Blogs & Interviews

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Be proactive rather than reactive to Cancer, this World Cancer Day.

By , Feb 5 18

India recorded an estimated 3.9 million cancer cases in 2016, data available with the National Cancer Registry Programme of the Indian Council of Medical Research (ICMR) shows. The worst affected states were Uttar Pradesh with 674,386 cases, followed by Maharashtra with 364,997 and Bihar with 359,228. In South India, Tamil Nadu recorded 222,748 cases, Karnataka 202,156, Andhra Pradesh 159,696, Telangana 115,333 and Kerala 115,511 cases of cancer. Ravi Mehrotra, Director at the ICMR-National Institute of Cancer Prevention and Research says, “The numbers are too high in UP, Maharashtra and Bihar because these are the most populous states in the country. But if we look at the percentage of cancer in population, the prevalence and incidence (the number of new cases per population at risk in a given time period) are much higher in North East region such as Assam and Arunachal Pradesh.”

Cancer cases in India are shooting up, not just because life expectancy has increased by more than a decade in 15 years — from 57.9 years in 1990 to 68.3 years in 2015 – but also because of tectonic shift in the way we live our lives. Tobacco and alcohol use, processed food and diets low fresh food and vegetables, air pollution, inactivity and obesity are among the primary triggers, which have made non-communicable diseases (NCDs) like heart diseases, cancers and stroke account for 61% of all deaths in India, up from 37.9% in 1990. Around 1.45 million people in India are diagnosed with cancers each year, with the leading sites being breast and cervix in women and lung and mouth cavity in men. By 2020, cancer cases are projected to cross 1.73 million.

Every year an astonishing rate of 7 lakh new cases are registered as cancer cases. It is quietly becoming an epidemic, in spite of the dearth of knowledge about prevention and early diagnosis available in India. A stark statistic is that of India, who continues to have a low survival rate for breast cancer, with only 66.1% women diagnosed with the disease between 2010 and 2014 surviving, a Lancet study has found. The US and Australia, in comparison had survival rates as high as 90%, the study said. The gist of this is the means to combat the disease are available and growing everyday, but the awareness about the condition along with few tinkering lifestyle changes; we can reduce the chances of the disease rearing its treacherous face.

Ignorance and denial leads to delayed diagnosis and treatment; most Indians change doctors when asked to go in for a screening or biopsy. Other than the fear of invasive treatment, disfigurement, lack of diagnostic centres and knowledgeable oncologists in tier II and tier III cities and financial burden, the ill-placed belief that a cancer patient will always die makes patients and their families refuse specialised treatment. Hence, when it comes to cancer, it is important to remember that early treatment is the best treatment. Experts suggest that if you notice any other major changes in the way your body functions or feels, you should see a doctor, especially if the changes persist for more than three weeks or gets worse. It may not be cancer but it is safer to get it checked out.

One does not have to be a medical professional to know some tell-tale signs and methods to prevent the occurrence of cancer. There are seven warning signs mentioned by NICPR (National Institute of Cancer Prevention and Research) and the American Cancer Society has given a very apt acronym for easy referral called ‘CAUTION’
C: Change in bowel or bladder habits
A: A sore that does not heal
U: Unusual bleeding or discharge
T: Thickening or lump in the breast or elsewhere
I: Indigestion or difficulty in swallowing
O: Obvious change in a wart or mole
N: Nagging cough or hoarseness

Most of these symptoms can occur due to many non-malignant disorders, and different types of cancer can lead to symptoms like unexplained weight loss and appetite.

Another important aspect in reducing the prevalence of cancer is knowledge of how certain lifestyle changes can prevent cancer from rearing its nefarious head. Some important lifestyle changes that a healthy/unaware individual can incorporate in their daily lives are:

Refraining from tobacco use in any form: Most cancers of the mouth and lung occur due to long-term tobacco use. Avoid inhalation of second-hand smoke as well.

Watch what you eat: Limit spicy, fried, preserved and junk food, red meats, charbroiled foods. These foods increase the risk of colon and prostate cancer. Opt for a diet containing whole grains, lean meats, vegetables and fruits.

Get off the sofa: A sedentary lifestyle is linked to many cancers of the digestive tract. Excess fat in the body has been associated with cancers of the breast and ovaries. Be physically active; try to keep a check on your weight.

Just one drink: Excess alcohol can cause cancers of the mouth, larynx, oesophagus, liver and colon and breast cancers in women. Smoking further increases the risk. If you choose to, limit yourself to no more than 1-2 drinks a day.

Practice safe sex: Individuals indulging in unsafe sexual practices or heterogeneous partners endanger themselves to infections like hepatitis, HIV, HPV (human papilloma virus) which can lead to many types of cancers.

