30 Jan 2012

Lured by higher salary, nurses make a beeline for govt hospitals in MP

Article contributed by Mr. Kounteya Sinha, Health Editor, Times of India

MANDLA (JABALPUR): More often than not, you've heard of government nurses making a beeline for private hospitals.

But in a reverse brain drain, 30 nurses from private hospitals in Madhya Pradesh quit last year to work in government-run sick and newborn care units (SNCUs) in Shivpuri, Burhanpur and Khandwa.

More applications are piling up in the state health department from private nurses wanting to work in the public sector in MP.

The catch: the state raised salaries of nurses from Rs 10,000 in 2010 to Rs 15,000 in 2011. It has proposed to increase their salary to Rs 20,000 from April 1. "Around 12 nurses from a private hospital in Indore joined the SNCU in Burhanpur, eight in Khandwa and 10 in Shivpuri. Nurses from private hospitals in Jaipur are applying to work in the SNCUs here," said a state health department official.

Catch-up Newsletter- An Update of the India's Immunization Programme (Jan 2012)

Catch-UpNewsletter Jan2012 (1)

Why is equity in health care crucial for the well being of children?

Health care is crucial for the well-being of children and women. But just how important is equity when it comes to the subject of health for all? Our Debate brings together Dr Cesar Victora, President of the International Epidemiological Association, Dr Janet Vega, the Director of the Centre for Epidemiology and Public Health policy in Chile, and Dr Mickey Chopra, UNICEF's Chief of Health to tackle this issue and elaborate on why equity and health care must go hand in hand.

Uploaded by on Jan ,2012 .

Equity, Human Rights, and Health: Here, There and Back Again

Source:UNICEF Innocenti Research Centre
Prof. Sofia Gruskin, Director of Program on Global Health and Human Rights at the USC Institute for Global Health

The Countdown to 2015 for Maternal, Newborn and Child Survival monitors coverage of priority interventions to achieve the child mortality and maternal health Millennium Development Goals (MDGs). A June 2010 Lancet article summarizing the report offered welcome news to those of us concerned with the rights and health of children. It noted the need to go beyond the MDGs to truly impact newborn, child and maternal survival, and emphasized work underway to develop measures that "include elements that are indicative of social determinants of health" (pg 2036). It is promising to see the donor community beginning to reengage with concepts related to equity and rights. It remains unclear, however, if relevant measures can actually be married to the MDGs, and alongside this whether current discussion of these measures in political for a are actually going to take us where we need to go in terms of public health policy, research and practice - or at least any time soon.

Despite their importance on the global stage and their good intentions, the recent spate of political declarations with a focus on health do not offer any conceptual, let alone procedural, clarity as to how relevant measures will be developed or used. The Rio Political Declaration on Social Determinants of Health, for example, brought together heads of government, ministers, government representatives, UN officials, and civil society representatives (though civil society was not part of the negotiations) in October of this year to move forward concerns with health equity through action on the social determinants of health. Interestingly, the Rio Declaration pays formal tribute to the Millennium Declaration, but refers only obliquely to the MDGs.

Its focus is achieving health and social equity, and it brings explicit attention to the relevance of human rights principles to achieving its goals. It accompanies this with a detailed call for the development and implementation of reliable measures of societal well-being, but with no explicit time frame attached. The Rio Declaration came on the heels of the September Political Declaration on the Prevention and Control of Non-communicable Diseases (the NCD Declaration), which included 34 heads of state in the negotiations. The NCD Declaration names the human right to health as relevant to the prevention and control of non-communicable disease, references a range of global and regional strategies and declarations, and also does not put the MDGs front and center. It notes, instead, on two occasions “internationally agreed development goals, including the Millennium Development Goals.” [emphasis added para 31 and 65].

The NCD Declaration also includes a call for a comprehensive global monitoring framework and for a set of indicators capable of application across regional and country settings to be completed before the end of 2012, but explicit attention to health inequities was sufficiently vague that it was good to see the Rio Declaration specifically noting the need to ensure a focus on reducing health inequities in taking it forward. Alongside their implicit sidelining of the MDGs, and their explicit language around the need for monitoring, accountability and follow-up, it is of concern, therefore, that these new equity and rights-oriented declarations, even as they do not have Programmes of Action attached, do not find any well-defined equity sensitive measures to propose or support.

Why does this matter? It is worth recalling that the Millennium Declaration included strong attention to human rights but by the time the MDGs had been drafted this had all disappeared. The lack of attention to explicit measures is not a picayune issue. The international community has long recognized that to achieve meaningful progress, rhetorical commitment is not enough. Concrete measures and accountability mechanisms at global and national levels are required. The exclusion of relevant concepts and language in these documents are the result of active political negotiation. Every word of what is, and is not, in these documents matters because what is named is what, if all goes according to plan, is measured. What matters most, in other words, is what is counted not, unfortunately, what is said.

