Beruflich Dokumente
Kultur Dokumente
20 Pradanya 2015
International Conference
on
Technical
Sessions
Pre-Conference
Workshops
Organized by
th
20 Pradanya 2015
International Conference
on
Technical
Sessions
Pre-Conference
Workshops
Organized by
Editorial Team :
Prof. A. L. Shah
Mr. Hem K. Bhargava
Mr. N. K. Sharma
Dr. Risho Singh
Designed By :
Mr. Chaitanya Dadhich
2
Contents
Index
Page No.
Messages
The IIHMR University
Organizing Committees
Pre-Conference Workshop
Conference Programme
Conference Sessions
List of Abstracts :
11
Paper Presentation
Poster Presentation
Abstracts for Paper Presentations
18
54
113
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The Visionary
Late Shri PD Agarwal
(01.01.1920 - 17.09.1982)
The late Shri Prabhu Dayal Agarwal (PD Ji) was born on Ist January, 1920, in Bari Nangal, a hamlet in the
desert district of Churu in Rajasthan. From humble beginnings, he rose by dint of sheer hard work and singleminded devotion to become an eminent entrepreneur, setting TCI group of enterprises. With time, he grew
in both stature and kindness and became a legend in his lifetime.
With his strong commitment to the virtues of hard work, truth and goodness, he won the love and trust of all
those who came into contact with him. His fair-mindedness, magnanimity and altruism, as also his
determination and rare confidence were proverbial. A self-made man, he continued to work hard through
his life, and became a synonym for success. In work, he represented a blend of energy and ambition.
He has been a great source of inspiration to his sons, employees and peers. The many growing TCI and
Bhoruka enterprises owe their stature primarily to his progressive outlook and his ability to think big.
***
It was to continue PD Jis missionary work that his son, Dr Ashok Agarwal, founded Indian Institute of Health
Management Research (IIHMR) in Jaipur in 1984. With a mission to make healthcare research, education,
and training accessible to all corners of the country, IIHMR Bangalore was established in 2004,IIHMR Kolkata
in 2010 and IIHMR Delhi was established in 2008 with the aim to spearhead education and training of
professionals looking for gaining a strong edge in Hospital and Health Management. The mission will
continue manifesting itself in future also. Philanthropy and altruism have a beginning but they never have an
end.
***
We dedicate our achievements during these three fruitful decades to Shri PD Ji because of whose vision
and mission we are what we are.
5
VASUNDHARA RAJE
CHIEF MINISTER RAJASTHAN
Message
I am glad to know that the IIHMR University, Jaipur is conducting the 20th International
Conference Pradanya 2015 on Universal Health Coverage- Roadmap 2020 on October 34, 2015.
It is imperative that the professionals working in government and private healthcare sector
discuss and exchange knowledge about the new researches made in various fields, so that
they are in a position to provide best healthcare services. I believe that the conference
through the exchange of ideas, knowledge and expertise between professionals,
academicians and healthcare researchers shall accentuate the health issues that need
immediate attention and care.
I hope that the outcomes of the conference shall be beneficial for preparing a roadmap to
provide quality healthcare services.
I wish the conference the very best.
(Vasundhara Raje)
Message
I am extremely delighted to know that the IIHMR University, jaipur is conducting 20th International
conference, Pradanya 2015. It is gratifying to know that the theme of the conference is Universal
Health Coverage-Roadmap 2020.
I am wished that this conference shall open new avenues for the healthcare organizations to
welcome new approaches and practices within the reach of every individual especially for the
senction of the society that struggles hard to make the ends meet.
Thesharing of ideas and expertise of renowned speakers and the illustrious efforts of the students
who shall be making a poster and paper presentations, will provide an insight in to the current
practices and what all can be done to tweak the services being offered at different levels.
I heartily congratulate the faculty for choosing this theme for the yearly event of Pradanya. I would
insist on capitalizing on the networking opportunities created by this two day conference on recent
trends in healthcare sector by the faculty and students and making the conference a big hit.
(Rajendra Rathore)
08
Mukesh Sharma
I.A.S.
Principal Secretary
Medical, Health &
Family Welfare Department
Government of Rajasthan
Secretariat, Jaipur-302005
Tel. : 0141-2227132
Fax : 0141-2227797
e-mail : sharmamk@ias.nic.in
Message
It is a privilege to know that the IIHMR University, Jaipur is conducting 20th International
conference, Pradany a 2015. It is gratifying to know that the theme of the conference is Universal
Health Coverage - Roadmap 2020.
It is wished that this conference shall open new avenues for the healthcare organizations to
welcome new approaches and practices within the reach of every individual especially for the
section of the society that struggles hard to make the ends meet.
The sharing of ideas and expertise of renowned speakers and the illustrious efforts of the students
who shall be making a poster and paper presentations, will provide an insight into the current
practices and what all can be done to tweak the services being offered at different levels.
I heartily congratulate the faculty for choosing this theme for the yearly event of Pradanya. I would
insist on capitalizing on the networking opportunities created by this two day conference on recent
trends in healthcare sector by the faculty and students and making the conference a big hit.
I wish the institution all the best.
(Mukesh Sharma)
ICMR
10
D. P. Agarwal
President, Management Board, IIHMR
CMD, Transport Corporation of India Limited
Message
th
I am extremely delighted that The IIHMR University, Jaipur is organizing the 20 International
Conference, Pradanya 2015. It is gratifying to know that the theme of the conference is Universal
Health Coverage - Road Map 2020.
Though prodigious efforts have been taken to improve the healthcare standards in India, problems
of paramount importance are yet to be resolved. Hence, it is incumbent upon us, the healthcare
professionals and the corporates under their CSR to work diligently to make adequate healthcare
facilities available to the poor and needy population.
I am sure that the deliberation in the conference will enlighten us with better measures to improve
healthcare.
I send my best wishes for the success of the conference.
D. P. Agarwal
11
S. D. Gupta
President
The IIHMR University
Jaipur
Message
It is a matter of immense pleasure that The IIHMR University is organizing international conference
Pradanya 2015 on Universal Health Coverage Road Map for 2020 on 3 & 4 October, 2015. I take
this opportunity to congratulate the whole IIHMR team for the successful 20 years of Pradanya.
Over these years, it could provide a platform for all the healthcare leaders, professionals working in
this area and the industry leaders to come together and exchange their ideas and discuss strategies
on various issues. This, I believe that, could establish a prodigious efforts to improve the healthcare
standards of the country. This thought provoking platform also created a corporate social
responsibility among the healthcare professionals and their corporates to work diligently and make
adequate healthcare facilities available to the poor and needy population of the country. The IIHMR
University is committed to create health professionals with imbibed knowledge, skills and a positive
attitude.
rd
th
I am sure, as in the past, this conference will also surely generate many useful ideas and enlighten us
with better measures to improve health delivery system in India. It is also a learning platform for the
IIHMR students in planning, organizing and delivering the conference successfully.
I am obliged to the luminaries for being supportive by their presence and messages that they have
imparted. IIHMR University is privileged on having them here. On this auspicious occasion, I would
like to express my heartfelt gratitude towards all our eminent speakers from India and abroad for
taking out valuable time to share their knowledge on crucial topics. I am sure that the participants
will be learning a lot from these inputs and effective interactions.
I, once again, take this opportunity to congratulate the students, faculty and the conference
committee for their tremendous efforts to make this conference a mega event.
I convey my best wishes for the success of this prestigious event.
(S. D. Gupta)
12
Message
Its my immense pleasure to congratulate Institute of Health Management Research Jaipur for
organizing an International Conference on Universal Health Coverage - Road Map 2020 on
October 3-4, 2015.
I hope this conference will go a long way in bringing awareness in health care professionals about
latest trends in the field. The event will widen the understanding of students and faculty members
of various branches for innovative work and help them in bringing qualitative changes in the
management of Health and Hospital Care organizations.
I take this opportunity to compliment the organizers and give my best wishes for the success of the
event.
13
Sudarshan Jain
Managing Director
Healthcare Solutions
Abott Healthcare Pvt. Ltd.
Message
I am happy to learn that Indian Institute of Health Management and Research (IIHMR), Jaipur is
organizing a two-day international conference on Universal Health Coverage- Roadmap 2020.
We have made tremendous strides in the Healthcare & Pharmaceutical arena. This area is
knowledge driven and is at inflection point in our country. The theme chosen for the conference is
most relevant with respect to dynamic change in the Indian healthcare system. It is a time for the
healthcare and pharmaceutical professionals to assess the strength back and come up with
innovative way of thinking and implementing ideas to cater to the healthcare needs of the country.
I congratulate the Organisers for providing a platform for pharmaceuticals and other healthcare
leaders and professionals working in this area to share ideas, innovations, best practices and brain
storming on how we can achieve universal health care and way forward strategies for the benefit of
the society at large through interaction in this Conference.
I have no doubt that the thought provoking suggestions on increasing accessibility, affordability and
availability of healthcare in India made by the eminent speakers across the globe would be well
taken up to the policymakers and for further implementation by the authorities concerned for the
achievement of universal healthcare.
I wish the Conference a great success.
(Sudarshan Jain)
14
Message
It is a fascinating fact that our Institute, having been metamorphosed into University quite
gloriously, continues to be resilient and resonant. A strong bond created over the years by its
dedicated directors, deans, teachers, pupils, past pupils and well-wishers is undoubtedly the elixir
of this magnificent life. Its success bears out the truism that tough times never last; tough
institutions do.
I would like to quote Robert Frost
Two roads diverged in a wood, and I I took the one less traveled by, and that has made all the
difference.
I would like to thank our Director Dr SD Gupta for making all of us trek the one less traveled
15
Rajesh Varma
Director-HR
VPS Healthcare
Abu Dhabi, UAE
Message
It is a matter of immense pleasure to know that IIHMR University is organizing 20th Annual
International Conference-Pradanya under the theme Universal Health Coverage-Road map for
2020 on 3rd-4th October 2015 at Jaipur, India.
The theme of the conference indeed represents an agenda of topical interest. Pradanya 2015
represents a knowledge sharing platform with incredible scientific sessions, workshops and panel
discussions focusing trending challenges and innovative strategies in the goverance of healthcare.
IIHMR University, a pioneer organization in health sector continuous initiatives clearly reflects its
mission to improve the healthcare standards in national and global perspective.
I congratulate the organizing and scientific committee of the Conference and wish a grand success.
(Rajesh Varma)
16
Bijender Vats
Director - HR
MSD INDIA
Mumbai
Message
The conference theme is very apt and is need of the hour. Thanks to IIHMR for converging various
facets of the topic for fruitful and insightful dialogue. Feel privileged to be a part of healthcare
industry that touches lives of millions and of HR profession that touches careers of millions.
Bijender Vats
17
Joy Chakraborty
Chief Operating Officer
P.D. Hinduja Hospital & Medical Research Centre
Mumbai
Message
I am happy to know that IIHMR University, Jaipur is organising an international conference on
Universal Health Coverage Roadmap for 2020 between October 3th and 4th, 2015. The theme of
the conference is very appropriate with the need of the hour for our country and also adopted by
the Government for the benefit of larger society.
I am sure that the discussions and deliberations during this conference will be beneficial for the
participants and help all of us to develop some working plan to reach the goal by 2020. I want to
congratulate organisers for selecting and working towards the Alma matter.
IIIHMR as an institute has immensely contributed healthcare industry by producing many finest
healthcare leaders. I had the opportunity to interact and work with some of them. I am sure with the
back ground of research, education and training IIHMR will contribute the country in future too.
I wish you all for a very successful conference.
(Joy Chakraborty)
18
Message
I am happy to learn that IIHMR University, Jaipur is organizing two days event, 20thPradanya, an
rd
th
International Conference on Universal Health Coverage Road Map for 2020 on October 3 - 4 ,
2015. I am also delighted to see the theme of conference and topics incorporated in various sessions
regarding different issues revolving around healthcare system.
I congratulate the organizers on providing a platform to healthcare professionals working in this
area to share their ideas, innovations, how to protect it and brain storming sessions on how to reach
our mission by 2020 to provide better healthcare to the society at large.
I am confident that through two days sessions on various issues revolving around healthcare, the
emerging thought provoking suggestions on how to move forward for better healthcare by 2020,
would be taken up to the policymakers for effective implementation.
I convey my best wishes for the success of the conference.
19
Message
it gives me immense pleasure that IIHMR University, Jaipur is organizing this glorious International
Conference on Universal Health Coverage- Roadmap 2020.
Access to healthcare has been recognized as basic human right and call upon all nations to set this as
the prime agenda in their health policy. This has also been identified as major goal under Millenium
Development Goals and consequently Sustainable Development Goals as well.
I am sure this conference will be successful in the augmentation of the perspectives of healthcare
professionals in India and will encourage students and faculty members of various streams to create
a thinking lens and to analyze as creative thinkers. This will probably ensure to bring quality changes
in the management of healthcare and hospital care organizations for the provision of universal
healthcare.
Making the most of this opportunity I would like to appreciate the commendable work done by the
organizers and convey my best wishes for the success of this prestigious event.
20
Message
I deem it my fortune and privilege to be in a position to welcome all speakers, delegates and
members of the 20th International Conference - Pradanya 2015 with the theme, Universal
Health Coverage - Roadmap 2020 on 3-4 October,2015. This event is a prominent milestone for
healthcare managers, researchers & academicians and we IIHMR University, are proud to play host
this annual conference. We are certain that you will enjoy all the planned events, and we look
forward to meet you during the conference.
I fully acknowledge that the scientific sessions of the 20th Annual Conference - Pradanya 2015 will
reflect the evolution of Healthcare System Management, including state-of-the-art presentations
on various relevant topics.
