Scaling Up Primary Health Services in Rural Tamil Nadu: Public Investment Requirements and Health Sector Reform

We attempt to address two key questions in this paper: 1) In terms of state-wide scaling up of rural services in the area of primary health, what will it cost financially and in terms of human resources to scale-up these services in all the rural areas of the state? And 2) what policy, institutional and governance reforms may be necessary so as to ensure proper service delivery? As is well known, merely setting up more health clinics, for instance, is not going to be enough; higher public investments in these areas needs to be accompanied by systemic reforms that will help overhaul the present service delivery system, including issues of control and oversight, for example

Pervasiveness of metabolic syndrome and cardiovascular disease in tribal/rural population of India: a review

Diseases classified as non-communicable diseases (NCDs) are those that are often caused by unhealthy behaviors rather than by infection or by contact with others. One of the main NCDs causing many fatalities is cardiovascular disease (CVD). Recent research has shown that the prevalence of metabolic syndrome (Mets) associated CVDs among tribal populations is increasing in rapid pace. In this review, we have included studies investigating the components of Mets and the relationships between Mets and CVDs. From the assessment of studies, we may predict a significant association between Mets and CVDs as a whole. Our evaluation of these studies revealed that carrying at least three Mets risk components, like hyperglycemia, obesity, dyslipidemia, and high blood pressure, significantly enhances the risk of CVDs. Undernutrition, smoking, and a low intake of fruits and vegetables in the Indian tribal population are the main risk factors for managing Mets associated CVDs. Furthermore, various studies have also shown that Mets may be influenced by genetic and environmental factors. Finally, healthy habits such as a balanced diet and frequent exercise should be introduced from a young age in individuals, to prevent Mets progression. In order to combat the Mets associated CVDs, functionally upgraded primary health centers and special IECs (Information, education and communication) programs may play a beneficial role. Furthermore, strengthening public healthcare systems and focusing on prevention, early identification, and treatment using medical and social interventions can be of immense help in managing the metabolic risk factors that can lead to CVDs

Viksit Bharat Sankalp Yatra: The Health Perspective

In 2023, India became the most populated country in the world with a population of 1.42 billion, providing it potential for significant economic growth by leveraging the demographic dividend.(1,2) As India becomes the global super power that the nation has potential to be, it is imperative to prioritize the well-being of the citizens. The government, being the elected representative body of people, holds the responsibility for ensuring the welfare of the masses. The Government of India periodically introduces welfare programs to cater to a diverse spectrum of the population.(3) As per the 2022 Union Budget, there are 740 central sector schemes.(4) The effectiveness of any program lies in its ability to reach its eligible beneficiaries. Unfortunately, several welfare schemes provided by the government do not reach its eligible recipients due to lack of awareness.(5) An information drought occurs, especially in rural areas despite the government’s best efforts in creating awareness through radio, TV, print or online media.(6

Impact of Income Disparities on Healthcare Accessibility in Rural Assam: A Comprehensive Study of Major Health Challenges.

As nations around the world work toward having all-inclusive healthcare systems, it is now crucial to investigate how income inequality affects health outcomes. To clarify the mechanisms by which economic disparities contribute to unequal access, utilization, and health outcomes, this study examines the complex relationships between income inequality and healthcare. In this study, the complex dynamics underlying the relationship between income levels and health disparities are investigated through a review of literature. Understanding the importance of this relationship, the abstract makes the case that reducing income inequality is essential to attaining health equity and developing a strong, inclusive healthcare system. Assam is a North-Eastern state which lacks medical infrastructure and medical staff, which is a matter of concern. This paper will try to study the impact of income disparity on healthcare accessibility in Assam. This paper will be based on secondary sources of data and the nature of the research will be explanatory.&nbsp

Our climate, our children, our responsibility: The implications of climate change for the world’s children

This report aims to draw the attention of the international community to the specific risks faced by children in developing countries due to climate variability and extremes, thus making it harder to achieve the child – related MDGs. It analyses the impacts of climate change upon children, and their role in mitigation and adaptation strategies. The report argues that children need to be mainstreamed into larger debates on climate change, hazards and vulnerabilities

Declining Transmission of Malaria in India: Accelerating Towards Elimination

India is ecologically vast and has close to a billion-population living at risk of malaria. Given the evidence-based present-day intervention tools and large-scale implementation, India has recorded declining trends in disease transmission from 2 million cases in 2001 to close to a million cases in 2017 and embarked upon malaria elimination in keeping with the Global Technical Strategy by 2030. India is malaria endemic, but transmission intensities varied across its landscape with just few States of the east, central and northeast contributing bulk (80%) of total positive cases. Plasmodium falciparum and P. vivax are the predominant infections of which there has been steady increase in proportions of the former for constituting >60% of total cases what was 50:50 in 2001, a phenomenon attributed to emerging drug resistance. With the rolling out of the available intervention tools, malaria elimination is foreseeable yet there are multiple challenges which must be addressed to overcome the constraints. We strongly advocate continued disease surveillance and monitoring, universal coverage and intensification of core-interventions for prevention and treatment prioritizing high-risk States, strengthening cross-border collaborations for information sharing and coordinated activities, and above all sustained allocation of resources, creating the enabling environment to end malaria transmission