To be fair, determining appropriate measures sensitive to equity and human rights concerns, and with global application, is not an easy task. Even as all agree on general principles, the devil is of course in the details. All too often what has been counted falls back into a traditional paradigm of economic inequity – measuring poorest and richest quintiles – not for lack of interest but for lack of agreement on an appropriate measure, let alone what priority measures should be. While we all recognize the need to go further, tested and validated measures bringing attention to geographic, ethnic, age and gender disparities are few, let alone those which truly measure inequities and inequalities in health and the related availability, accessibility, acceptability and quality of services as mandated under the right to health. But this must be the goal, with important implications for the health and well-being of children.

Building off these recent political commitments, it is incumbent on us all to bring to light relevant measures and data sources, ensure sufficient funding for the development of robust measures where they do not yet exist, and do all we can to ensure that equity and rights measures are fully integrated into global accountability frameworks going forward. This will require political support and international cooperation to allow us to develop the necessary research, and eventually policy and programmatic interventions. This, in turn, will give a firm basis for work to ensure that poor, marginalized, and vulnerable groups are given access to the health and other services to which they are entitled and, ultimately, achieve better health.

(i) Bhutta et al., Countdown to 2015 decade report (2000-2010): taking stock of maternal, newborn and child survival, The Lancet, Vol 375, 2032-2044, June 5, 2010

22 Jan 2012

Media Visit to District Mandla (19 -20 Jan),Madhya Pradesh under IGNOU-UNICEF Partnership on Routine Immunisation

A group of 4 National Media from TOI, Amar Ujala, Prabhat Khabar and Bag Radio recently visited Mandla Tribal District in MP on 19-20 January under the IGNOU-UNICEF Partnership on Routine Immunization. The media persons visited the SCNU, the Malnutrition treatment center and interacted with AWW on Routine  Immunization.
                                      Anil Gulati/UNICEF India/2012

From Left to Right : Mr. Nitin Kumar, Senior Editor,Amar Ujala with Mr. Santosh Singh, Senior Correspondent, Prabhat Khabar and Mr. Kounteya Sinha, Senior Editor (Health) ,Times of India visited village in Mandla District, Madhya Pradesh under the IGNOU-UNICEF Partnership on Routine Immunization.


20 Jan 2012

"2012: Year of Intensification of Routine Immunization”

Source: Press Information Bureau , Government of India .
Dated: 16 January,2012

Total Drug Resistant TB : An Insight

Contributed By:  Mr.Santosh Kumar Singh, Senior Correspondent, Prabhat Khabar

13 Jan 2012

Polio Free India

Contributed by : Mr.Santosh Kumar Singh, Senior Correspondent, Prabhat Khabar

10 Jan 2012

5 Jan 2012

Nitish Kumar being considered for Gates Vaccine Innovation Award

Source: The Economic Times, 3 Jan 2012

PATNA: The Bill Gates and Melinda Foundation has accepted the proposal for conferring the Gates Innovation Award to Bihar Chief Minister Nitish Kumar for the first Gates Vaccine Innovation Award.
The proposal came in the wake of Bihar's remarkable contribution for effectively stregthening the immunisation programme, Executive Director State Health Society Sanjay Kumar told PTI today.
Chief Minister Nitish Kumar had conceded to the request, Kumar said.
The Union External Affairs ministry too has given the nod for Kumar to receive the award, he said.
The Bihar Chief Minister will thus be the first recipient of the Vaccine Innovation Award, introduced globally by the Foundation having carried a cash of US $ 250,000.
The Gate's foundation leadership has on their part acknowledged the winner of the award, Kumar said.
The Foundation had taken the decision last year to bestow the award on an individual/a team having made the most innovative contribution in vaccination field.
The Foundation was of the view that hundreds and thousands of lives could have been saved by improved access to vaccines, which should be cost-effective, safe and proven to protect children from diseases.
Innovation is essential in overcoming the most persistent challenges in reaching more and more children with vaccines, the Foundation felt.
The rise in routine immunisation played a major role in making Bihar a polio-free state in the country with not a single case of the dreaded disease reported in one year, 2011.

3 Jan 2012

नौनिहाल करेंगे टीबी को 'टाटा'

Article by : Mr.Raju Kumar
 राजु कुमार | Issue Dated: दिसंबर 9, 2011, मध्य प्रदेश
Source: The Sunday Indian, Bhopal
मध्य प्रदेश के आधे से ज्यादा यानी 52 लाख बच्चे कुपोषित हैं और लगभग 8.8 लाख बच्चे अतिगंभीर कुपोषण के शिकार. अतिगंभीर कुपोषित बच्चों में सामान्य बीमारियों के साथ-साथ टीबी होने की आशंका कई गुना ज्यादा होती है. समय से उचित इलाज की सुविधा न होना, जानलेवा साबित होती है. सरकार ने अब यह निर्णय लिया है कि पोषण पुनर्वास केंद्र में आने वाले सभी अतिगंभीर कुपोषित बच्चों की टीबी जांच कराई जाए. साथ ही साथ कांटेक्ट ट्रेसिंग के माध्यम से उन बच्चों की मां की भी टीबी की जांच हो. राज्य टीबी अधिकारी डॉ. बीएस ओहरी कहते हैं, 'टीबी का मुख्य कारण शरीर की रोग प्रतिरोधक क्षमता कम होना एवं टीबी के मरीज के संपर्क में आना है.'