Pradanya Conferences has always been a great venue for frank exchange of experience and
knowledge in a relaxed and convivial setting. We will continue this tradition at this 20th Conference.
I wish this conference brings together the Healthcare fraternity of National and International, and is
an excellent chance for networking. I welcome all Healthcare Professionals to join us at the
conference, to share and exchange ideas and to enjoy each others company. I wish everyone a most
beneficial experience.
Thanks & Regards
21
22
Our Mission
The IIHMR University is dedicated to the improvement in standards of
health through better management of healthcare and related
programmes. It seeks to accomplish this through management research,
training, consultation and institutional networking in national and global
perspective.
Thrust Areas
Program Management
Capabilities
Project Management
Survey Research
Program Evaluation
23
Organizing Committee
Top (Left to Right): Dr. Ajmal, Dr. Shubhankar, Mr. Banoj Mahanta, Dr. Akanshaa, Ms. Sneha Priya,
Dr. Sakshi Kushwaha, Dr. Priyanka Cherian, Dr. Risho Singh, Dr. Vikram Chopra, Mr. Kush Dua,
Mr. Chaitanya Dadhich.
Bottom (Left to Right): Dr. Vijay Pratap Raghuvanshi, Mr. Hem K Bhargava, Dr. Santosh Kumar,
Mr. Bajrang Lal Sharma, Brig (Dr.) S.K. Puri (Retd.), Dr. S.D. Gupta, Col (Dr.) Ashok Kaushik, Dr. P.R.
Sodani, Dr. Nirmal Kumar Gurbani, Dr. Suresh Joshi.
24
Limited innovations
Healthcare professionals are constantly finding the need to rethink operations management, funding and
financing, staffing issues, quality management and assurance. The healthcare industry is also striving to
enhance hospital design and integrate technology to improve healthcare service and delivery. Opportunity is
being created both by developments in healthcare industry itself as well as increasing awareness amongst the
people for their own well-being. The result is rise in spending on healthcare products and services of all kinds.
Taking into account the opportunities and challenges faced now a days, the health care industry aims at
improving the quality of life, diagnostic and treatment options, as well as the efficacy and cost effectiveness of
the healthcare through proliferation of innovations.
Based on the concept of need of innovations and governance in healthcare in India, the IIHMR University is
organizing an international conference on innovations in governance & strategies: reimaging healthcare in
India and will try to address the questions regarding the need for good governance and innovative strategies
for betterment of healthcare in India.
Mission: Ourmission is to put good governance in implementation of sound and innovative healthcare
strategies.
Conference Schedule
Pre-Conference Workshop
02nd October, 2015 (Friday)
IIHMR University, Jaipur
Time
Topic
Speakers
10:30 am 01:00 pm
10:30 am 01:00 pm
Healthcare Governance
10:30 am 01:00 pm
Healthcare Governance HR
Conference Programme
Day : 1
03 October, 2015 (Saturday)
rd
08:30 am - 09:30 am
Registration
09:30 am - 11:00 am
Inaugural & Theme Address - Dr. S.D. Gupta - President, IIHMR University, Jaipur
Chief Guest : Dr. Rakesh Kumar - Joint Secretary - MoHFW - GOI
Guest of Honour
Welcome Address - Dr. Ashok Kaushik
Conclusion of the Inaugural session/Vote of Thanks - Dr. Vijay P Raghuvanshi
Tea Break 11:00 am - 11:30 am
11:50 am - 12:10 pm
Dr. Chandrakant Lahariya National Professional Officer-Universal Health Coverage, World Health Organization
12:10 pm - 12:30 pm
12:30 pm - 12:45 pm
Mr. Sundeep Kumar - Head - Corporate & Public Affairs, Novartis India Ltd.
02:00 pm - 02:20 pm
02:20 pm - 02:40 pm
02:40 pm - 03:00 pm
03:50 pm - 04:10 pm
04:10 pm - 04:30 pm
04:30 pm - 05:00pm
Day : 2
04 October, 2015 (Sunday)
th
10:20 am - 10:40 am
10:40 am - 11:00 am
11:00 am - 11:30 am
Dr. Ram Narain - Executive Director, Kokilaben Dhirubhai Ambani Hospital, Mumbai
12:20 pm - 12:40 pm
12:40 pm - 01:00 pm
01:00 pm - 01:20 pm
01:20 pm-01:30 pm
02:50 pm - 03:10 pm
03:10 pm - 03:30 pm
Dr. Saumitra Bharadwaj - Vice President, Medica Hospitals Pvt. Ltd., Kolkata
03:30 pm - 03:45 pm
04:00 pm - 4:30 pm
Closing Ceremony/Valedictory
Summarization of Conference - Dr. Anoop Khanna, Professor, IIHMR
Guest of Honor
Address - Dr. S.D. Gupta, President, IIHMR
Vote of Thanks - Dr. Vijay Pratap Raghuvanshi
Healthcare Governance
Healthcare is an integral operational component of a society. Good health indices reflect the strength and
plethora of a society. Governance is increasingly seen as the basis for good practice, successful organizations
and ethical behavior. Good governance is central to enhancing performance in any field and Healthcare
system is no exception. Whether the health system is meeting its objectives or whether the resources are
being used appropriately and if the priorities of the government are being implemented, all pertains to
effective health governance. There are, however many issues and challenges which needs to be taken care
off. The low healthcare expenditure by the government at the national level and underutilization of the
resources has always remained an issue in Indian healthcare governance. In developing countries with poor
governance, as incomes rise, the private sector steps in to replace public service, as in India. Even the poor
select to pay significant amounts of disposable income to obtain private care, as public services are substandard
and underutilized. Thus the issue of healthcare governance cannot be neglected in order to upgrade the
accountability of the Indian healthcare system.
Conference Sessions
UHC-Equity Lens : Increase Access, Affordability and Availability in Healthcare
Universal health care, sometimes referred to as universal health coverage, usually refers to a health care system
which provides health care and financial protection towards healthcare to all citizens of a particular country.
It is organized around providing a specified package of benefits to all members of a society with the end goal
of providing financial risk protection, improved access to health services, and improved health
outcomes.Universalhealthcareisnotaone-size-fits-allconceptanddoesnotimplycoverageforallpeople
for everything.
Many people do not receive basic healthcare facilities when required and even if metro-healthcare facilities
availed, many of them are forced to enter the BPL (Below Poverty Line) zone. There are many reasons which
explain the troublesome question about the inability of the government to meet the UHC objectives. This
creates a necessity of a roadmap to the healthcare industry driving it towards UHC which in turn needs an
equity lens to increase accessibility and availability with affordability. Thus bringing everyone to a common
horizon from the healthcare perspective and thereby creating a healthy society.
Systems on all fronts i.e. availability, accessibility, affordability and finally the quality. Indeed it could be said
that quality is at the heart of medical practice.Whether you see patients at a hospital, private clinic, or other
setting, time is often limited. In order to make a patients visit efficient, a hospital needs to work on improving
the quality of service delivery by all means. This should be a continuous process coupled along with safety in
healthcare.Quality in healthcare is directly linked to patient safety and therefore it plays pivotal role in saving
of human lives.
Quality management standards include series like ISO 9000, 14000, 18000 and 22000. In this segment we
also cover quality tools like 5S, Kaizen, LEAN Health, Six Sigma, Balance Score Card etc. the government has
laid down a framework in the form of NABH for quality governance of hospitals based on above standards.
Operations Management
Operations Management involves the planning, scheduling, and control of activities that transform inputs
into finished goods and services. One reality that distinguishes operations management for the human service
industry versus the manufacturing sector is that services cannot be inventoried. Health services must be
provided on demand to the consumer.. As the size of a healthcare organization or a hospital increases, the
issues related to cost of medical treatments and quality of delivered care are likely to remain at the forefront.
Proper management of health care operations is essential for achieving operational excellence which is one
of the important ways of driving down costs of care while maintaining its desired quality. Operations
management covers all the healthcare functions that allow efficient healthcare delivery.
Delivering high quality and affordable healthcare to all its citizens is a huge challenge and in order to overcome
this, a sustainable management of all the operations in a prerequisite. The operations management includes
materials management, use of technology and proper use of capital. Nevertheless, there arise issues and
challenges which need to be addressed appropriately.
10
Topic
Code
Institution
B6
B7
B8
IIHMR, Bangalore
B9
IIHMR, Bangalore
IP15B01
IIHMR, Jaipur
IP15B03
IIHMR, Jaipur
IP15B10
IIHMR, Jaipur
IP15B11
IIHMR, Jaipur
B10
IIHMR Bangalore
B13
Punjab University
B14
IIHMR Bangalore
B17
No.
Topic
Code
Institution
IP15B12
IIHMR Jaipur
IP15B13
IIHMR Jaipur
IP15B14
IIHMR Jaipur
IP15B15
IIHMR Jaipur
IP15B16
IIHMR Jaipur
IIHMR Jaipur
IP15B18
IIHMR Jaipur
IP15B20
IIHMR Jaipur
B1
Punjab University
B2
B3
Punjab University
B4
SMIT, Ankushpur
IP15B05
IIHMR Jaipur
IP15B06
IIHMR Jaipur
IP15B07
IIHMR Jaipur
IP15B08
IIHMR Jaipur
IP15B09
IIHMR Jaipur
12
No.
Topic
Code
Institution
IP15B22
IIHMR Jaipur
IP15B19
IIHMR Jaipur
B11
B12
B19
IP15B04
IIHMR Jaipur
13
Code
Institution
IP15A016
IIHMR, Jaipur
IP15A017
IIHMR, Jaipur
3. Emerging Trends:
Health Insurance in the Medical Tourism
IP15A019
IIHMR, Jaipur
IP15A020
IIHMR, Jaipur
IP15A022
IIHMR, Jaipur
IP15A030
IIHMR, Jaipur
IP15A024
IIHMR, Jaipur
IP15A025
IIHMR, Jaipur
A3
PGIMER,
Chandigarh
A4
PunjabUniversity
A5
Punjab University
A7
IIHMR Bangalore
IP15A033
IIHMR, Jaipur
IP15A034
IIHMR, Jaipur
IP15A035
IIHMR, Jaipur
IP15A036
IIHMR, Jaipur
14
No. Topic
Code
Institution
IP15A037
IIHMR, Jaipur
IP15A038
IIHMR, Jaipur
IP15A039
IIHMR, Jaipur
IP15A040
IIHMR, Jaipur
IP15A041
IIHMR, Jaipur
IP15A042
IIHMR, Jaipur
IP15A043
IIHMR, Jaipur
IP15A044
IIHMR, Jaipur
IP15A045
IIHMR, Jaipur
IP15A046
IIHMR, Jaipur
IP15A047
IIHMR, Jaipur
IP15A048
IIHMR, Jaipur
IP15A050
IIHMR, Jaipur
IP15A051
IIHMR, Jaipur
IP15A052
IIHMR, Jaipur
IP15A053
IIHMR, Jaipur
IP15A055
IIHMR, Jaipur
IP15A056
IIHMR, Jaipur
15
No. Topic
Code
Institution
IP15A058
IIHMR, Jaipur
IP15A059
IIHMR, Jaipur
37. Blue Ocean Strategy for Corporate Hospitals Mobile Healthcare Services
IP15A063
IIHMR, Jaipur
A9
Amity University,
Rajasthan
A1
IIHMR Delhi
A2
PGIMER,
Chandigarh
B5
IIHMR, Delhi
IP15A032
IIHMR, Jaipur
IP15A027
IIHMR, Jaipur
IP15A028
IIHMR, Jaipur
IP15A031
IIHMR, Jaipur
IP15A-001
IIHMR Jaipur
IP15A-002
IIHMR Jaipur
IP15A-003
IIHMR Jaipur
IP15A-004
IIHMR Jaipur
IP15A005
IIHMR Jaipur
16
No. Topic
Code
Institution
IP15A006
IIHMR Jaipur
IP15A007
IIHMR Jaipur
IP15A009
IIHMR Jaipur
IP15A010
IIHMR Jaipur
IP15A012
IIHMR Jaipur
IP15A013
IIHMR Jaipur
IP15A015
IIHMR Jaipur
IP15A066
IIHMR Jaipur
IP15A067
IIHMR Jaipur
IP15A068
IIHMR Jaipur
IP15A069
IIHMR Jaipur
IP15A062
IIHMR Jaipur
IP15A057
IIHMR Jaipur
17
Screening for Work related Repetitive strain injuries (RSI) in Young adultsOccupational Therapy Perspective
Dr. Preetee Gokhale
(Master of Occupational Therapy-Neurosciences) Occupational Therapist at Goenka and Associates Educational Trust, Mumbai
Rationale:
Work-related musculoskeletal disorders (WRMSDs) are worldwide problems that affect worker class in a
wide variety of occupations, causing workers disability. Poor posture at work is a major cause of back pain,
workplace stress, repetitive strain injury; resulting in lost time, reduced productivity, poor employee health,
low morale, and higher costs. Thus, early screening of employees is necessary to prevent &/or lower the
incidence of work related Repetitive strain injuries.
Objectives:
To identify early signs and symptoms that can lead to RSI and suggest ergonomic guidelines to employees at
risk for acute low back pain using Preventive Occupational Therapy.
Methodology:
125 randomly selected healthy individuals were screened using Acute low back pain screening questionnaire
and Fatigue Severity Scale.The study was conducted on 100 individuals, both males and females in the age
group 20-40 years from two Private Banks and one Government organisation. Subjects with medically
diagnosed history of low back pain or any other orthopaedic problems were excluded from the study. 25
subjects dropped out and data of 100 subjects was analysed statistically.
Key Findings:
Mean age of the sample was 29.0 years The sample was inclusive of 24 males and 76 females. Mean score on
acute low back pain screening questionnaire was 90.82
And 30 individuals scored more than 105 which suggest they were at risk for low back pain.
