Search

One Health has been coming of age through the G7 and G20 leadership and explicitly referred to in increasing ministerial declarations. Those leaderships, however, have been slow in knitting the One Health approach into the larger systems approach. by understanding the complexity of resilience and health system resilience is one of the key features of pandemic preparedness. Among others, health system strengthening is another key factor that urgently requires much attention in the theme of pandemic preparedness. Here, how the health system strengthening requires more imperative attention in the One Health gambit is discussed in the Indian context. [ABSTRACT FROM AUTHOR]

System analysis is examination of various elements of a system with a view to ascertain whether the proposed solution to a problem will fit the system and in turn effect an overall improvement in the system. The National Medical Commission (NMC) which was constituted by the act of the Parliament, has brought out minimum requirements for annual MBBS admissions regulations, 2020, which replace minimum requirements published by erstwhile Medical Council of India. The NMC also published new competency-based medical education syllabus for MBBS students with an aim to focus on practical skills. This study brings out the scope of the community medicine (CM) in the present context and as envisaged by the NMC. It also analyzes the infrastructure and workforce required in the department of CM and gives recommendations to improve the system. [ABSTRACT FROM AUTHOR]

Context: The government of India has recently decided to upgrade subcenters (SCs) to health and wellness centers (HWCs) for providing comprehensive quality services. Aims: The present study was undertaken to determine workforce- and infrastructure-wise gaps in the SCs for upgradation to HWCs and assess knowledge of the auxiliary nurse midwives (ANMs) regarding services to be delivered through HWCs. Settings and Design: This cross-sectional study was conducted in Bhatar block of Purba Bardhaman district between August and October 2019. Subjects and Methods: Workforce and infrastructure availability was assessed using a checklist in 38 SCs and knowledge was assessed using a questionnaire among ANMs. Statistical Analysis Used: Data entry and analysis was done in Microsoft™ Excel™. Results: No Subcentre had Community Health Officer and 23.7% of Subcentre were without second ANM. 28.9% of the ANMs had adequate knowledge about services to be delivered through HWCs. Infrastructurally, lack of staff residential facility (76.3%), water supply (34.2%), and inadequate civil construction (34.2%) were major barriers. Conclusions: Adequate recruitment of HCWs, infrastructure upliftment, and proper training of HCWs in the SCs are the need of the hour. [ABSTRACT FROM AUTHOR]

Background: A large number of government primary health-care facilities (GPHCFs) in India do not have access to the regular electricity supply. Objectives: To assess the status and change in electricity access, sources, and reliability at primary health centers (PHCs) in India; and to understand the effect of regular electricity supply on health services provision and on workforce availability and retention. Materials and Methods: Secondary analysis of data from the lastest two rounds of district-level household survey (DLHS) in India, conducted in 2007-2008 and 2012-2013. Results: Data of 8619 PHCs from DLHS-3 and 8540 PHCs from DLHS-4 were analyzed. The proportion of PHCs with access to electricity increased from 87% to 91%. However, regular electricity supply was available at only 50% of PHCs in 2012-2013, which was an increase from 36% such PHCs in 2007-2008. PHCs with regular electricity supply provided services to 50% more beneficiaries (deliveries and vaccination) than PHCs without regular or no electricity (P ≤ 0.001). Increased access to regular electricity was associated with improved availability and retention of health staff (P = 0.001). Conclusion: Government policies should aim to ensure access to regular electricity-supply-beyond just connection from grid-at all GPHCFs, including health sub-centers, PHCs, and community health centers. Indicators on electricity access at GPHCFs could be standardized and integrated into regular health and facility-related surveys as well as in the existing dashboards for real-time data collection. Health policy interventions should be informed by regular data collection and analysis. Improving access to regular electricity supply at GPHCFs can contribute to achieve the goals of National Health Policy of India. This will also help to advance universal health coverage in the country. There are lessons from this study, for other low and middle income countries, on improving health service provision at government health care facilities. [ABSTRACT FROM AUTHOR]

