ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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National Medical Commission Bill, 2017

The National Medical Commission Bill, 2017, which aims to overhaul medical education in India and replace the 83-year-old Medical Council of India with a government-appointed NMC, has several worrying features. While the long-term implications of the bill have not been satisfactorily debated and addressed, the bill itself is in danger of causing similar or even worse outcomes than the previous MCI Act. The NMC Bill remains a questionable remedy, and it has drawn criticism from several quarters, including the country’s medical fraternity.

Political Interests and Private Healthcare Lobby Collude to Stifle Patients’ Rights in Karnataka

The amendments in the Karnataka Private Medical Establishments Bill, 2017 contained key provisions related to patient rights, cost regulation, and grievance redressal. The bill also provided substantial opportunity for private medical establishments to be part of the regulatory process, thereby defeating the very purpose of regulation. PMEs misrepresented the bill as “draconian” and rejected the amendments. PME’s resistance to the bill is part of the larger resistance of the medical fraternity in general to any regulation. This has led to a crisis in both the public and private health sectors. While the KPME Bill is an important first step in ensuring accountability of the private health sector, the Karnataka government needs to also increase budgetary allocation for the public health system and reverse its pro-private healthcare policies.

Cut Practice in Private Healthcare

The Government of Maharashtra had set up a committee to draft the Prevention of Cut Practice in Healthcare Services Act, 2017 to stop cut practice in the medical profession. In the last two decades, there has been rapid commercialisation of medical services which has led to cut-throat competition among doctors to attract patients for higher revenue generation. This article presents the views of doctors about different aspects of cut practice, such as its prevalence, trends and the ways to stop it.

Efficiency of Healthcare Sector in Bihar

In this article, we focus on the efficiency of the healthcare system at the district level for Bihar. Although relatively an economically and socially disadvantaged state, the infant mortality rate in Bihar is very close to the all-India average. We explore the reasons for the differential performance of different districts by using data envelopment analysis. The efficiency rankings from our results indicate a mix of inefficiency, inadequacy of inputs, and the presence of an optimal targeting of funds under the National Rural Health Mission to low-performing districts.

Deploying the Power of Social Protection to Improve Nutrition

The nutritional status of women and children in India continues to be poor. In this paper, we discuss how three major flagship social protection government programmes—the Targeted Public Distribution System, the Mid-day Meal Scheme, and the Mahatma Gandhi National Rural Employment Guarantee Act—can be made more nutrition sensitive. We discuss three potential approaches to making these programmes deliver better nutrition outcomes. These are strengthening governance and operations so that the programmes achieve their basic goals of improving food security and poverty; integrating nutrition goals and actions for each of these programmes; and leveraging the reach and scale of these programmes to also deliver specific nutrition interventions via these programmes, especially the tpds.

 

Investing in Health

The publication of “Investing in Health,” the World Bank’s highly influential 1993 World Development Report, has guided structural adjustment policies and health sector reforms in many developing countries. This study looks at how investment in health has since taken place in India with the withdrawal of the state from healthcare, transformation of healthcare into a commodity, and promotion of the private healthcare sector by the state. This has led to an unregulated industry that is aggressively seeking expansion and profits from the provision of healthcare, and attracting investments by global finance capital.

Where Is the Husband?

Despite global efforts towards creating awareness and involving men in maternal and reproductive health of women, their participation remains low, particularly among the tribal population.

India’s Slip on Global Hunger Index

After witnessing an improvement from 2008 to 2014, India’s rank on Global Hunger Index slipped in 2016. This slip is attributed to reformulation of GHI to encompass the multidimensional character of malnutrition, wherein underweight was replaced by stunting and wasting. While GHI scores of several other countries witnessed a decline, India fared worse. This is explained through a stickiness in child stunting levels in India attributed to gendered norms, poor sanitation, and high regional concentration.

Right to Safe Abortion

The case of the 10-year-old victim of rape who is pregnant and awaiting delivery after being denied permission to abort by the courts is an urgent indication that all stakeholders must come together and find a solution for unwanted pregnancies of more than 20 weeks.

Barriers to Antiretroviral Therapy Adherence

Strict adherence to treatment is critical for the effective management of HIV. Research suggests that adherence to treatment should be greater than 95% for maximum benefit from antiretroviral therapy. However, observation at one of India’s 355 ART centres identified several barriers to adherence, including shortage of drugs and CD4 test kits.

Treatment Gap in Mental Healthcare

There is a wide treatment gap in Indian mental healthcare. This article discusses the treatment gap and the contributing factors, and suggests ways to reduce it. The political (policy perspective), social (stigma, discrimination, and gender), cultural (beliefs, explanations, and help-seeking behaviours), and economic (direct and indirect costs of treatment) factors addressed have long impeded mental healthcare. A policy and research review reflects that mental illness in India contributes significantly to the global occurrence of mental illness. The treatment gap causes substantial losses to individuals, families, society, and the nation. Innovation and capacity building are necessary to develop and implement locally relevant, feasible, and effective community-based mental healthcare models.

India Badly Needs Public Health Education

This article calls for the need to introduce undergraduate courses and degree programmes in public health across local colleges and universities in India. Undergraduate degrees in public health should be promoted in order to have an optimum number of public health professionals who can successfully meet the health challenges posed by rapid economic development.

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