The data also suggested that intensity of low back pain increases with advancing age.
The mean fatigue score on Fatigue severity scale was 30.88 which were related to physical as well as mental
stress experienced at work by the employees.
Conclusion:
Employees working for more than 8 hours a day and attaining a sustained posture for long are at a high risk
of developing Work related musculoskeletal disorders.
Thus, regular screening of employees is essential for the benefit of employee health and work productivity.
Key words:
Work related musculoskeletal disorders, Repetitive strain injury, Back pain, Fatigue
18
Code - B7
Rationale:
Family caregivers are essential partners in the delivery of complex health care services and this study
exemplifies the associated caregiver burden and stress during cancer treatment. Unlike professional caregivers
such as physicians and nurses, informal caregivers, typically family members or friends, provide care to
individuals with a variety of conditions, most commonly advanced age, dementia, and cancer. As more and
more evidence suggests that caregiving is deleterious to ones health, increased attention is being paid to the
day to day well-being of caregivers. Compared to non-caregivers, caregivers oftenexperience psychological,
behavioural, and physiological effects that can contribute toimpaired immune system function and coronary
heart disease, and early death.
Objectives:
Screening for early signs of distress and impaired Quality of Life in caregivers.
Methodology:
70 caregivers (Relatives of Cancer patients) were screened for distress using Caregiver Burden scale and were
assessed for Quality of Life using Caregiver Quality of life-Cancer Questionnaire. There were 20 drop outs.
The data of 50 subjects was statistically analysed.
Key Findings:
The mean age of the selected sample was 42 years. The scores on the Caregiver burden scale suggest high
level of distress in relatives of cancer patients in all the scale components namely burden, disruptiveness,
positive adaptation and financial concerns. Also, there score onCaregiverQuality of life- Cancer
QuestionnaireSuggested reduced Quality of life in these individuals.
Conclusion:
The distress was more in older caregivers, especially spouse of cancer patients. The distress had direct impact
on caregivers Quality of Life which was decreased. If the signs of distress are tapped early, it can be beneficial
in reducing or stabilizing depression, burden, stress and role strain. Thus, regular screening can help health
professionals to educate and counsel caregivers to lead a healthy life using various individualized interventions.
Key words:
Distress, Caregiver burden, Quality of Life
19
Code - B8
Introduction:
More than two decades of research has shown that sexual violence and intimate partner violence within or
outside marriage are major public health problems with serious long-term physical and mental health
consequences, as well as significant social and public health costs. Internationally, one in three women have
been beaten, coerced into sex or abused in their lifetime by a member of her own family. However, in a
conservative society like India, talking about sex and other gynecological problems of women is a taboo.
Across all strata of the society, these issues are not discussed with the girls before marriage.In this regard a
culture of silence prevails that inhibits women from revealing their private problems to others due to various
social factors. Development and use of IEC material along with active participation by the community ensures
delivery of appropriate information and knowledge to people which in turn empowers them to make informed
decisions about their life. Health care workers in rural areas act as change agents and are trained to
communicate the information contained in these materials to the community.
Objective:
To empower and engage the Self Help Groups (SHGs) women against violence during sex/ intimacy with the
use of IEC strategy so that they can act as change agents for others women in the community.
Methods:
This was multi-centric Action Research Demonstration Study. Funded by Indian Council Of Medical Research
(ICMR), to sensitize, mobilize and engage women through the SHGs, to take care of their reproductive health,
including cervical cancer, and act as change agent for other women in the community. The Kolar district in
the Karnataka was the primary intervention site from Kolar district an intervention taluk (Bangarpet)was
selected from eleven taluks of Kolar district by simple random sampling geographical, climatic, development
and health indicators was selected as control by adopting purposive sampling. As an intervention, a total of
fifteen workshops, each consisting three days, targeting 75 SHGS in each were conducted in Bangarpettaluk.
Sample size was 400 household (200 from Bangarpet and 200 from Malur) of SGH women were interviewed
for baseline and end-line each.
Results:
The intervention was found effective in the form of a significant change in the level of perception among SHG
women that violence during sex or intimacy is abnormal, improvement in awareness about womens right to
decline the partner form having sex while encountering violence from him and significant reduction in their
experience of facing violence during intimacy or sex in last one year.
Conclusion:
This study provides experience of the feasibility; efficacy and impact of health education interventions and
an insight into the development and implementation of effective interventions against violence during sex or
intimacy in India.
20
Code - B9
An educational intervention to empower and engage the SGH women [Post Graduate
Diploma in Healthcare Management, Institute of Health Management Research,
Bangalore] against cervical cancer
Dr. Neeraja Lakshmi, e-mail: drneerajaangel7@gmail.com
Dr. Rachana Ramesh Chandra Amaliyar, Dr. Manoj Kumar Gupta
Introduction:
Cervical cancer is second most frequent cancer among women next to breast cancer in India. Control and
prevention of cervical cancer largely depends upon the level of awareness of the disease itself. Self-help
groups women are seen instruments for empowering women in the community. Realizing this, it was
hypothesized that if the strategy that if the knowledge of the study population, then this strategy may be a
financially sustainable and practicable method for creating awareness about cervical cancer in rural India.
Objective:
To empower and engage the SHG women against cervical cancer by creating awareness and sustaining interest
through lesson plans in the IEC material so that they can act as change agents for other women in the
community
Methods:
This was a Multi-centric Action Research Demonstration Study which was intended to sensitize, mobilize
and engage SHG women as agents for generating awareness among village women on reproductive health,
including cervical cancer. The study was conducted for a period of one and half year (from May 2012 to
October 2013). From Kolar district an intervention taluk (Bangarpet) was selected from eleven taluks of Kolar
District by simple random sampling. To establish an adequate counterfactual, a nearby taluk (Malur) with
similar geographical, climatic, development and health indicators was selected as control by adopting purposive
sampling. As an intervention, a total of fifteen workshops, each consisting three days, targeting 75 SHGS
were conducted in Bangarpettaluk. Sample size was 400 households (200 from Bangarpet and 200 from
Malur) of SHG women were interviewed for baseline and end line each.
Results:
Only 38.5 percent of SHG women (49.7 % in intervention taluka and 27.5 % in control taluk) reported that
they have ever heard about cervical cancer. With the help of planned intervention almost all (98.0%) the SHG
women could make aware about cervical cancer in the intervention taluk. Besides that, this educational
intervention could also make significant improvements in their awareness level about the various symptom
of cervical cancer like abdominal pain, abnormal vaginal bleeding, vaginal discharge and pain during sexual
intercourse. Majority (95.9%) of the SHG women in Bangarpettaluk and nearly two thirds in Malurtaluk were
considering cervical cancer as a lethal disease. On the other side of coin, nearly 15 per cent of the respondents
were either not aware or were not considering cervical cancer as life threatening condition. This intervention
was successful to change their wrong perception or unawareness in this regard, which is very crucial to
change the mind-set in the direction of prevention efforts and treatment seeking behaviour of the community.
Conclusion:
Despite the government efforts to increase the awareness about cervical cancer in the community, the
awareness in the study area was highly unsatisfactory and the planned intervention could bring significant
changes in this regard.
21
Code - IP15B01
A study on people availing the Cardiac treatment and out of pocket expenditure
burden on their house hold in Jaipur
Vikash Kumar, Md. Ataullah, Kumari Swati Sinha
Introduction:
Out of pocket expenditure in health is a main component of the house hold expenditure of health services
users and sources of concern especially for India. About 80% of public financing of healthcare comes from
state government budgets, 12% from the union government and 8% from local government of the total
public health budget. About 10% is externally financed in contrast to around 1% prior to structural adjustment
loans from the World Bank and other agencies. Private financing is the mostly out of pocket with a large
proportion, especially for hospitalization which is coming from savings account Countries having universal or
close to universal access to healthcare generally have single payer mechanisms in which either a single
autonomous public agency or a few coordinated agencies pool resources to finance healthcare.
Rationale:
In India, health-care expenditures aggravate poverty, resulting in about 39 million people falling into poverty
every year as a result of such expenditures. Therefore, identification of the key challenges for achieving the
equity in health service provision, equity in financing and financial risk protection in India is an immediate.
The Planning Commission too accepts that OOP to pay for healthcare costs is a growing problem in India.
(Times of India - May 17, 2012). It says 39 million Indians are pushed to poverty because of ill health every
year. In urban areas, 20% of ailments were untreated for financial problems the same year, said a recent
study in the Lancet. About 47% and 31% of hospital admissions in rural and urban India, respectively, were
financed by loans and sale of assets.
Objectives:
To assess the out of pocket expenditure on house hold in cardiac treatment in Jaipur district.
To analyze the shift in economic transition while availing the cardiac treatment from various hospitals of
Jaipur district.
Methodology:
Study type: Descriptive study
The convenient sampling has been done having sample size 100.
Study area: Two tertiary hospitals one government hospital (Swai Maan Singh hospital) and another
private hospital Narayana Hrudayalaya of Jaipur district.
Study tool: A pre designed, pre tested, semi structured questionnaire with open ended questions.
Code - IP15B03
urban hubs in which they concentrate high-quality talent and sophisticated equipment. Spoke facilities are
then arrayed around the hubs to reach underserved patients in far-flung towns and villages. It put greater
emphasis on the spoke rather than the hub. The Spoke facilities may consist of telemedicine centre, Daycare centres and small hospitals pertaining to that area. In his case, that means a focus on ambulatory care
units and other outpatient facilities. The government can support this model by increasing penetration of
health insurance as well as reducing tax on medicines, providing land at subsidized rates and collaboration
with companies for providing medical equipments at lesser rates in India, etc.
Conclusion:
Maximising value at the lowest cost possible should be the aim of healthcare providers. Some innovative
Indian for profit health care providers have successfully proven that the delivery of high quality, low cost
medical care is not a myth. A comprehensive model can help in universalizing low cost medical care which
will not only reduce the cost of care but also minimize the hospital expenditure.
Code - IP15B10
Secondary Data:
a. Information about the previous appointment system was obtained and analyzed through the Bay
Management Report of March 2015.
b. Information about Qikwell was analyzed with the help of Qikwell monthly and daily generated report,
provided by Qikwell
Key Findings:
Based on the root cause analysis done, it was evident that the implementation of a new software based
technology experiences a lot of glitches operationally.
Proper training of the patient care provider is mandatory for the success of the implementation of the
software.
Software should have a leeway and scope for customization according to the client usage and comfort.
Software based appointment systems helps in efficiently managing the patient queue.
Conclusion:
An operationally well working appointment system helps to manage the patient queue in the most efficient
way possible. It gives a psychological satisfaction to the patient that he is going to be seen by the doctor on
time, this in turn acts in favor of the organization and helps in retaining its patients. It acts as an important
tool in positioning themselves in the patients minds since it act as a parameter on which patients judges an
organization. As rightly said
Time is the scarcest resource, and unless it is managed nothing else can be managed Peter Drucker
Code - IP15B11
Objective:
To explore the effectiveness of Enterprise Resource Planning system on the patient, human resource and
supply chain management of government hospitals.
Methodology:
This is an exploratory study to explore the need of Enterprise Resource Planning system in the government
hospitals in respect to different contexts such as monitoring of supplies, patient and human resource
management. Data was gathered from the reviewed information extracted from the contribution of different
authors who are interested in understanding the effectiveness of ERP system in healthcare sector. It was
then structured, analyzed and synthesized into the current article.
Conclusion:
The review indicated that the implementation of Enterprise Resource Planning in the government hospitals
will help in streamlining and standardizing the process of human resource, supply chain and patient
management, thereby leading to significant reduction in the operational cost and improving the efficiency
and effectiveness of the system.
Keywords:
Enterprise Resource Planning, healthcare sector, government hospitals
Code - B10
Introduction:
With the adoption of western life style the problem of overweight and obesity is gradually increasing in
adolescent age group. While the problem of malnutrition is still persisting continually in the country and thus
leading to double burden of malnutrition. With this background this study was planned to assess the nutrition
status of adolescent girlsage(10-19) in rural area of Bellarydistrict, Karnataka.
Method:
This study was conducted for 4 months (form May 2015to august 2015). This was a community based crosssectional study in which anthropo-metricmeasurements were done of adolescent girls in the study area. A
total of 400 adolescent girls where included in the study. BMI of study subject where calculated and assessment
of nutritional status was done in reference to WHOs BMI percentiles. The data was analysis using SPSS v.16.
Results:
On Appling the BMI percentile criteria nearly 46% of adolescent girls where underweight. The proportions of
under nutrition where significantly (P <0.05) higher in early adolescent age group, girls belonging to Muslim
religion and who were illiterate.
Conclusion:
Besides having concentrated nutritional interventional efforts, the malnutrition was prevalent in study area
among adolescent girls and there is need and scope to tackle this issue on priority bases.
26
Code - B13
Assessment of Knowledge, Attitude & Practices About Oral Health Care Among
Multipurpose Health Workers of Block Sangat, District Bathinda, Punjab
Kaur Harmanjeet* (shinharman@gmail.com), Gupta Saurabh Kumar*, Sharma M.K.**
*Students of MPH 2nd year (Panjab University,Chandigarh), **Assistant Professor (Centre for Public Health, Panjab University)
Introduction:
In developed countries the decreased prevalence of oral diseases is due to paradigm shift of oral health
services from being mainly curative to preventive care. In under-resourced countries, i.e. developing countries,
the use of non-oral health care workers in the promotion of oral health, can contribute substantially to
improving oral health and the adoption of a multidisciplinary team approach in oral health is highly
recommended.
Aims & Objectives:
Aim - The aim of the study was to assess the knowledge, attitude and practices about the oral health care
among Primary Health Care workers (Multipurpose Health Workers).