Avoiding or limiting exposure to different environmental carcinogens, go for regular screenings; both self and professional and encouraging loved ones to do the same, can go a long way in preventing cancers thus allaying fears of body disfigurements, financial loss, and mental trauma.
This World Cancer Day, for the years of 2016-2018 the tagline is ‘We can. I can’. We can defeat cancer by proactively bringing about certain lifestyle changes, which are not at all difficult to incorporate. We need to show the tenacity, desire, awareness and the knowledge to learn more about the ways to prevent cancer from creeping in our bodies in the first place, rather than reacting to the dire consequences cancer throws at us. As the age old saying goes “Prevention is better than cure”, nowhere is this idiom more congruous than in these situations. Let us unite and live up to their motto and nip cancer in the bud before it has far-reaching consequences.

References
Publishing, H. H. (2009, April). The 10 commandments of cancer prevention. Retrieved February 03, 2018, from https://www.health.harvard.edu/newsletter_article/The-10-commandments-of-cancer-prevention
Cancer Detection, Cancer Prevention and Cancer Treatment in india. (n.d.). Retrieved February 03, 2018, from http://cancerindia.org.in/
Kaul, R., & Maniar, P. (2017, December 10). Fighting cancer by living right. Hindustan Times. Retrieved February 3, 2018, from https://www.hindustantimes.com/india-news/fighting-cancer-by-living-right/story-Xmae5kgiGKjbMvpDw26ffM.html
Pal, S. (2016, November 07). Cancer in India and The Fight Against It: What Every Indian Should Know. Retrieved February 03, 2018, from https://www.thebetterindia.com/74188/cancer-awareness-india/
Sharma, N. C. (2017, December 23). India recorded about 3.9 million cancer cases in 2016, data shows. LiveMint. Retrieved February 3, 2018, from http://www.livemint.com/Politics/3eXX60XBig4bWZ25Kr1iQO/India-recorded-about-39-million-cancer-cases-in-2016-data.html
Sharma, N. C. (2018, February 01). India still has a low breast cancer survival rate of 66%: study. LiveMint. Retrieved February 3, 2018, from http://www.livemint.com/Science/UaNco9nvoxQtxjneDS4LoO/India-still-has-a-low-breast-cancer-survival-rate-of-66-st.html
World Cancer Day 2016-2018. Retrieved February 03, 2018, from http://www.worldcancerday.org/about/2016-2018-world-cancer-day-campaign

mHealth for Rural India; are we ready?

By , Jan 8 18

What is mHealth?

mHealth India

mHealth is generally viewed as the delivery of healthcare services or information with a mobile phone. The services available today in global markets vary greatly in their level of sophistication. Some provide static information about a disease or illness, while others move considerably up the value chain by providing comprehensive healthcare management beyond what could be delivered by only a face-to-face interaction with a healthcare provider. As mobile networks cover new swaths of the world and reach more people, the cost of mobile phones and airtime is declining. Meanwhile, continual innovation in technology infrastructure means mHealth can reach communities in ways that health services and other communication tools cannot.

mHealth drivers mHealth barriers

Current scenario in India

In India, there is considerable potential to leverage mHealth (mobile health) as an alternative healthcare delivery channel. India has only 0.7 Doctors, 1.3 Nurses and 1.1. Hospital beds per 1000 population thus creating a need for alternative channel like mHealth for delivery of healthcare. Additionally, there are some worrying statistics on the Indian healthcare ecosystem. In fact, a large segment of the population is deprived of even primary healthcare facilities. It is imperative to leverage newer ways to make quality and affordable healthcare accessible to everyone.

Dr. Rana Mehta, Partner & Leader – Healthcare, PwC India said, “If mHealth is adopted completely in India, it has the potential to play a critical role in improving the healthcare outcome for the country. We can expect that through mHealth, an additional 12-14% of the population will gain access to healthcare. India’s population is around 1.3 billion and if we take a conservative estimate of 6-8%, we can expect to provide access to healthcare to an additional 79 to 105 million people.”

In India’s rural communities, heart disease and related illnesses, such as diabetes, account for a very large proportion of all premature death and disability. These chronic conditions strike at a much younger age in India than they do in the West – as a consequence, they are now the most common killers of people of working age, as well as the most common causes of “catastrophic” personal and family expenditure on emergency medical care. Not surprisingly, therefore, these diseases represent a rapidly growing cause of poverty in India today.

snapshot of Indian health ecosystem

Challenges to mHealth

Unfortunately, most people in rural India do not have reliable access to the healthcare required to prevent and manage serious chronic diseases. For example, most people with heart disease in rural India receive no regular medical care whatsoever. In India, there is considerable potential to leverage mHealth as an alternative healthcare delivery channel. Structural, financial and behavioural factors have created a significant need for such a channel. The structural issues are basic. The Indian patient base is rising and distributed. Access to even basic healthcare is a challenge because the supporting infrastructure and resources are inadequate. Financial constraints like rising healthcare costs and limited budget allocation for healthcare by the government further constrain the healthcare ecosystem in India. Behavioural factors such as change in lifestyle have resulted in newer types of diseases, which require access to specialists who are few in number and cannot be reached through traditional means of healthcare delivery. Also, the population is getting more tech-savvy and demanding easier and convenient means to receive care.

key barriers of mHealth top barriers to adopting mHealth

 

 

Positive future for mHealth

Unless there is an interest or demand, mHealth is unlikely to succeed. According to data gathered from Google Trends, a tool which helps understand the relative interest in a particular search term, India ranks among the top five countries for search terms like ‘mobile health’, ‘health apps’, ‘medical apps’ and ‘mHealth’. This confirms that the Indian population is interested in mHealth. India needs newer and innovative ways like mHealth to provide care and compensate for the deficiencies of the healthcare workforce and infrastructure. The country does not meet the minimum WHO recommendations for healthcare workforce and bed density. A large segment of the population resides in rural areas, where the numbers are even worse. In particular, the low-income group lacks access to quality healthcare.

