees higher than surrounding areas. Remote sensing data and climate modelling were used to evaluate UHI across the country.

When the surrounding of non-urban areas have no agriculture during summer, cities are relatively cooler during daytime. However, if the non-urban areas are under irrigated agriculture, cities are warmer than surroundings. This means UHI effect during day time is mainly driven by agriculture and irrigation. However, in the night-time, cities are significantly warmer than surroundings in both winter and summer seasons. Night time urban heat is mainly driven by the amount of heat stored in buildings and other impervious surfaces.

Urban areas located in highly irrigated regions – Indo-Gangetic Plain and north-west India (Haryana and Punjab) – show UHI intensity of 3 to 5 degrees. During summer season (April and May), when air temperature is at the peak, land surface temperature becomes is higher than that of the post monsoon season in absence of agricultural operations. Moreover, amount of moisture and vegetation in non-urban areas are also limited as crops are largely harvested by the end of March and soil moisture is depleted due to high atmospheric water demands, the study said.

“While urban areas have experienced increased number of heat waves and temperature extremes in recent past, urban heat island effect driven by rapid urbanization can further worsen extreme hot conditions in cities,” pointed out Dr Vimal Mishra, a scientist at the Water and Climate Lab of Indian Institute of Technology, Gandhinagar, which did the study. The results of the study appeared in journal Scientific Reports on Wednesday.

The development of smart cities will result in rapid growth in urban infrastructure and population, leading to increases in UHI intensity. “Our results can provide policy insights for development of smart cities,” Dr Mishra said. “Considering night-time heating which could be significant during heat waves, measures such as passive cooling should be used. Building materials that absorb less heat and are sustainable can reduce the amount of heating caused by stored heat.” The presence of water bodies and vegetation in cities can also help reduce additional nighttime heating in urban heat islands.

The study team included Rahul Kumar and Vimmal Mishra (IIT Gandhinagar); Jonathan Buzan and Matthew Huber (Purdue University, USA); Rohini Kumar (UFZ-Helmholtz Centre for Environmental Research, Leipzig, Germany); and Drew Shindel (Duke University, USA).

(Article shared from India Science Wire)

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post Smartcity development are heat islands appeared first on InnoHEALTH magazine.