Objectives To assess the level of knowledge about basic oral health care among Multi Purpose Health Workers
To know whether they get training on oral health care and they practice it or not
27
Code - B14
Introduction:
Epidemiological transition has given the opportunity to grow the traditional system of medicine across the
world. Indian healthcare system which is already famous for providing quality of medical services at affordable
cost as compared to developed countries took advantage of this opportunity and created a basket of services
by merging traditional medicines in existing allopathic system to attract patients across the borders.
Government has made efforts in the direction of promoting medical tourism in the country and this has been
fueled by the private players both nationally and internationally. Recently this medical tourism has proved a
major growth factor for expansion of Indian economy. India has a 2% share of global health tourism market.
However, the growth in this sector is underscored in terms of market share and cost advantages due to
various challenges. There is also a need for proper diversion of revenue by a clear cut mechanism to strengthen
the nations healthcare sector.
Objectives:
This study tries to explore potential of medical tourism industry in India and an overview why India has
emerged as destination for medical tourism.It tries to evaluate strategies in order to promote medical tourism
in the country. The study has also tried to analyze the Indian medical tourism industry based on its strengths,
weaknesses, opportunities and threats in its current state.
Methods:
The following paper is based on articles collected from various search engines like Pub Med, J- Gate, Google
scholars, proquest and websites pertaining to medical tourism, from 2008 onwards. A systematic review was
done pertaining to the pre-decided objectives.
Result:
The success of medical tourism in India lies in its cost advantage, shorter waiting periods, technical expertise
and cutting edge technology. In order to promote medical tourism in the country, the government of India
has introduced a new category of medical visa (M visa), and campaigns such as Incredible India!, wellness
campaigns. Further, at state level, associations like Bangalore International Health City Corporation have
been initiated by the Government of Karnataka. India covers high level of tertiary care at affordable costs
without compromising on service quality. Availability of alternatives such as yoga, meditation, Ayurveda and
other systems of medicine, provide a strong opportunity to India in order to boost medical tourism.
However, India lacks in: uniform pricing policies in hospitals, co-ordination between healthcare and tourism
industry and hygienic conditions. Thus, it is being threatened by competing countries like Thailand, Malaysia,
Singapore and Phillipines.
Conclusion:
Although India has been successful in medical tourism, there is still a need to put efforts to handle weaknesses
and threats. Besides that, a mechanism to divert the revenue generated through medical tourism, should be
in place, to provide affordable and quality healthcare for the betterment of the community.
Key words: Medical tourism, quality, affordability, healthcare industry
28
Code - B17
Code - B18
Objective:
To evaluate patient reported adverse outcomes in type 2 diabetes mellitus with or without co-morbidities in
South India. Mainly to contact the study subjects using mobile phones, to record patient reported adverse
outcomes including ADR, AE and Unresolved Condition, to ensure medication adherence and to evaluate the
role of active surveillance in reporting of events.
Methods:
This Pharmacovigilance study was a prospective Cohort study design with 3 follow ups on active surveillance
to improve the passive reports form diabetic patients who are taking medicine from BGS GLOBAL hospital.
We included ADR, AEs, unresolved problems and medication adherence in surveillance to conduct PROs.
Results and Discussion:
Data on 133 diabetic patients were included in the study and data were collected for first 3 months and
followed by 3 active surveillance. Totally we our tem got 171 outcomes, (126) (73.68%) was through Active
surveillance and (45) (26.31%) was through Passive surveillance. Active surveillance repots were received
while an interventional enquiry as passive reports was received voluntarily. Many patients are interacted
with us for asking counseling regarding diet, exercise and medial information in regular follow ups. They are
totally 35, in which 9 diet, 6 exercise, 17 medical information and 3 other.
Conclusion:
We expected more passive reports from patients but very few are shown interest to report and share their
medical information with medical staff. We can conclude that many of the patients in line of medical adherence
are risk zone, can chance to exposure ADR. By the study our team says that, its very difficult to improve and
apply PROs system in developed areas likeBangalore, Hyderabad, and Chennai. Because patients dont bother
about medical induced problems and they wont show any interest and responsibilities in reporting. Patients
need to encourage and given value added basic information and tips in process of reporting in medical induced
issues. In future we are planning to provide education to patients along with leaflets to improve patients
reported outcomes system for better patients medical improvement.
Key Words:
Diabetes, Glibenclamide, patient reported outcomes, active surveillance, and passive surveillance
30
Code - IP15B12
31
Code - IP15B13
professional society or other medical organization should not accept any grants that are tied to conditions
that could provide a marketing advantage to the donating company.
The bottom line is that in their relationships with industry, health professionals must be focused exclusively
on scientific purposes, not marketing tactics. The government must aggressively target the pharmaceutical
and device industrys marketing practices to physicians, as well as physicians themselves in some instances.
Code - IP15B14
Cause Related Marketing: Impact and Perception on Over the Counter drug
consumers
Kush Dua; Bhavana Ghughtyal, Dr. Sakshee Kushwaha
Cause Related Marketing (CRM) a strategy in use since 1974 is a marketing strategy wherein a product/
service/brand or a company is marketed in association with a designated cause. This cause is usually a
problem that is prevailing in customers setting. The cause can range from being a social one like women
empowerment, child welfare, health and hygiene, environmental like global warming, wildlife conservation
or even abstract motivations like friendship, family bonding, patriotism etc. according to IEG Sponsorship
Report, Cause sponsorship is predicted to reach $1.92 billion in 2015, a projected increase of 3.7% over
2014.
Cause Related Marketing is a successful strategy as far as branding and marketing of segments like FMCG but
it a relatively new concept as far as Over The Counter drugs segment is concerned. Therefore the study was
carried out with an aim To identify Over The Counter consumers perception towards Cause Related Marketing;
To determine the impact of Cause Related Marketing on buying behavior of Over The Counter consumers
and To identify a prominent factor that motivates a consumer to opt for a brand associated with Cause
Related Marketing.
A Descriptive (Cross-sectional) research design was selected for which, a structured questionnaire on 5 point
scale was constructed and administered to a total 100 respondents including both the gender and across
four different age groups. Approximately 66% of respondents were found to a have a positive perception
towards Cause Related Marketing. As far as impact was concerned, 55% of respondents were found to switch
to a brand associated with Cause Related Marketingand companys involvement in supporting a social cause
and a company which gives preference to a Local cause instead of International one were found to be the
prominent factors motivating consumers to opt for a brand associated with Cause Related Marketing.
It was concluded from the study that though respondents of different age groups had a positive perception
towards Cause Related Marketing and 88% of respondents believed that every organization should be involved
in supporting a local cause, still there is a population (45% respondents) who consider Cause Related Marketing
to be merely a marketing strategy. A need for creating awareness for Cause Related Marketing was therefore
observed.
33
Code - IP15B15
Palliative care : Reconceptualising death It isnt about dying, its about living
Dr. Priya Bhat, Dr. Priyanka Bhat, Dr. Priyanka Sharma
Introduction:
Palliative care doesnt deliver on its aim to value people who are dying instead making death and dying a
natural part of life. It is an important and essential part of cancer care therapy and 12th five year plan makes
a special provision for it. Atleast 10% of the budget needs to be earmarked for it. In April,2008 Kerela became
the first state in India to announce a palliative care policy. Effective palliative care services needs to be
integrated into the existing health system at all levels of care, especially community and home based care is
the need of the times.
Objective:
To determine the prevalence of pain among cancer patients.
To explore different palliative care interventions for pain alleviation in cancer patients
Rationale:
In India, every year 6 million patients are estimated who need palliative care and these figures are likely to
grow because of increasing life expectancy and a shift from acute to chronic illnesses. It is estimated that
around 60% of people dying annually will suffer from prolonged advanced illnesses.
Methodology:
A cross sectional descriptive study was carried out on cancer patients in a cancer hospital in Jaipur for a
period of two months. A systematic literature review was carried out and a questionnaire was prepared.
Key findings:
From the study it was found that around 52% to 77% patients suffered from pain in the terminal stages. Also
from the literature review we came to know that around 24% to 60% patients on active anticancer treatment
suffered from pain.
Conclusion:
The palliative care is not merely a treatment, it is what a terminally ill persons want at the end of their lives.
Palliative care is an example of how health services can go well beyond the biomedical model of health and
can be a compassionate tool for terminally ill patients to live with dignity and accept death as an inevitable
part of life.
34
Code - IPB15016
To determine the existence of any bottlenecks in the working strategies of Integrated Nutrition Project.
Methodology:
A cross sectional descriptive census study was carried out using a structured questionnaire and anthropometric
measurements for height and weight. The primary data on 280 children is obtained by directing the
questionnaires at the mothers or care takers of the children.
Data thus obtained was analyzed using WHO Anthro software.
Key Findings:
Based on the review of data obtained from the study, clear evidence for the following exists:
A noticeable uptake of antenatal care services by availing the facilities at immunization camps especially
consumption of vitamin A and Iron Folic Acid supplements.
Improved nutrition status of children enrolled at balwadis when compared to children who do not go to
balwadis.
Adoption of soft WASH (water and sanitation hygiene) techniques by the respondents.
Conclusion:
INP has been adequately placed to address the major causes of malnutrition. More attention has been laid
on increasing the coverage and distributing food as compared to quality of services and changing home
based feeding patterns, somehow limits the impact of the programme. Immediate measures needs to be
taken to bridge the gaps existing in the policy intentions of the programme and its actual implementation.
Continuous strengthening the programmatic link between service delivery (balwadis)and community
participation (children enrollment at balwadis)may further enhance the reach of the program.
35
Code - IP15B17
Health Financing and Health Insurance - A study on BRICS Nations with special
reference of India
Dr. Naveen Kumar, Dr. Narendra - IIHMR University Jaipur
Universal Health coverage, as a concept, is about people having access to needed health care without suffering
financial hard ship, thus, encompassing improvement in access, quality and financial protection. Indias health
sector has been challenge by overall low level of public financing, entrenched accountability issues in public
delivery system and persistence dominance of out of pocket expending. For reducing financial hardship of
the people and to make health care delivery a accessible and affordable process, Health insurance is a viable
alternative available to policy makers for reducing cost of healthcare.
In India due to high medical expenses, out of pocket expenditure on healthcare is very high,which leads to
the exclusion of a large section of the population from availing quality healthcare services .Now onward
effective distribution channel and a good network of banking services in Tier 2 and Tier 3 cities will enhance
the insurance penetration in these cities. Today Good and attractive health insurance scheme are available in
market, but various issues like uniformity in various company policies regarding benefits, waiting periods,
age entry ,exclusions etc, required to be addressed. With the changing consumer behavior, insurance industry
is coming with many innovativeproducts targeting specific disease, age, area, etc, toattract more stakeholders
in the insurance sector
Rationale:
To study the out of pocket expenditure in India and other BRICS nations on healthcare and to do an analyses
of health insurance to reduce the cost of healthcare financing
Objectives of Study:
- To identify the Private prepaid plans as a percentage of private expenditure on health
-
To find out State Wise Health Insurance Penetration and Density in India
Methodology:
Secondary data from 2005-2013 on National Health Account and Health Insurance data taken from WHO
portal of National Health Account, and IRDA Publication and was entered in Microsoft Excel for analysis.
Firstly the raw data was organized and was checked for completeness and consistency after data cleaning
data was analyzed using appropriate statistical methods in Microsoft Excel.
Findings:
Health expenditure as a share presented in this table with various regions, Global and India. Total expenditure
on health on percentages of GDP in India all most not to much differ from 1995 to 2012 better than south
East Asia region but lower than Africa and Global, see Government expenditure on health as a percentage of
total expenditure on health its increase 7.1% but lower than Africa and Global ,Private expenditure on health
as a percentage of total expenditure on health its reduce by govt. efforts by good scheme and preventive and
ability of public health facility, Out of pocket expenditure as a percentage of private expenditure on health its
to high than other 40% above than global ,reduce 5% its good than other , in private prepaid plans as percentage
of private expenditure on health its increase than 1995 to 2011 but see global % ,so insurance sector lots of
opportunity to grow in market in India.
36
Conclusion:
In last five years ,Health insurance sector has made a significant progress in India, Private players in insurance
sector are growing fast by doing lots of innovations in aspect of customer behavior, product innovation and
market research. As compared to other BRICS nations our penetration and density is low but its growing
significantly from last 5 years, still lots of new initiatives are required like In aspect of universal health coverage
the RSBY policy should be expanded and its premium should be rationalized to improve the insurance
penetration, Comprehensive health insurance policy covering both life and non-life aspect of insurance should
be implemented on priority basis and new innovative schemes like family floater plan providing comprehensive
health insurance coverage should be promoted.
Code - IP15BI8
To compare and critically analyses the State-wise variations in Brain Death Declaration.
To assess the future scope of Cadaveric Transplant based on a survey at a tertiary care hospital ofNew
Delhi.
to take care of the majority of demands of kidneys, liver, heart, other essential organs and tissues. Brain
Death Declaration is discussed below as: Origination, Types and Sources, Present Scenario, State wise
comparisons in India, Issues and Challenges and Medico legal Implications
Conclusion:
Currently, THOA has put leverage to various legal and ethical challenges that led to more ease of cadaveric
donation.State Level and National Level Organ Registry Systems are being formed.National Organ Donation
Dayconcept with Donation Cards has been introduced. There is a strong need for NGOs and Community
Participating Bodies along withinclusion of Medico legal cases.
Key words: Brain Death Declaration, THOA, Non-heart beating donors
Code - IP15B20
Conclusion:
Billing related errors is a common finding in the hospitals but this is directly affecting the patient and the
hospitals financially. Errors in the billing is related to the medication charges, they can occur at any stage of
medication process: at dispensing and administration level.