देश की 40 फीसदी आबादी टीबी के जीवाणु से संक्रमित है. हर डेढ़ मिनट पर एक, और एक दिन में 1,232 लोगों की मौत टीबी से होती है. डॉ. ओहरी बताते हैं, 'देश को टीबी से मुक्त कराने के लिए पुनरीक्षित राष्ट्रीय टीबी नियंत्रण कार्यक्रम चलाया जा रहा है. इसके तहत 70 फीसदी नए मामलों को ढूंढऩे तथा 85 फीसदी क्योर रेट का लक्ष्य रखा गया है. हमारी कोशिश है कि संयुक्त राष्ट्र संघ द्वारा तय सहस्त्राब्दी विकास लक्ष्य यानी 2015 तक टीबी से होने वाली मौतों की संख्या आधी करने के लक्ष्य को हासिल कर लिया जाए.'

प्रदेश के सहरिया आदिम जनजाति बहुल श्योपुर और शिवपुरी में टीबी के मरीजों की संख्या बहुत ज्यादा है. श्योपुर के पोषण पुनर्वास केंद्र में कार्यरत फीडिंग डिमॉंस्ट्रेटर आरती पाठक कहती हैं, 'अप्रैल से अब तक यहां 300 बच्चे भर्ती हुए. पहले सभी बच्चों की टीबी स्क्रीनिंग नहीं की जाती थी,  उसके बावजूद 20 बच्चे टीबी से पीडि़त थे. अब जब सभी बच्चों की टीबी स्क्रीनिंग की जाएगी तो ऐसे और बच्चे मिलेंगे.' शिवपुरी पोषण पुनर्वास केंद्र पर तैनात फीडिंग डिमॉंस्ट्रेटर आरती तिवारी कहती हैं, 'पिछले तीन महीने में यहां 104 बच्चे भर्ती हुए थे और अधिकांश बच्चों में टीबी के लक्षण पाए गए थे.' मंदसौर जिले में सौ से ज्यादा स्लेट-पेंसिल कारखाने हैं. इस जिले में भी टीबी के मरीज बहुत ज्यादा हैं. मंदसौर के पोषण पुनर्वास केंद्र में तैनात फीडिंग डिमॉंस्ट्रेटर सविता मूंदड़ा कहती हैं, 'पिछले तीन महीने में यहां 66 बच्चे भर्ती हुए और लगभग सभी टीबी से ग्रस्त थे. उनकी मां की भी जांच की गई और वे सभी टीबी की मरीज निकलीं.'

सूबे में 256 पोषण पुनर्वास केंद्र संचालित हैं, जहां अतिगंभीर कुपोषित बच्चों को 14 दिन तक भर्ती कर इलाज किया जाता है. इन 256 केंद्रों पर साल में लगभग 70 हजार बच्चों को भर्ती कर इलाज किया जा सकता है. बच्चों को टीबी से बचाने के लिए किए जा रहे इस सराहनीय प्रयास में कई बड़ी चुनौतियां हैं, जिनके समाधान के बिना अभियान की सफलता मुश्किल है. सबसे बड़ी चुनौती है पोषण पुनर्वास केंद्र में टीबी के लिए चिह्नित बच्चे के परिवार की बजाए सिर्फ मां की टीबी की जांच, जबकि योजना में ऐसे बच्चे के पूरे परिवार एवं उसके लगातार संपर्क में रहने वाले लोगों की भी जांच की बात कही गई है. टीबी से ग्रस्त बच्चे पोषण पुनर्वास केंद्र में अन्य सामान्य बच्चों के साथ 14 दिन तक रहते हैं, इसलिए वहां अतिरिक्त सावधानी और टीबी ग्रस्त बच्चे के मुंह पर कपड़ा रखना अनिवार्य किए जाने की जरूरत है. जब 14 दिन बाद बच्चा घर जाता है तो उसे छह माह तक डॉट्स की दवाइयां नियमित दी जा रही हैं या नहीं, इसकी मॉनिटरिंग की जानी चाहिए, क्योंकि गरीब तबके से आने वाले परिवार रोजगार के लिए पलायन करते हैं. उनके पलायन से न केवल अन्य बच्चों में भी टीबी के जीवाणु फैल सकते हैं, बल्कि बच्चे की सामान्य टीबी भी खतरनाक मल्टी ड्रग रेसिस्टेंस में बदल सकती है. सबसे महत्वपूर्ण बात तो यह है कि पोषण पुनर्वास केंद्रों के माध्यम से 10 फीसदी से भी कम अतिगंभीर कुपोषित बच्चों की टीबी जांच संभव हो पाई है, बाकी 90 फीसदी अतिगंभीर कुपोषित बच्चों की टीबी की जांच के लिए वृहद योजना पर काम करने की जरूरत है