Background: Changing trends of privatization and globalization of health care compel the hospitals to practice cost accounting for providing accurate information about the cost of patient care. Objectives: The objectives were to determine unit cost and to identify major cost areas of outpatient department (OPD) services provided by the community health center (CHC) of Bankura district, West Bengal. Materials and Methods: A cross-sectional study was conducted at Amarkanan CHC in 2016. Work sampling (WS) and time motion (TM) study were conducted for assessing the workforce cost, otherwise complete enumeration was done to assess the cost of different service areas such as medicine, logistic, maintenance, transport, electricity, building, equipment, and furniture. A predesigned pro forma and a questionnaire were used for WS and TM study and for interviewing the key informants for collection of information pertaining to different costs. Unit cost of different services as well as overall unit cost was estimated. Results: If a patient received injection, undergone dressing, and had electrocardiogram and X-ray both done in a day, then the total cost of OPD services for workforce was Rs. 85.33/. Cost of logistics per patient per day was maximum in X-ray room. Manpower exerted the maximum cost incurred by the government to conduct OPD in Amarkanan CHC. Overall, the unit cost in OPD incurred by the government was Rs. 44.53/-. Conclusion: Close monitoring is required by aligning the staffing pattern and patient activities and having adequate number of staff with right skill at right place and time for efficiency, productivity, and cost-effectiveness. [ABSTRACT FROM AUTHOR]

Indian health sector is a complex admixture of public and private providers, but several lacunae of public health service delivery system in terms of human resource, access, and quality have resulted in unprecedented growth of private sector. Although seamless delivery of services at rural and urban areas, timely approach, and improved information technology system are the strength of the private sector, this package comes at the cost of high out-of-pocket expenditure. Mobilization of private sector health workforce by their capacity building in terms of orientation toward public health services is one of the available solutions to move toward wider coverage of public health services. However, numerous challenges need to be addressed before realization of this vision. [ABSTRACT FROM AUTHOR]

With the launch of new Government of India's initiative Ayushman bharat that envisages conversion of all subcenters into health and wellness centers, the role of nursing professionals in primary health care will be undergoing paradigm shift. Nurses are approximately two-third of the population of health workforce in India. Nurses' scope of work has widened with additional roles and responsibilities due to shift in the pattern of burden of diseases. The emergence of zoonotic infectious diseases has further enlarged their responsibilities. The main areas, which need attention, are development of nursing workforce, selection and recruitment, placement as per specialization, and preservice and in-service training related to zoonotic surveillance. This article attempts to discuss the role of nurses under emerging zoonotic disease infections. [ABSTRACT FROM AUTHOR]

Background: While the roles and responsibilities of nursing professionals have multiplied over the years, but there are huge concerns with regard to the development of the nursing workforce and human resources (HR) issues for their career growth. The major lacuna is in not involving the nursing professionals in policy framing and decision-making. As a result, there is a leadership crisis of the nursing workforce across India. Objectives: The paper, is part of the WHO supported study, entitled "Study on Nursing and Midwifery in India: a critical review", is developed with the objective to review the current organizational and management structure for the nursing positions at the State Directorates in India and obtain a Leadership perspective to strengthen nursing management capacities to address maternal health issues. Materials and Methods: The study descriptive and qualitative in nature and the sources of information were both primary and secondary collected from 16 states of India. Results: Since none of the states have neither a Nursing Cell nor the post of Director Nursing, final decision-making powers rest with state health secretaries and medical directors. The nursing management structure majorly managed by senior policy makers from the medical fraternity, and provides very little scope for nursing professionals to participate in policy decision making to bring about reforms. There is no uniformity on HR issues concerning career graphs and pay structures across the states. Conclusions: In order to strengthen nursing as a profession and for facilitating their role at the policy level, more powers and autonomy needs to be given to them and this requires HR policy guidelines for nurses. Setting up a separate nursing directorate, to be headed by a senior nursing professional, is suggested in every state along with a strong nursing division at the National level. This total paradigm shift will empower nursing professionals to take up the leadership role at the policy level to bring about necessary reforms. Across the country, nursing professionals repeatedly echoed one requirement: To reframe nursing leadership at all levels. [ABSTRACT FROM AUTHOR]

The article discusses the context of positioning and maximizing the output of district level health officers, rendering greater autonomy and streamlining their roles in department of public health in Maharashtra and attempts to articulate challenges faced by existing district level human resources for health (HRH) architecture and discussed possible changes to face these challenges. It cites recommendation for state health directorate to have a full-fledged HR department.