Code - B1
Rationale:
Disasters have an uncanny ability to bring to the forefront vulnerabilities of systems, structures, processes
and peoples which in turn cause large scale damages; and hospitals are no exception in this matter. In the last
two decades, countries across the world have suffered a huge loss of confidence, as well as economic losses
on account of damages incurred by hospitals from disasters. On the behalf of that Hospital Safety Audit was
conducted in 16 district hospitals and 3 medical colleges of Chhattisgarh State. The audit was conducted by
State Health Resource Center, Raipur Chhattisgarh Facilitated by Directorate Health Services, Chhattisgarh.
The audit aimed to know the disaster safety levels may be external or internal of hospitals and to give
recommendations to improve the same in government hospitals. This assessment in hospitals is first such
initiative in Chhattisgarh.
Key objectives:
1. To assess the level of preparedness of district hospital for disaster management
2. To identify gaps in Structural, Non-structural and Functional parameters
3. To give recommendation for further improvement of disaster preparedness in district hospitals
Methodology:
A cross sectional study was conducted during a period of 22 days in month of June and July 2015, in 16
districts hospital and 3 medical colleges hospital of Chhattisgarh. Data was collected on the basis of structured
questionnaire (WHO safety checklist) filled with the help of hospital consultant or authorized person of district
hospital. Study based on check list which includes (structural, non structural and functional) part total no. of
question is 19(major points). Data collected and analyzed by Microsoft Excel.
Key findings:
Results shows that there is no system of planning, monitoring, control and coordination during any type of
disaster (external or internal). There are no procedures developed that are to be followed in case of a serious
and imminent danger. Employees are not provided with any information on dealing with such eventualities
and responsibilities.
Conclusion:
To improve safety levels in hospital, there is a need of better management regulation, fix possible sources of
fire that are through electrical wirings, equipments and safe storage of acids, basis and chemicals in
laboratories, and training of staff on disaster management, possible mitigation measures that could be taken
including usage of fire extinguishers, water sprinklers and putting up of fire alarms. The improvement in
workplace regulation, formation of protocols and responsibility sharing among the staff can go a long wayin
mitigating the risks arising out of various hazards and in preventing such disasters.
39
Code - B2
Abstract:
With a population of approximately 1.3 billion, the second most populous country in the world also leads in
sharing the global burden of diseases. There is a huge momentum in the global healthcare industry with
regards to Universal Health Coverage. The planning commission of India has constituted a High Level Expert
Group (HLEG) on Universal Health Coverage (UHC) in late 2010. The sole purpose was to develop a model for
availability of easily accessible and affordable health care to all Indians. Though the prime objective of this
initiative was financial protection it was established that the delivery of Universal Health Coverage also needs
the availability of adequate healthcare infrastructure, skilled health workforce and access to affordable drugs
and technologies.
A strengthened health system under Universal Health Coverage will result in better outcomes. Increased use
of Information Technology to link health care networks will improve health surveillance in the country with
the establishment of a health information system that will generate valuable data on various health and
disease trends and outcomes which can be used for effective policy initiatives. Developing a robust system
by integration of technology will ensure access to essential drugs, vaccines and medical technology by
enhancing their availability and reducing cost to the end user.
This paper is an attempt to bring forth the significant roles; technology can play in healthcare reforms under
Universal Health Coverage.
Key words:
UHC, HLEG, Information Technology
Code - B3
Awareness about MTP Act (safe & legal abortion) among the women and the
Frontline health workers in the villages of Punjab, Haryana & Chandigarh
Alampreet Kaur*, Garima Bhatt*, Sukhmanpreet Kaur*
*
MPH students 2nd year, Centre for Public Health, Panjab University, Chandigarh.
Rationale:
Unsafe abortion is defined as an induced abortion as a process either conducted by unskilled personnel or
performed in a non- accredited facility. In third World countries, unsafe abortions are attributed to maternal
mortality and morbidity. In India, the majority of these events remain concealed initially, thereby further
complicating the scenario.
Unsafe abortion represents a preventable yet major cause for maternal mortality in India. A majority of
these abortions are performed confidentially. Patients and their relatives often fail to disclose the abortion
40
despite the critical state of patient. This scenario creates considerable confusion for diagnosis and treatment
and can lead to further complications.
Objective:
To find the awareness about MTP Act (safe &legal abortion) among the women and the Frontline health
workers in the villages of Punjab, Haryana & Chandigarh.
Methodology:
Sample size:
25 women & 5 frontline health workers from each village respectively.
Sampling technique:
Simple random method.
Study time period:
5th June to 15th July 2015
Study area:
Vill. Kaimbwala (Chd), Vill. Mataur, District Mohali (Pb), Vill. Saketri, District Panchkula.
Study tool:
Pre tested Performa filled through face to face interview, observation and counter checking.
Also we tried to understand the awareness level about safe and legal abortion among the adolescent girls of
each village through conversation.
Key findings:
Only 10 - 15% people were aware about the MTP Act (safe & legal abortion). Even the frontline health
workers who have the responsibility of imparting awareness regarding the health issues and rights to the
public are very less informed regarding this act. Among them 47 % were aware about the MTP Act which is
very less. The frontline health workers include ANM, ASHA workers, Aanganwadi workers (AWW).
Conclusion:
Also the people consider abortion to be a crime and a sin even if its safe and legal. People did not talk
freely and openly about this topic due to the stigma attached to it. Very few women know that safe and legal
abortion is their right. And can take the decision of terminating the pregnancy on their own without any
consent from her husband and family. During survey we observed that out of 75 women whom we interviewed,
65 wereaware about the PC-PNDT Act, 1994 (which regulates sex determination and disclosure of sex by
medical professional to the women and her family members). Which is more known and popularised among
the people through television, radio and newspapers. People confuse the MTP Act with the PC-PNDT Act and
as a result the benefits of MTP Act are not utilized.
41
Code - B4
Abstract:
Medical or health care expenditure is a leading cause of poverty in the developing countries.
Lack of universal health insurance scheme and unaffordable private health insurance premium are the measure
cause of financial distress due to disease or dissability. The worst and prominent sufferers are the worker
group and the BPL people who cannot afford a space in hospital. For social security of the poor and
marginalised, RSBY (Rashtriya Swasthya BimaYojana) was launched by the Ministry of Labour and Employment,
Govt. of India, whichentitles cashless in patient treatment (both surgical/medical) in empaneled hospitals
(Public/Private) with RSBY; even the cost of transportation of the patient is also borne by the scheme. It is a
boon amounting to 62 million BPLs of India including around 52 lakh BPLs from Odisha. The insurance benefits
are extended to five members of a family on floaterbasis by an investment of rupees thirty a year as premium.
The insurance provision covershealth intervention up to a maximum of thirty thousand per year. The objective
of this study is to find out the beneficiary satisfaction level in terms of health standard improvement and
quality accessible and available medical care, reasons behind under utilization of health services by smart
card holders, status for out of pocket expenditure after implementation of RSBY, identify the gaps in framework
of scheme, fraud management at different level of operation.
The data were collected by Household survey; Focus group discussion (FGD); In-depthinterviews (IDI) of
different involved stake holders like doctors, RSBY protocol managers, data entry operators and beneficiaries
residing in various districts of Odisha and Somesecondary data of various sources (Census, RSBY site) were
used.
The study revealed that beneficiaries are satisfied with quality medical care asthere is a option to choose a
public or private hospital for their treatment. There is considerable improvement in the health status of rural
poor. Some were not enlisted in RSBY due to their absence during enrolment days in their locality, people are
still unaware of RSBY scheme due to improper IEC (Information education communication) activity, there is
a fear of people that unnecessary surgeries are undergone in private hospitals to lure more money,some
were asked money after surgical procedures, most hospitals are not providing the transport incentive to the
beneficiary and out of pocket expenditure is notably decreased. Stake holders are active in operating the
scheme successfully, frequent failure of internet connectivity and less human resource in hospitals are some
gaps to propagate the scheme. Random visit to hospitals, on site audit, tracking Bio-metric smart cards for
blocked amount for a particular procedure, Indoor patient strength of hospital, cross-checking prescription
of patients at field level are key ways for fraud identification and management. RSBY drastically changed the
scenario by minimising the fear of financing expenses on health.
Key words:
RSBY, bio-metric smart card, cashless treatment, hospital expenses.
42
Code - IP15B05
Treatment seeking behavior of diabetic patients with special emphasis on followup in the government health facilities A case study of Pudukottai district, Tamil
Nadu, India
Dr. Gopinath Thirugnana Sambandam, MBBS
MPH Candidate (2014-16), Cooperative program of: Johns Hopkins Bloomberg School of Public Health, Baltimore &Indian Institute of
Health Management Research University, Jaipur.
Introduction:
In an effort to address the Non Communicable Diseases (NCDs), the Government of Tamil Nadu has
implemented the NCD Screening, Prevention and Treatment Program in all the 32 districts of the state in
2012 through the World Bank funded Tamil Nadu Health Systems Project (TNHSP). The program aims to
screen people aged 30 years and above visiting the government health facilities for Diabetes Mellitus. Once
detected positive, they are followed up every month.
Rationale:
The importance of regular follow-up of diabetic patients with the health care provider is of great significance
in averting any long term complications. The number of patients lost to follow-up after is alarming and is a
serious concern to both the implementers and funders of the program. This study tries to identify the treatment
seeking behavior of patients which will further provide valuable information for policy makers to improvise
the program.
Objective:
The study has the following objectives with a diagnostic approach rather than a prescriptive approach for the
problem stated above.
To study the proportion of diabetic patients on regular, irregular and lost to follow-up during treatment
of diabetes in the particular government health facility where they got enrolled during the months of
Jan, Feb and Mar, 2014.
To find out the motivating factors for patients who are on regular follow-up.
To find out the major reasons for patients who are either irregular or lost to follow-up during treatment
of diabetes in the government health facility where they appeared during the months of Jan, Feb & Mar
2014.
Methodology:
The methodology has two distinct parts. The first part involves a group discussion meeting of all NCD staff
nurses of Pudukottai district to find out their perspectives of treatment seeking behavior of patients. The
second part is a telephonic survey of patients who visited the government health facilities in Pudukottai
district during the months of January, February and March of 2014. Patient clinic cards of all patients are
collected and 300 cards are randomly selected. All the patients having valid phone numbers from these 300
cards are interviewed using a semi-structured questionnaire. The responses are fed into SPSS and data analysis
is done.
Results:
The study is in its last stage of analysis and interpretation. Therefore, final results will soon be arrived. A
major learning from the study as of now is that there are gaps in updating patients clinical records on a
regular basis. Most of the patients who are noted as irregular or lost to follow-up are actually regular visitors
in the government health facility.
43
Conclusion:
Considering the increased burden of Diabetes Mellitus and therefore increased state health expenditure, it is
important to ensure that the services of screening, prevention and treatment for Diabetes are utilized to the
maximum. The results obtained through this study will give a new perspective of policy issues to program
managers.
Code - IPB1506
Day care centres as capacity development in elderly care: A need of the hour as
India grays
Dr. Vidya Chandran1
Do not go gentle into that good night, Old age should burn and rave at close of day, Rage, rage against the dying of the light. Dylan
Thomas
Rationale:
Withering of joint family system has contributed to the challenges faced by elderly where they are forced to
live alone and are exposed to various kinds of problems. Their often poor financial condition, lack of affordable
health care and the general neglect by society calls for an effective system for their well-being at the dusk of
their lives. Census 2011 suggests that India is home to over 75 million elderly, contributing 7.5% of the total
population, which is projected to reach 10.7% in 2021 and 12.4 % by 2026. Hence, government has to be
prepared for the additional strain this will put on families and health and welfare services
Objectives:
To assess the need of having elderly day care centres to cater to the geriatric care essential for the elderly
population in Indian slums.
To understand the bottlenecks in availing the services provided by Sandhya Kirana, a day care centre for
the elderly.
To assess the benefits generated by those who are availing the facilities of Sandhya Kirana day care
centre.
Methodology:
Quantitative Study:
Qualitative Study:
Study type
Duration
Area
Sample size
100
20
Respondents
Sample selection
Primary data
Type of data
Qualitative
Quantitative
44
Technique
Tool
Structured questionnaire
Key Findings:
1. The dire need for a day care centre was suggested by the profile of the elderly in the slums where over
half of the sample was the younger elderly, who were healthy enough to avail the facilities at a day care
centre. Almost four fifth of the sample was deprived of the meagre elderly pension that the government
provides.
2. There were several bottlenecks that the potential beneficiaries of Sandhya Kirana face that can be resolved
by spreading more awareness about the services provided and also by providing a few more services to
combat the bottlenecks.
3. The qualitative study suggested that the reasons for the beneficiaries joining SK and their interests keep
over one third of the beneficiaries fully satisfied with the services provided.
Conclusion:
Providing direct services rather than monetary benefits can prove more effective in elderly care in a country
like India. Hence, a day care centre for the elderly can solve most of the unmet needs of the elderly and
prove to be an efficient social security in India. Such centres could include nutritional supplements for the
elderly along with basic medical care, a platform for socialization and to keep them engaged through economic
empowerment as is seen at Sandhya Kirana.
Code - IP15B07
To assess the Knowledge, Attitude and Practices (KAP) and identify gaps related to the nutrition and the
health-seeking behavior of mothers (of children under 5 years) in three resettlement colonies of Delhi.
45
Methodology:
Primary data wascollected using a structured questionnaire and anthropometric measurements were recorded
using standard tools. A sample size of 280 households was obtained in three resettlement colonies of Delhi
(Sanjay Camp, Dwarka & Dakshinpuri) .Study respondents comprised of mothers of children under five years
of age.
