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Sectoral Workshops - Health & Nutrition


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PROCEEDINGS

Objective of the Workshop

The objective of the Sectoral Workshop was to bring together various representatives from the field of Health & Nutrition and have them deliberate on the key sectoral challenges, the possible solutions and what could be the key sectoral Vision for 2025.  

Time & Date         :   10:30 – 16:35 Hours, 28nd September, 2017
Venue                   :   JW Marriot, Bangalore
Mode of Meeting :   Focused
Anchored By       :   Karuna Trust

KEY HIGHLIGHTS

The vision for 2025 should be accessible and affordable health services irrespective of the place of choice of the citizen by 2025.

Role of Private sector:
Vision: There is need for trustful and transparent relationship (mistrust) between doctor and patient, regulation in both private and public sectors and come out with integrated management information system through CSR

  • How can the private sector play a crucial role with the government in ensuring better health delivery services?
  • Public Private Partnership convergence where the public and private sectors converge in all aspects of health service delivery
  • Primary health care services have been the main focus of the government, while secondary and tertiary care have been a big concern;
  • Collaborate with private sector in facilitating the government schemes and providing secondary and tertiary services in hard-to-reach areas across the state
  • PPP models need to be strengthened and bring in quality standards
  • Specialist care provision from private sector in order to reduce the Out-Of-Pocket (OOP) expenditure
  • Assist the government in a sustainable reliable costing policy
  • Accreditation of the private sector  
  • Leveraging the services of the private sector

Health Technology:
Vision: Every patient who accesses any health delivery service needs to have a record, which should be accessible to all

  • Innovations and appropriate use of technology so that it supports   PHC
  • Creating an enabling environment via appropriate technology
  • Integration of technology to have a comprehensive approach
  • Use of technology for shortage of human resources not only in treatment aspect but training as well
  • Need for a benchmark for efficiency of equipment
  • Why not use technology as an enabler to identify visible and invisible hotspots of diseases (GPS mapping)
  • Effective use of data mining in decision making
  • Use of technology to identify or early diagnosis of diseases
  • Data analytics: Vertical set of data being used for actionable work
  • Use of technology for diagnostic tools at grassroot level: At every facility from grassroot level health technology should help with available and affordable diagnostic services
  • Creating a State Health portal which is dynamic and accurate and available on public domain linked to national health portal related to the health programme that includes multi sectoral data 

Role of AYUSH:
Vision: Role of AYUSH needs to be given a serious thought at intervention level with a holistic approach for all health conditions

  • Policy documents need to mention role of AYUSH where there is a clear definition of AYUSH practitioner in the health system and to be recognised as part of the system
  • Health centres should be holistic centres incorporating AYUSH interventions when needed
  • Making AYUSH an evidence based science
  • State should establish a unified health system with AYUSH and FM Directorate where swasthya is the main focus
  • Need to rethink the role of traditional healers in revitalization of Local Health Traditions

Human Resources:
Vision: Less than 10% vacancy in all levels of health system

  • There is a need to look at the doctor-patient ratio
  • Workforce needs to be motivated constantly: Enabling environment should be provided to all health worker to help them perform better
  •  Improving quality of infrastructure, basic services and security for the staff and  not just filling in vacancies
  • Need to decrease the workload of overburdened health workers
  • The Male Health Worker has become an endangered species, need for training institutes?
  • The issue of Maldistribution needs to be addressed where local recruitment is done (Selection of the health staff needs to be more local)
  • Need to create a national level human resource cell or human resource directorate  

Governance:  
Vision: Share of public expenditure on private sector should come down to 50% from current 70% i.e., 10% expenditure of any Household should be reduced to 2% on healthcare (total health expenditure)

  • Set up performance targets where citizen engagement is seen
  • Grievance redressal needs to be set up
  • Accreditation of all facilities
  • Biometric presence at the facilities with access to data by all
  • Need to create Public State Health accounts
  • Public display of budget monitoring that integrates into a single health account port available in public domain

Healthcare delivery:

  • The need to change and improve the perception of the public health sector
  • Households to be recognized as places of health delivery for promotive, preventive care where home is recognized as part of the 4th tier health system
  • Continuous capacity building: Training of workforce that is continuous with the goal of providing best knowledge and practice

Nutrition:
Vision: Under nutrition and specific micro nutrient deficiencies of U5 should reduce it to national nutrition target

  • Need to look at proper indicators (Stunting and wasting than underweight)
  • Health programmes need to revise their focus where nutrition should be across the lifespan and not just U5 especially in vulnerable age groups  (geriatric, adolescent, pregnant anemic)
  • Need to improve the nutrition status of all pregnant women, peri-conceptually
  • There needs to be a linkage between the current schemes provided  and nutritional intake
  • A strong need to  prioritize neglected public health issues like elderly, oral, mental health and RTA
  • Incentives need to be provided for workers (for example, as the tendency is to not record children who are very sick as it reflects badly on her work; incentives is the key)

Others:
Vision: How can we make our government services better?

  • One of the ways forward is receiving accreditation for all our government health facilities.

 

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