indian health care khatrti
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Health Care In India Lecture for CHBR Students, Karolinska
Institutet, Sweden
Subhash Khatri PT,PhD
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Ayurveda (Indigenous medicine) is one of the oldest system of health care in the World
Mixed & Interlinked
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Humor
• A man goes to a shrink and says, “Doctor, my wife is unfaithful to me. Every evening, she goes to Larry's bar and picks up men. In fact, She sleeps with anybody who asks her! I'm going crazy. What do you think I should do?” “Relax”, says the Doctor, “take a deep breath and calm down. Now, tell me, exactly where is Larry's bar?”
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Incredible India! South Asia Largest Democracy Second most populous 1.2b Third largest army Four world religions originated here Hindu,
Buddhism, Jainism & Sikhism Seventh largest country by area Eight military expenditure 28/7 states & territories 11th largest economy Multilingual PPP
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Country %GDP spent on health
Private spending % of all health spending
Per capita spent on health in $
Per capita Govt spent
Doctors per 10,000
India 4.1 70.8 132 39 6.49
http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-spending-world-country
21,511/1,236,344,631=57474
Facts !
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Incredible health?
• Highest no of medical colleges • Highest no of doctors• 4th largest export of Medicine • Limited health care • 2/3 don’t get essential medicines • Medical paradox• Financial accessibility• Physical accessibility• Information accessibility• Self medication
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Who runs hospitals?
Government
Charitable trusts Private
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Private Hospitals
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Public health organizational structure
National
• Ministry health & family
State level
• State level: Ministry health & family welfare
District level
• District health officer
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
GMCHIRHAFMCCGHSAIMS
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
• A business executive injured his leg skiing one weekend. By the time he got home Saturday, the leg was very swollen and he was having difficulty walking, so he called his physician at his home. The doctor told him to soak it in hot water. He tried soaking it in hot water but the leg became more swollen and painful. His maid saw him limping and said, "I don't know, I'm only a maid, but I always thought it was better to use cold water, not hot, for swelling." He tried switching to cold water and the swelling rapidly subsided. On Sunday afternoon he called his Dr. again to complain. "Say, what kind of a doctor are you anyway? You told me to soak my leg in hot water and it got worse. My maid told me to use cold water and it got better." "Really?" answered the doctor, "I don't understand it. My maid said to use hot water."
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Who controls
1. MCI2. AYUSH3. Health ministry 4. Family welfare 5. No council for PT
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
A middle aged woman has a heart attack and is taken to the hospital. While on the operating table she has a near death experience. During that experience she sees God and ask if this is it. God says no and explains that she has another 30 years to live.
Upon her recovery she decides to just stay in the hospital and have a face lift, liposuction, breast augmentation, tummy tuck, etc. She even has someone come in and change her hair color. She figures since she's got another 30 years she might as well make the most of it.
She walks out of the hospital after the last operation and is killed by an ambulance speeding up to the hospital. She arrives in front of God and complains: "I thought you said I had another 30 years.
God replies, "I didn't recognize you."
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
• A man was making love to a village girl overChristmas when she realized he was not using a condom.She asked him, "U 're not using a condom"?Man answered, "Yes".She said, "Hope u don't have HIV / AIDS .Man, "NO".Girl: "Thank God, I don't want to get that thingagain" !
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Business in Indian way3 contractors bid to fix a broken fence at the White House in D.C. One from Bangladesh , another from India and the third, from China . They go with a White House office to examine the fence. The Bangladesh "I figure the job will run about $900. ($400 for materials, $400 for my team and $100 profit for me)". The Chinese "I can do this job for $700. ($300 for materials, $300 for my team and $100 profit for me)".The Indian contractor leans over to the White House official and whispers, "$2,700." The official, How did you come up with such a high figure?"
The Indian contractor whispers back, "$1000 for me, $1000 for you, and we hire the guy from China to fix the fence." "Done!" replies the government official.
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Concerns
• Severe shortage of bed (bed density 2.1/1000)
• Morbidity = Medical Equipment, Supplies and Facilities productive capabilities
• Human resources in health • 63 million diabetics and 2.5 million cancer
sufferers, 20 million blind people • 2.5 million Indians annually need heart
surgery severe shortage of hospital beds and medical facilities
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Health issues
1. Malnutrition2. Infant mortality rate3. Poor sanitation4. Safe drinking water 5. Diseases6. Health priority
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
"I told my doctor I broke my leg in two places. He told me to quit going to those places." - Henny Youngman
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Secret of happy married life for 25 yearsHusband: "We had been to Scotland for honeymoon after marriage. My wife tried horse riding horse jumped suddenly, making my wife topple over. Once again she tried to hop on horse and said "This is your first time". She again climbed the horse and continued with the ride. After a while, it happened again. This time she again kept calm and said "This is your second time" and continued. When the horse dropped her third time, she silently took out the revolver from the purse and shot the horse dead!! I shouted at my wife: "What did you do you psycho. You killed the poor animal. Are you crazy?”
She gave a silent look and said: "This is your first time!!!"."
Husband:"That’s it. We are happy ever after. "
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Government efforts
• National Rural Health Mission (NRHM)• Health insurance
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
Key Achievements
• Life expectancy 50 -64• IMR 1476 to 7• Crude birth rates dropped to 26.1 • Death rates to 8.7.
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
What needs to be done?
1. Increase public expenditure2. National Health Package3. National Council for Human Resources in
Health (NCHRH)4. Rational use of drugs5. National Drug Regulatory Authority6. Pay for performance (30%absentism)
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]
04/09/2023 09:10 PM (c)Subhash Khatri [email protected]