Findings:
Nutritional status of the children was analyzed by using WHO anthroplus and further parameters like breast
feeding practices, health seeking behaviour, health facility utilization, water and sanitation practices, awareness
and utilization of government schemes were analysed using advanced applications of Excel.
Data shows evidence of improper breastfeeding, water and sanitation practices, gaps in health seeking
behaviour and exclusion of respondents from public distribution system and lack of proper identification
system for optimal utilisation of government services.
Conclusion:
It is very necessary to address the cultural and social determinants hampering the overall growth and
development of children in such resettlement colonies. This can be done effectively through inclusive planning
of health service delivery in urban areas with special reference to migrants,provision of dedicated outreach
clinical services for migrants at work sites, allocation of dedicated budget for migrant welfare and identification
of migrants for improving health seeking and resource utilization.
Code - IP15B08
Key Findings:
There were many issues that were found at Community health centers. The most important and common
issues were shortage of resources like manpower, equipments, supplies and rooms etc.
There were no properly setup operation theaters with proper instruments and if there was properly setup
operation theatres there were no general surgeons and anesthetist. No surgeries were done including
caesarean sections. Ante-natal or Post-natal clinics were also not available. There was no pediatrics was
there for sick children. There were not even providing 24 hour emergency services. There were no eye surgeons
or dentists. Equipments like surgical instruments, dental chair, Ultrasound machine etc. were not provided.
There were no proper transportation facilities.
Many patients were not satisfied with the services provided especially pregnant women that undergo their
deliveries at CHCs. There were no facilities to handle special delivery cases.
Conclusion:
There were many issues that were found at the health centers. The ineffective and inefficient services at
health centers will affect the health system. Because of these issues patients are unable to get proper
treatment. These issues should be taken into consideration by health managers and they should try to solve
them for the betterment of patients who require proper treatment. Health managers should visit the CHCs
regularly.
Code - IP15B09
Methodology:
Area covered: Five blocks of Udaipur- Badgaon, Girwa, Jhadol, Kherwara and Kotra.
Objectives:
Primary
i. To find the association between education level and vaccination awareness among mothers coming to
the camps conducted by seva mandir in rural Udaipur, rajasthan
ii. To find the association between education level and vaccination frequency among mothers coming to
the camps conducted by seva mandir in rural Udaipur, Rajasthan.
Secondary
i. To find the association between education and number of children born to mothers coming to the camps
conducted by seva mandir in rural Udaipur, Rajasthan.
ii. To know the status of mamta card retention among mothers coming to the camps conducted by seva
mandir in rural Udaipur, Rajasthan.
Findings and Conclusion:
Out of 357 respondents more than two third (263) mothers were Illiterate. (Literate here means women,
who could read, write and understand.)
i).
Education level
(n)
To prevent diseases in
(%)
It is beneficial for
health in (%)
Dont know in
(%)
Literate (94)
36
20
Illiterate (263)
64
80
100
91
100
100
100
100
Education level
(n)
Every month in
(%)
First time in
(%)
Literate (94)
26.5
19.6
15
31
Illiterate (263)
73.5
80.4
85
69
Total (357)
100
100
100
100
Total (357)
ii).
iii).
Education level
(n)
Number of
children is 1
Number of
children is 2
Number of
children is 3
Number of
childrenis 4
Number of
children is 5
Literate (94)
46.7
27.5
21.5
12.2
3.4
Illiterate (263)
53.3
72.5
78.5
87.8
96.6
Total (357)
100
100
100
100
100
48
Almost fifty percentof mothers who came to immunization camps said they had mamta card with them
while seventeen percentdid not have mamta card because of some reasons.
Twenty percent of mothers forgot to bring their card at the campsites, while 5 %mothers had lost mamta
card.
3 percent had come for first ANC check up so mamta card would be issued in subsequent visits
Code - IP15B22
Methodology:
Sampling Technique - Non Probability Sampling (Convenient Sampling)
Data Collection Method - Tool Structured Questionnaire, Technique-Interview
49
Conclusion:
This model will ensure for receiving the promotive, preventive, curative health services to those people who
are living in the urban slum. People are addressing their issues or grievances in front of government officials
in ward sabha meeting.
Code - IP15B19
For this purpose, a secondary research was carried out to identify the factors influencing service delivery in
OPD Pharmacy which were found out to be Availability of drugs, Behavior of pharmacists, Knowledge of
Pharmacists, Interaction with patient (Practice Perspective) and Availability of staff. A questionnaire was
then prepared on above parameters which was administered to patients visiting OPD Pharmacy in Jaipur,
Rajasthan to assess their satisfaction level. A total of 180 patients were surveyed across 6 major hospitals in
Jaipur. The survey revealed that Timeliness, Availability of drugs and Patient counselling are the major areas
of dissatisfaction among patients in Jaipur. Approximately 68% showed their dissatisfaction from timeliness
and 48% each for availability and counseling. It is evident from previous studies that there is a regular basis
50
need for educational intervention to update the knowledge and awareness of the pharmacist to the healthcare
services provided by them.
On the basis of findings, following recommendations were proposed:
For Timeliness, Proper utilization of staff and concept of E-prescription;
For Availability, Efficient use of Hospital Pharmacy Computerized Inventory Program; For Counselling, concept
of Counselling Course;
A concept of Departmental Awards is also proposed to improve the efficiency of the pharmacy department.
Code - B11
Hearing loss in patients attending the Out Patient Clinic in an Industrial Tertiary
Healthcare centre
Dr. Bhudeb Sengupta
Additional Chief Health Director (Administration & Public Health), Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata
Dr. K P Verma
Divisional Medical Officer & Head of Department- ENT, Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata-700043
Mr. Mayank Awasthi (Speech Therapist & Audiologist), Ram Manohar Lohiya Institute of Medical Sciences, Lucknow
Rationale: Hearing loss is invisible disability of one of the distant senses, which affects individual in performing
activities, secondary to psychosocial problems, life threat and the basic loss of effective communication. This
may cause serious harm to the individual, to the family and dependents and also the co-workers in an
organization.
Objective:
This study aimed to determine the frequency, causes, types of hearing impairment in patients attending the
out-patient ENT clinic of a tertiary Health care unit of an Industrial Organization.
Methodology:
Purposive sample included Hearing profile of 160 patients, in 6 months duration (January 2014- June 2014),
was grouped into 4 age groups (0-20, 21-40, 41-60, above 60 years). Complete profile of each person were
noted including onset, growth, complaint, Medical & other relevant history, Associated system, Hearing
evaluation report, Other related tests, final Diagnosis and Recommendations. Descriptive statistics and other
statistical test showed age wise significant differences for many features. A detail analysis helped to understand
types of possible causes, therefore indicating preventive measures in many cases.
Key findings:
Total 117 patients were found to have same site of lesion in both ears, constituting 102 sensorineural, 10
Conductive and 5 mixed hearing loss. Patients seen with unilateral or bilateral different lesions were 21, with
other 22 patients not grouped into any. Majority of patients were found have a gradual onset (110) and a
progressive growth of the condition (107). The severity of condition showed a wide difference. Patients with
associated symptoms were high. The complaint & reporting were analyzed and seen to be patient specific
perception of their problem.
51
Conclusion:
Occupation wise analysis indicated the chances of noise induced effects on hearing mechanism to be a
predominant factor. However, detail analysis is warranted in terms of testing all the subjects with similar job
profiles to confirm a noise induced hearing loss.
Key words: Hearing impairment, Tertiary Healthcare Unit, Industrial organization
Code - B12
Dr. K P Verma
Divisional Medical Officer & Head of Department- ENT,Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata-700043
Rationale:
Balance requires reliable sensory input from the individuals vision, vestibular system (the balance system of
the inner ear) and proprioceptors (sensors of position and movement in the feet and legs), muscle strength
and joint mobility. The elderly are prone to a variety of diseases that affect these systems. Effect extends to
functional incapability or loss of confidence in mobility.
Objective:
This study aimed to determine the extent of mobility impairment in elderly individuals with hearing and
balance disorders. It was also required to find out if a scale or questionnaire should be mandated when
dealing with elderly population.
Methodology:
Hearing profile, Balance assessment and mobility scale score for 177 patients, in 1.5 years duration (January
2014- July 2015) was grouped into 4 age groups (50-60, 60-70, 70- 80, above 80 years). Each age group were
sub divided into four groups, such as- a) with only significant senile hearing loss without observed balance
problems; b) only reported and observed balance problems; c) both with balance problems and hearing loss;
and d) no reported and observed significant balance or hearing problems. Exclusion criteria were specific to
no neurological problems, no musculo-skeletal deformities, no significant vision loss. Complete profile including
hearing assessment, vestibular and balance evaluation was done along with scales for mobility and gait.
Individuals with BPPV, diagnosed by symptomatic progress with maneuvers, were excluded.
Key findings:
It was observed that there was a huge difference within the groups for balance and gait indices. Detail
observation suggested that hearing loss, though may not be directly causing balance problems in many
individuals, it helps retain a healthy mental condition and confidence, which in turn helps in balance and
mobility. In the older groups, the mobility issues were significant, with most of them having some sort of
reported problems related to balance. The aspect of reported growth in problems were noted but not analyzed
52
statistically, as they were subjective reporting. The severity of condition showed a wide difference. The most
elderly group (70-80 and 80 years above) were less numbered in the fourth sub group, as most of them had
either reported, observed and both for some kind of hearing or balance related issues.
Conclusion:
The study is evident to mark a need of a mandatory use of questionnaire for all individuals above 70 years, to
avoid risk of fall, though never reported any problems.
Keywords:
Hearing loss, balance disorders, mobility impairment, and elderly.
Code - B19
53
Study The Impact of Dots on Accessibility & Affordability of Medical Treatment for
Patients
Pratiksha Pal (MBAHM 19) & Vivek N. Mahodaya (ph06)
Rationale:
India is the country with the highest burden of TB, with World Health Organisation (WHO) statistics for 2013
giving an estimated incidence of 2.1 million cases of TB for India out of a global incidence of 9 million. The
estimated TB prevalence for 2013 is given as 2.6 million.It is estimated that about 40% of the Indian population
is infected with TB bacteria, the vast majority of whom have latent rather than active TB. The emergence of
multi-drug resistant TB (MDR TB) contributed to worsening impact of the disease - the principal reasons for
the WHO declaring TB a global emergency in 1993.RNTCP was launched in India in year 1997 to combat
tuberculosis.
Objective:
1. To determine the impact of DOTS on Tuberculosis in India.
2. To know the needs of innovations in DOTS strategy.
Methodology:
Secondary data collection - Published articles, non-published articles and papers, various web sites.
Discussion:
India accounted for 24% of global TB burden. DOTS (Directly observed treatment, short course) was launched
in 1997 treated, 14.2 million cases, saving additional 2.6 million lives and have achieved success rate of 85%
new smear positive patients. Because it includes unique features like district TB control society, modular
training, patient wise boxes, sub district level supervisory staff & robust reporting & recording system. But
the prevalence of MDR TB is increasing throughout the world both among new tuberculosis case as well as
previously treated ones. The risk of developing MDR TB is more in previously treated patients because of
spontaneous mutation or transmission of resistant strains. To deal with this problem some new innovations
are required like Trials are underway to evaluate the efficacy of a new TB treatment called PaMZ which
contains pretomanid, moxifloxacin and pyrazinamide. If these trials succeed, then TB patients might get new,
shorter treatments within the next 5 years.
To make sure that Indian patients benefit from new drugs, the Government will need to streamline its
regulatory and policy adoption processes, and proactively coordinate the introduction of new drug regimens,
along with companion diagnostics that can detect drug-resistance to new regimens.
While we wait for better and shorter therapies, doctors and programmes can improve the effectiveness of
existing treatments by improving treatment adherence. Drug-sensitive TB requires a full 6-month course of
treatment. If adherence is poor, then drug-resistance can emerge.
There are many methods to ensure adherence, including directly observed therapy (DOT). While it is
challenging for patients to visit health care centres for DOT, we must harness the enormous potential offered
by mobile phones to electronically monitor adherence to medications.
54
Conclusion:
As we can see the DOTS strategy is effective in reducing prevalence of new cases of TB, but by incorporating
some new innovative strategies it can be more effective for MDR and XDR cases.
Code - IP15A017
Code - IP15A019
surgical care, which they do because of affordability, better access to care or a higher level of quality of
care. Health Insurance is a type of insurance coverage that pays for medical and surgical expenses that are
incurred by the insured. Health insurance can either reimburse the insured for expenses incurred from illness
or injury or pay the care provider directly.
Health insurance in medical tourism is related in two ways - Travel related &Treatment related. Medical
tourism insurance products are an emerging part of health tourism industry.Companies that provide insurance
products for medical travel services will be seen by potential patients as having an advantage over their
competitors.
Objective:
To study the role of health insurance in the context of the medical tourism industry.
Methodology:
A systematic review of the information gathered from the journals has been done. Secondary data was
collected and studied to understand the current scenario of the medical tourism industry and the importance
of health insurance in promoting the further growth of this industry.
Key findings:
Increase in healthcare expenses in developed countries is the prime motivation behind the growth of
medical tourism. Insurance companies and cost alert employers prefer this trend of travelling to developing
countries to seek healthcare at affordable prices. Hence, insurance companies are now providing insurance
cover to such patients, making medical tourism an option for everyone.
A report published by the Mckinsey and Co. assesses that if insurers started providing travel medical
insurance, then annually around 500,000-700,000 Americans may travel overseas for surgery. This will
allow the developing countries (like India) to further strengthen their hold over the western market.
Conclusion:
By using strategies to promote the importance of health insurance in the medical tourism industry both the
patients (receivers) and the countries which provide medical tourism services (providers) will receive equal
benefits i.e. good quality healthcare at low cost for the receivers and a boost to economy for the providers.