India can benefit significantly from mHealth. Identifying relevant use cases to target by leveraging the available technology is key to driving mHealth adoption and improving care outcomes. Grassroots networks in rural India are an effective solution to the issue of technology access. Community driven programmes which match mind sets and technology should form the helm of development for mHealth technologies. India’s Ministry of Health and Family Welfare announced the national roll out of two MOTECH-powered programs developed by BBC Media Action, Mobile Academy and Kilkari, both aimed at addressing health challenges that result in high infant and maternal mortality rates. Under the Kilkari programme, pregnant women and mothers are contacted on their mobile phones and given crucial health information related to their stage of pregnancy or their infant’s age. Mobile Academy uses Interactive Voice Response (IVR) messages on mobile phones to train front-line health workers in maternal and infant care. The village they serve, and are central to India’s strategy to improve maternal and child health selects the health workers, known as ASHAs (Accredited Social Health Activists). the Swastha Bharat mobile application for information on diseases, symptoms, treatment, health alerts and tips; ANMOL-ANM online tablet application for health workers, e-RaktKosh (a blood-bank management information system) and India Fights Dengue.

mHealth related searches in India

Conclusion

For mHealth to succeed in rural areas a community-based strategy will be needed. Unlike more common mHealth partnerships that establish a link between a wireless carrier and a healthcare provider, rural mHealth may require a more complex model. A previously presented model, designed to address an array of mHealth barriers in rural areas, recommended a combination of using human resources, improving supply chains, providing micro-insurance and using low-bandwidth applications. Resources must be shared to lower per user costs and foster community involvement.

While there are huge opportunities for mHealth in theory, bringing them to fruition will not be easy. The first step is to create awareness about the various possibilities, available technology, successful implementations, as well as the possibility of partnerships with foundations, government organisations, telecom operators, etc. There is also an urgent need to recognize the elephant in the room in the form of wilful participation of all stakeholders of the healthcare industry-public and private. mHealth can potentially transform the healthcare landscape in India by improving healthcare access for the vast under-served rural market and enhancing patient care for urban consumers. However, rural and urban markets in India have distinct requirements.

References

Consumers Are Ready to Adopt Mobile Health Faster than the Health Industry is Prepared to Adapt, Finds PwC Study on Global mHealth Adoption. Retrieved January 07, 2018, from https://www.pwc.in/press-releases/global-mhealth-adoption.html

How mHealth can revolutionise the Indian healthcare industry. (2017). Retrieved January 07, 2018,from https://www.pwc.in/assets/pdfs/publications/2017/how-mhealth-can-revolutionise-the-indian-healthcare-industry.pdf.

Lunde, S. (2013). The mHealth Case in India. Wipro Council for Industry Research. Retrieved January 7, 2018, from http://www.wipro.com/documents/the-mHealth-case-in-India.pdf

Nationwide launch of Mobile Health Program in rural India signals new era of mHealth for emerging economies. (2016, January 15). Retrieved January 07, 2018, from https://www.grameenfoundation.org/press-releases/nationwide-launch-mobile-health-program-rural-india-signals-new-era-mhealth-emerging

India’s healthcare sector: A look at the challenges and opportunities faced by $81.3 billion industry. (2017, June 12). Retrieved January 08, 2018, from http://www.firstpost.com/india/indias-healthcare-sector-a-look-at-the-challenges-and-opportunities-faced-by-81-3-billion-industry-3544745.html

 

 

 

Preamble

By , Aug 15 17

We Indians have taken pride in our ancient wisdom & intellectual lead which made us a powerhouse of knowledge & know-how in diverse fields of mathematics, chemistry, biology, philosophy, art & culture much ahead of the rest of the mankind.

It is also a fact that we have a rich diversity & depth in our knowledge about medicine & disease sciences. We have contributed a full fledged system of medicine to the world, called Ayurveda.

In the modern day & age too, post independence, India has taken long strides to higher echelons of healthcare. However, our cherished goal of achieving health for all has been evading us ever since.

We are not yet in the striking distance of the target.

On the other hand, you would agree, the larger the gap between the demand & supply, the bigger the opportunity there to serve & earn.

So we have opened up that opportunity & inviting one & all to be able to do their bit  with the belief that TOGETHER WE CAN.

If you cannot provide healthcare, you can find healthcare.  This Collaborative Healthcare Project would be that much closer to its target.

Treat or get treated or do both. Want to do anything in this domain, you are welcome!