Advancing the Right to Health: The Vital Role of Law

Effective laws and an enabling legal environment are essential to a healthy society. Most public health challenges – from infectious and non-communicable diseases to injuries, from mental illness to universal health coverage – have a legal component. At global, national and local levels, law is a powerful tool for advancing the right to health. This tool is, however, often underutilized. This report aims to raise awareness about the role that public health laws can play in advancing the right to health and in creating the conditions for all people to live healthy lives. The report provides guidance about issues and requirements to be addressed during the process of developing or reforming public health laws, with case studies drawn from countries around the world to illustrate effective practices and critical features of effective public health legislation. Advancing the right to health: the vital role of law is the result of a collaboration between the World Health Organisation, the International Development Law Organisation (IDLO), the O’Neill Institute for National and Global Health Law, Washington D.C., USA, and Sydney Law School, University of Sydney. The Project Directors were: Professor Lawrence O. Gostin, Linda D. and Timothy J. O’Neill Professor of Global Health Law and University Professor, Georgetown University; Faculty Director, O’Neill Institute for National and Global Health Law, Georgetown University; Mr David Patterson, Senior Legal Expert – Health; Department of Research & Learning, International Development Law Organization; Professor Roger Magnusson, Professor of Health Law & Governance, Sydney Law School, University of Sydney; Mr Oscar Cabrera, Executive Director, O’Neill Institute for National and Global Health Law, Georgetown University Law Center; Ms Helena Nygren-Krug (2011–2013), Senior Advisor, Human Rights & Law, UNAIDS. The content and structure of the report reflect the consensus reached at the second of two international consultations in public health law that preceded the preparation of the report, hosted by WHO and IDLO in Cairo, Egypt, 26-28 April 2010. Part 1 introduces the human right to health and its role in guiding and evaluating law reform efforts, including efforts to achieve the goal of universal health coverage. Part 2 discusses the process of public health law reform. The law reform process refers to the practical steps involved in advancing the political goal of law reform, and the kinds of issues and obstacles that may be encountered along the way. Part 2 identifies some of the actors who may initiate or lead the public health law reform process, discusses principles of good governance during that process, and ways of building a consensus around the need for public health law reform. Part 3 turns from the process of reforming public health laws to the substance or content of those laws. It identifies a number of core areas of public health practice where regulation is essential in order to ensure that governments (at different levels) discharge their basic public health functions. Traditionally, these core areas of public health practice have included: the provision of clean water and sanitation, monitoring and surveillance of public health threats, the management of communicable diseases, and emergency powers. Building on these core public health functions, Part 3 goes on to consider a range of other public health priorities where law has a critical role to play. These priorities include tobacco control, access to essential medicines, the migration of health care workers, nutrition, maternal, reproductive and child health, and the role of law in advancing universal access to quality health services for all members of the population. The report includes many examples that illustrate the ways in which different countries have used law to protect the health of their populations in ways that are consistent with their human rights obligations. Countries vary widely in terms of their constitutional structure, size, history and political culture. For these reasons, the examples given are not intended to be prescriptive, but to provide useful comparisons for countries involved in the process of legislative review

Reaching the Millennium Development Goals in South Asia

The United Nations Millennium Development Goals (MDGs) set the stage for developing countries to reduce extreme poverty and the problems that accompany it, such as hunger, high rates of infant, child and maternal mortality, insufficient disease control, lack of education, illiteracy, gender disparity and environmental degradation. Each goal has a specific target level for progress, such as halving poverty or reducing infant mortality rates by two thirds. All goals are to be reached by 2015, using 1990 as the benchmark year. By setting a time frame and specific levels of reductions for a variety of indicators, progress towards the goals is measurable, if data on indicators is available. Tracking progress is an essential step towards meeting the goals, as problem areas can be identified only through monitoring and evaluation, and interventions and strategies can then be developed to target them. South Asia as a whole seems likely to halve poverty levels by 2015, due in large part to India's progress on this MDG indicator. However, the situation is not as promising in other areas, such as reduction of high rates of infant, under-five and maternal mortality. There are wide inter-country, inter-state and intra-state differences in levels of progress towards the goals throughout South Asia. In a country as large and as populous as India, tackling problems such as high maternal mortality rates at the state and even at the district levels could determine whether India as a whole achieves the MDGs. Over one billion of the roughly 1.37 billion residents of South Asia reside in India, which means that India's achievement of any of the goals brings South Asia as a whole a step closer towards regional goal attainment. For South Asia as whole and for India in particular, public spending must be increased in the areas of health, education, rural infrastructure and agricultural research and development. The Indian government under-invests in all of these areas. Not only must public spending be increased, but spending must be accompanied by reforms. Decentralization would lead to greater control and oversight, conditions necessary for accountability. There are only 11 years remaining to meet the MDGs. It is time for South Asian governments to focus on problem areas related to extreme poverty in the region, such as high rates of infant and maternal mortality, low primary school enrollment and completion rates, poor rural infrastructure and low rates of access to safe drinking water and sanitation, especially in rural areas