Code - IP15A020
Manual Scavenging : Reasons for continuation of the inhuman act and failure of
act, government policies and programmes.
Shivani Arora, Shivika Chugh (The IIHMR University, Jaipur)
Manual scavenging is the obnoxious and inhuman occupation of manually removing night soil and filth using
hands from insanitary or dry toilets, built without a flush system. The occupation has remained intact with
the Dalit communities dictated and forced upon by the caste-system. The forms of manual scavenging have
changed over the period of time both in rural and urban areas. However, this practice continues under different
forms and manner. It has been nearly a century since Mahatma Gandhi, first called for the abolition of manual
scavenging.But, the degrading practice still continues. As per the annual report of the Ministry of Social
Justice and Empowerment (Government of India, 2009), there were 7, 70,338 manual scavengers and their
dependents in India. According to census 2011, there are more than 20 lakh dry latrines in India where the
56
practice of manual scavenging is still prevalent. This situation persists despite the fact that the Employment
of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act, 1993, is in enforcement, which
provides for the prohibition of the employment of manual scavengers as well as construction of dry latrines
.Further the act regulates construction and maintenance of water-seal latrines for assuring the dignity of the
individual, as enshrined in the Preamble to the Constitution. In rural India as well as in urban slums of many
major cities of India, dry toilets are a sad part of the reality which has led to the practice of manual scavenging.
Many acts, government policies and programmes have come into force but they were unsuccessful in throwing
off the yoke of manual scavenging. Manual scavengers are still living at the threshold in expectation of help
from the government.
This research reveals the reasons for continuation of the manual scavenging practice and failure of the act,
government policies and programmes. It also suggests strategies to wipe off the unhealthy and inhuman
practice. The findings of paper were developed from the reviewed information extracted from the contribution
of different authors, internet research of journals, reports of organizations working in the area of water,
sanitation and hygiene, articles and blogs. The problem of continuation of manual scavenging practice can be
viewed from two angles: The community/society perspective (economic and social pressures, lack of wet
toilets especially in Indian railways which is thus considered the countrys biggest open toilet); and the act/
policy/programme perspective (insufficient financial assistance, more focus on male workers, no monitoring
of their implementation). The strategies to eliminate the practice could be to make the process more
mechanistic, providing alternate employment opportunities, technological innovations to limit manual
handling of human excrement on the railway tracks which include concrete washable aprons, controlled
discharge toilet systems (CDTS), bio-toilets and vacuum toilets. Numerous other reasons for failure and
strategies to overcome them have been traced which are further explored in the paper. It points out a strategic
approach to curb this menace. Implementation of the significant measures would also lead to reduction in
the plight of the communities employed for this practice.
Key words:
Manual Scavenging, Manual Scavengers, Dry Latrines
Code - IP15A022
Code - IP15A030
Conclusion:
The stigma of high cost health services can be covered through concerted effort of Public and Private healthcare
providers which would be achieved if better cost reduction through substantial methods is done that does
not drag with it the deficit and the consequences in the long run thereby contracting the most dreaded word
COST from the brains of the people and also allowing the governmental and non-governmental organizations
to actively serving the purpose in meeting and exceeding the expectations of the people hence easy transition
of the picture of the nation from developing to developed country.
Code - IP15A024
Human Resource In Indian Healthcare: Current trends and the way forward
Ishita Srivastava, Shivani Arora (The IIHMR University, Jaipur)
Rationale:
Healthcare is at an influx of paradigm shifts in terms of changing disease patterns, increasing dual disease
burden for both rural and urban India. Though Indian economy is growing at rapid pace of 7.5%, yet expenditure
on healthcare industry accounts for a mere 1.3%; making itamongst the bottom five across the globe.
Manpower for health services has been described as the heart of the health system in any country. Present
Indian scenario demands attention to challenges which broadly includes scarcity of physicians, nurses and
technicians and uneven distribution of human resources among the rural and urban areas. Presently, doctor
to population ratio is 1:1700 in urban areas and 1:25000 in rural areas, which is much less than the required
ratio of 1:1000 as specified by WHO. The scenario of nurses which is 1.5nurses per 1000 population projects
no good picture either. According to WHO, India requires additional 1.54million doctors and 2.4million nurses
to match the global average.
Objectives:
To study the current status of health workforce.
To identify innovative interventions to overcome the current shortfall and uneven distribution of human
resource.
Methodology:
The paper was developed from the reviewed information extracted from the contribution of different authors,
journals, articles and blogs.
Key Findings:
A deficit of about 2866 (12%) MBBS doctors in the PHCs exists, the requirement being 23 887. With the
latest guidelines which lay down that two doctors should be posted at each PHC, this shortfall is bound to
increase substantially.
The situation is even more serious with respect to specialists at the CHCs. A considerable shortfall of
surgeons, physicians, obstetricians and pediatricians occurs at the CHCs that is 12 301 (64%).
At the PHC/CHC level, there is a 23% shortfall of nurse midwives or staff nurses. The corresponding
figures for pharmacists are 22.5%, laboratory technicians 47.4% and radiographers 53.9%
There is a 37.8% shortfall in the number of health assistants (female) at PHCs, while the number of
health assistants (male) is less by 41.6%. There is a 1.9% deficit in the number of health workers (female)
at the sub centre and PHC. The number of male health workers is short by 64.6% at the sub centre level.
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Many Innovative interventions have unfolded to combat these challenges which include emergence of
e-health, mobile medical units, providing vocational training, reorienting the education pattern, provision
of tax benefits and better opportunities to help in the shift of skilled manpower to rural areas.
Conclusion:
Though production of health workers has greatly expanded in recent years, this has been at the cost of
increased privatization of medical education in India. The rapid growth in the production of skilled health
workers such as doctors, dentists, nurses and midwives has not helped fill vacant positions in the publichealth system. Moreover, the problems of imbalances in the distribution of these health personnel persist,
with certain states remaining at a disadvantage. Hence, there is an urgent need to adopt sustained and
innovative actions to address Indias current health-workforce crisis.
Code - IP15A025
Organizing health services around peoples needs and expectations (service delivery reforms)
Methodology:
Poster Presentation showing Qualitative study based on review of literature and discussion with our faculty
members. It is a review framework of six building blocks given by WHO in context of present situation in
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India. This is WHOs Health System Framework of Governance, Information, Financing, Service Delivery, Human
Resources, Medicines, Vaccination and Technologies.
On the basis of difference between healthcare espoused and practiced; we tried to give suggestions to improve
healthcare at primary level.
Key Findings:
It is expected that analysis will point towards certain implemental strategies or policy level directives.
Code - A3
What we have and what more should be done toimprove the quality and safety of
healthcare systems through accreditation in India : An analytical study
Dr. Rupinder Kaur*, Dr. Kirti Kataria*
MPH Scholars*, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh.
Abstract / Rationale:
Healthcare quality is the degree to which health services for individuals and populations increase the likelihood
of desired health outcomes and are consistent with current professional knowledge. Healthcare in India has
been undergoing rapid changes. Various parameters of the healthcare services arefocused not only on provision
of safe, effective, efficient, equitable and timely care, but also on quality aspect of the care being provided.
Quality improvement initiatives and tools can prove beneficial for the provision of better & improved health
care services. The Quality council of India has been working for the improvement of safety and quality of
health care in India through the International Organization for Standardization and National Accreditation
Board for Hospitals and healthcare providers, with the ultimate aim of enhancing quality of life.
Objective:
To identify the strengths, weakness, opportunities, and threats of guidelines/standards made to improve
quality of healthcare in India
Methodology:
The guidelines and standards for healthcare organizations by QCI are analyzed.The standardized policies are
analyzed thoroughly and relevant findings are noted and then summarized in key findings. The ultimate aim
of this study is to do SWOT analysis of the guidelines/standards.
Key findings:
The results are made on the basis of SWOT analysis taking into account all the beneficiaries perspective.
Strengths:
1. Benefits to all the stakeholders, major beneficiaries being the patients.
2. Focus on continuous improvement and commitment to quality care.
3. Regular evaluation of patient satisfaction.
Weakness:
Not a mandatory standard for all healthcare providers.
Opportunities:
1. Taking into account the strengths, it should be mandatory for all the healthcare providers ( not only
private sector but the government sector also).
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2. These set of good quality standards can be made as the National Standards for Quality and Safety of
healthcare.
3. Feedback from the patients can be used as a good tool to plan any interventional strategy, to further
improve the quality of services.
4. If standards of quality are implemented properly, it is helpful in increasing the growth of healthcare
market.
Threats:
As the tag of accreditation enable the healthcare organisation to levy more charges for the services, the
possibility of deviation from the main focus of quality maintenance may arise.
Conclusion:
A lots of research is needed in the field of quality and safety of health care systems in India. Patient is solemnly
dependent on the kind of quality service which he/she gets from any healthcare organisation which may lead
to either good faith or lack of faith in the services being provided. Standardization of evidence-based practices;
infection control issues, medication errors etc. were the areas which needed attention and are easily
identifiable through these quality standards. Quality Council of India will be the stimulus to create a
revolutionary change in quality and safety areas. The opportunities are the new way forward to strengthen
the quality of healthcare organisations.
Code - A4
Conclusion:
The mission being in its initial stages has led to an increased awareness about better sanitation & clean
surroundings among people. But a lot needs to be done to make this more than a paper project. Proper
implementation and aggressive spread of awareness is needed at ground levels to achieve the desired goals.
Code - A5
Norms & Reality - The Sanitation and Hygiene practices among students of schools
of Chandigarh
Sumit Kumar*, Manoj Kumar Sharma**
*Student (Masters of Public Health), Centre for Public Health, Panjab University, **Assistant Professor (Centre for Public Health)
Introduction:
It has long been recognised that investments in school sanitationand hygiene education together can create
improved learning environments, thereby facilitating increased attendance and retention of students.This
study was undertaken to assess the sanitation facilities and awareness about the hygiene practices adopted
by selected private and government primary schools in Chandigarh, Punjab.
Objective:
i) To assess the sanitation facilities in Govt. & Private Schools.
ii) To compare it with the national norms setup.
Methodology:
i) A cross-sectional study was conducted in Govt. Model High SchoolSector-25 Chandigarh & Ankur Public
School Sector -14 Chandigarh with randomly selected sample size of 70 students from each school(total
= 140).
ii) A self structured questionnaire comprising of 18 questions was used.
Result & Conclusion:
School-based hygiene education is vital in orderto decrease the rates of transmissible diseases as well as
school drop outs. During Interaction & survey, it was found that students are more receptive to learning and
are very likely to adopt healthy behaviors at a younger age. They can also be agents of change by spreading
what they have learned in school to their family and community members. Hence, it is recommended that
sanitary guidelines should be met before the establishment of schools.
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Code - A7
Abstract:
India has been experiencing the epidemiological transition in the form of addition of non-communicable
diseases. The increase in the lifestyle diseases has provided opportunity for the re-emergence of indigenous
system of medicine in the country. This system of traditional medicine gained popularity across the world
started attracting more number of foreign patients and has strengthened Indias position as a preferred
destination for medical tourism. This global flow of patients across borders changed the patterns of demand
and supply of healthcare services in the country and insisted for reshaping the Indian health care industry.
The growing medical tourism started provoking hospitals to improve the quality of services at par with the
international standards. Besides that, considering the innovations and fast pace growth of technology,
healthcare providers also started focusing on the technological aspect of healthcare delivery to fundamentally
change the way of practicing medicine. These swift changes in the scenario of Indian healthcare industry
market started attracting attention of private players, especially profit making organizations for the
investments. Foreign investors also consider India as a strategic location for conducting profitable international
business and started investing in Indian healthcare industry. Besides investing in usual hospital business,
private players also started exploring the areas of research and development (R & D) in the country.
Government of India grabs this opportunity for further progression of Indian economy and started changing
regulations of clinical trials in the country to make contract research as fast growing segment of healthcare
industry.
Key words:
Epidemiological transition, healthcare industry, medical tourism, technology, FDI
Code - IP15A033
Methodology:
This study presents an analytical model of Drug Inventory control. It was conducted by using Quantitative
research method. Relevant information was collected from primary and secondary sources. The central store
department was observed and staff was interviewed. Data was collected from organization database during
the research. ABC Analysis (Always Better Control analysis) and FSN Analysis (Fast moving, Slow moving and
Non-moving analysis) were used as study tools.
Key Findings:
Various drugs were classified into ABC and FSN categories. The matrix retrieved from combination of these
two classification methods, had proved to be an efficient and effective tool. Nine drug groups were generated
from the coupling of ABC and FSN analysis and each group requires different Inventory methods and types of
management.
Conclusions:
Under ABC analysis, the management must have control on A category than on B and C category of drugs
and under FSN analysis, the company must not go for the Non-moving items as far as possible, because there
will be unnecessary blocking of working capital which will hinder the other activities of the organization.
Thus, the company is required to maintain safety stock for drugs in order to avoid stock-out conditions &
help in Continuous Production Flow.
Key words:
Drug Inventory Management, ABC Analysis, FSN Analysis
Code - IP15A034
Key Findings:
Medication Errors due to Ordering Errors (41%) and Administration errors (39%) were the most frequent
kind of errors, followed by other reasons such as Legibility of hand writing and Improper Labeling (10%),
Many brands of the same drug (4%), Lack of Communication among health professionals (4%), Lack of Patient/
Relative Participation (2%). The challenges faced during this study were under reporting of errors by nurses
and doctors, Lack of Authenticity and Inadequate use of Technology
Conclusion:
This study has shown that Medication Errors are mainly related to Ordering Errors and Administration Errors.
So, different approaches are recommended to reduce Medication Errors, such as Introduction ofCPOEComputerized Physician Order Entry with Pop-up Alerts and DO NOT DISTURB apron for Medication Nurse,
followed by other approaches such as Set up a Pharmacovigilance System which can collect information on
Adverse Drug Reactions, Use of Patient Identifiers like wrist bands, Encouraging doctors to prescribe the
medicine by the generic/chemical name and not by the brand name.
Key words:
Medication Error, Patient Safety, COPE-Computerized Physician Order Entry
Code - IP15A035
Findings:
It aids in increasing the reach ofrural population to basic, specialty, super-specialty consultations at an
affordable price. It serves as a platform to provide easy and ready access to quality healthcare in geographically
remote and inaccessible regions of the country. It serves as an easy means to treat and closely monitor
immobilized patients whose accessibility to healthcare services is questionable for eg. Elderly patients.It
serves as an effective platform for resolution of healthcare queries and sharing of health related information
with the beneficiaries.It provides easily accessible mobile solutions for the rapidly moving mobile working
population of India.
Code - IP15A036
Conclusion:
Innovation and technology can save lives and improve the quality of healthcare but may introduce complexities
and risk, if used unsafely. The need of the hour is efficient management of hospital settings which includes
adopting of correctivemeasures like establishment of an Auditory body which can randomly inspect patient
safety and satisfaction determinants, security indicators, sanitation system, state of infrastructure and
equipmentsas well as ensure no violation of patients rights without compromising on the staffs dignity.
Also, transparency in regard to patients awareness about the medical procedure and its complications should
be implemented. Staff should be motivated to admit errors caused by them and government should lay
guidelines to provide compensation to the suffering patient for same.
Code - IP15A037
Delivering Innovative solutions in Maternal and Child Health through Google glass:
..... your Journey Our lens
Anudeep Aggarwal, Surbhit Gupta, MBA-HM (19), The IIHMR University, Jaipur
Introduction:
Healthy mothers and healthy children contribute to a healthy family and a healthy society. India is home to
one fifth of the worlds births while contributing to one fourth of total maternal, infants and child deaths that
occur globally. Significant number of these deaths are preventable.
Although the Government of India is committed to address maternal and child health through its increased
financed and flagship programmes, healthcare indicators show otherwise. It is because it lacks in its capacity
to cater to Indias mammoth population and its growing healthcare demands.
This provides an opportunity to private enterprises to apply all their skills to tackle the problem of women
and child health with innovative solutions, noveltransformationalbusiness models and new mindsets as
well as established methods that are already known to work.
Aims and Objectives:
The study aims at understanding Delivery of maternal and child health though the use of Google Glass in
India, make it a self sustainable healthcare delivery model, increase its penetration in the Indian Healthcare
system through partnership with government for installation of WI-FI towers which are a prime requirement
for the functionality of Google glass, training of healthcare workers for use of Google Glass so that response
times could be reduced and precious lives could be saved in a healthcare system where public spending on
health is amongst the lowest in the world.
Methodology:
Secondary data from various published case studies were analyzed. Data on different healthcare models,
performance indicators,success criteria, challenges faced by different healthcare models were collected from
different health care surveys, health care websites and journals.
Findings:
The findings reflect the key operating principles for self-sustainable healthcare delivery models which are4As (accessibility, affordability, acceptability & awareness), local engagement & skills building, Mobile tools(mobile registration, mobile health saving plan, mobile health cards), Telemedicine-Google Glass technology,
Spoke and Hub, Technology integrationand their scalability. The use of Google glass in healthcare is cost
effective as compared to the heavy investment required in traditional Telemedicine Infrastructure and
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through proper training provided to healthcare workers can work wonders in the realm of maternal and
child health.
Conclusion:
Women and child health is a unique area where compassion, altruism and economics combine in a single
cause. By saving lives, we not only do something morally right but also help build more prosperous, productive
communities.
Women and children represent more than half of the worlds population, so their well-being is a cornerstone
of human development and progress. Women who are health literate and can access the health care they
need to give birth safely and ensure their babies get a healthy start in life create the preconditions for
economic growth and prosperity.
Here is where Google Glass steps in. By various educational programmes aimed at doctors and other ground
level healthcare workers Google glass Promises the beginning of a new Era of technology which could transform
Indias Healthcare delivery system.
Code - IP15A038
It has been used for treatment of infectious conditions because of its presumed antimicrobial and immuneenhancing properties. Garlic is thought to have cholesterol-lowering and other antiatherosclerotic and
antihypertensive effects and is used for prevention of cardiovascular disease
Grapefruit is used as a dietary intervention to lose weight and improve cardiovascular health.
In postmenopausal women taking estrogen, grapefruit juice may increase the risk of breast cancer by
inhibiting estrogen metabolism by CYP3A4 . These potential interactions should be discussed with patients
taking medications metabolized by the CYP3A4 system and they should be advised to avoid grapefruit
consumption.
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Code - IP15A039
Statistical Quality Control Chart : A Six Sigma Initiative to measure and controlquality
in healthcare operations
Ishita Srivastava, Shivani Arora (The IIHMR University, Jaipur)
Rationale:
Statistical Process Control is a methodology of statistical analysis used to discover special cause variation in
a process. A statistical quality control chart is a tool that graphically displays the control limits on process
outcomes. Attribute based c-charts are used to count bad occurrences as quality defects, attribute based p
charts are used to monitor the proportion of defects in a process that has binomial distribution as its theoretical
base and mean and range charts are used for variables that are measured continuously.
In a health care setting, quality managers can use the appropriate type of control chart to monitor the outcomes
like infections, accuracy of medications, satisfaction among patients regarding hospital services and various
others issues that hampers the smooth running of a hospital.
Currently, statistical quality control charts are being used in the measuring and controlling stage of Six Sigma.
Objectives
To construct various quality control charts viz.:
Attribute based p- chartto monitor the patient satisfaction level regarding delivery of services.
Variable based mean and range chartsto monitor the T.A.T. of initial assessment in Emergency
department as per NABH clause.
To analyzethe Control Chart Patternsfor variations using Run based pattern tests.
Methodology
Study type: Descriptive and Exploratory.
The study was conducted in a tertiary care hospital in Gurgaon. Primary data was collected through
semi-structured questionnaire and direct observations.
To create c-chart, data was collected from a sample of 50patients over a period of 12 months.
For creating p-chart, data was collected from 50 patients daily for a period of 10days.
To construct mean and range chart, data was collected from 10patients daily for 10days.
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Key Findings:
Analysis of attribute based and variable based charts revealed that the processes under study were statistically
out of control as per 3sigma limits.Run based pattern test was conducted to further investigate any anomaly
in the control charts.Quality manager of the hospital was requested to take appropriate control measures
and bring the processes under control.
Conclusion:
SPC is both a data analysis method and a process management philosophy, with important implications on
the use of data for improvement in various clinical and administrative processes, thus ensuring improved
standards of healthcare.
Control charts have found their applicability in various areas such as hospital performance infection rates,
rates of patient falls, waiting times of various sorts, rates over time in a medical context, such as mortality
rates, rates of disease, bio-vigilance such as patient identification and non-infectious hazards of transfusion,
surveillance of infectious diseases, lab turnaround, patient satisfaction scores, medication errors, emergency
service response times, post-operative lengths of stay, door-to-needle times, counts of adverse events and
many others. Thus, they act as phenomenal toolin providing an effective method to visualize data over a
specific monitoring period while considering for boundary conditions and helps to check if the corrective
action has resulted in an improved process.
Code - IP15A040
Methodology:
Secondary data analysis of the maternal nutritional status available, has been done to obtain the following
results.
Keyfindings:
During 500 days, child is initially dependent on mother for nutrition through placenta, then via exclusive
breast feeding. Maternal nutrition status varies pan India. The 3 major problems discussed are : 1. Anemia, 2.
BMI of pregnant women, 3. IUGR
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Anemiaan easily treatable disease affects 38% pregnant women (aged 15-49 years) and results in 20 40% of
maternal deaths in India (WHO in 2011). India contributes to 50% of global maternal deaths. Anemia follows
a 2-way modality; 1) affects maternal health, causing lethargy, decreased physical capacity, fatigue and
diminished work performance, 2) affects child health by LBW, decreased iron store in newborns.
Mothers who consumed IFA for 90 days or more when they were pregnant with their last child (%) 22.3(totalNFHS 2005-06), 34.5 (in urban), 18.1 (in rural). Anemia among pregnant women(in rural) is 59%, (urban) is
54.6%, totaling to 57.9 % (IIPS NFHS 2006).
BMI-distinguished as thinness (BMI<18.5; 41% in India),short stature (39%) and over weight (BMI=25-29.9).
Under-weight causes lethargy, decreased physical activity, immunosuppression and high morbidity and
mortality, Overweight causes spinabifida infants. Short stature-due to early childhood malnutrition, poses
risks of pregnancy-related complications and decreased immunity.
IUGR- Maternal nutrition has a strong influence on perinatal outcomes including intrauterine growth
retardation as there is scanty supply of nutrients via placenta to the fetus resulting in small for gestational
age babies. IRof IUGRin India 25-30 %( UNICEF 2007). Estimated annual incidence-56% /year by 2020(WHO
2003).
Conclusion:
One of the limitation is thatin-equity has not been quantified for BMI (infeasible to assess in pregnant women),
IUGR(NFHS does not include IUGR in its survey). However since maternal nutrition holds substantial
importance, thus government too has initiated PPPs for generation of fortified nutritional supplements, backing
organizations like Sukarya, programs like national iron + initiatives which work to scale up the iron scores of
mothers, life course approach(WHO),strict following of the RDAs , NNACP.
Key words:
Maternal healthcare, nutrition, Anemia, Health Indicators.
Code - IP15A041
Finding:
Internationally, drug patents are awarded for a period of 20 years, during this time, no other pharmaceutical
company is allowed to manufacture or market the same drug which is manufactured by patent holding
company. After the patent expires, other companies are allowed to manufacture and market the drug now
their brands are known as generic versions.
In the early era of 1970s, the Indian Patents Act was passed under the Indira Gandhi government which
granted greater access of medicines at affordable rates to the poor people in the country. This ACT is process
patents but not product patents and it was for 14 years.In 2005 the alteration was made to the act and then
product patent was established. India has to improve its presence in the global market. India is worlds 3rd
largest producer of generic drugs in term of volume. India is a member of the World Trade Organization. So
that it requires a new patent law to fulfil its obligations under the TRIPS.
On 2007, January 26 the Union Ministry of Chemicals and Fertilizers of India announced that it was considering
the formation of a committee which would suggest a about price negotiation system for patented drugs so
that such drugs could be easily available at an affordable price for everyone within the ambit of the National
Pharma Policy. Drugs would not be given marketing rights in India without negotiated pricing policy. The USA
allows gene patents therefore, private organizations can govern the IPR on genes that determine health and
disease. This gene patents will allow the individuals or organizations to permit or deny the permission for
other, to research or even test for these genes or diseases. So that not only the drugs but also some enzymes
and biotechnological products are patented for human welfare its also an innovative idea in the pharmaceutical
world.
Conclusion:
Government gives most of policies for research and development in pharmaceutical so that industries puts
lots of effort in drug innovation and new drugs will be developed and the patent procedure is also made so
simply for the industry.
Code - IP15A042
Key findings:
It was revealed that marketing executives accept that the competition of health care is ruthless and competing
in existing market space: the so called red ocean is not easy and it needs to be uncontested (BOS).
Conclusion:
Blue Ocean Strategy is an alternative approach to growing an agencys revenue. It requires a complete
commitment; upfront investment and willingness to take a risk, on the other hand it should only be implicated
after a thorough analysis of recent market trends.
Code - IP15A043
in the early morning hours, that can significantly reduce waiting time of patients. This will help the department
to function with optimum efficiency and provide quality care to patients.Online indenting of the medicines
can reduce errors as well as improve the efficiency and accountability of the pharmacy personnels.Seperate
counters for credit and payment purchase can reduce the long waiting time in the pharmacy department of
the hospital.
Code - IP15A044
Universal Health Care and Sustainable Healthcare Financing in India: Lessons from
German Healthcare Market
*Dr. Nidhi Nigam, *Dr. Paridhi Mehra, *Institute of Health Management Research University, Jaipur
Introduction:
WHO defines Universal Health Coverage as ensuring that all people can use promotive, preventive, curative,
rehabilitative and palliative health service of sufficient quality to be effective while also ensuring that the use
of services do not expose the user to financial hardships. To achieve UHC countries adopt various funding
models including compulsory insurance, single payer, tax based financing, social health insurance, private
insurance and community based insurance.
The German healthcare system is based on compulsory health insurance which grew out of self help friendly
societies and became a federal system in 1998 with Bismarcks RVO (Imperial Insurance Decree). In 2009 it
became mandatory for all German citizens and long term residents to have health insurance. The country
has two main types of health insurance where the citizens can enroll themselves with either a statutory
health insurance (SHI) provided by the government or private health insurance. The public health insurance
which is provided by Federal Ministry of Health comprising of 150 competing Sickness funds and constitutes
85% of the population covered under SHI. While the remaining 15% percent being covered by private and
special regimes such as scheme for soldiers. German healthcare system is recognized worldwide as providing
good quality healthcare. The total health expenditure is 11.6% of GDP. The country ranks 20th in the world
with the average life expectancy of 80.5 years. The practicing physicians per thousand population are 3.7
while practicing nurse per thousand population are 11.3. Infant mortality rate is 3.4 per thousand live births
and maternal mortality ratio is 8 per one lakh.*
India is embarking on an ambitious target of achieving UHC where every citizen would be entitled for
comprehensive health security in the country. Currently the total expenditure on healthcare is 4.1% of GDP
where only 1.3% is public funded.* The number of people covered under health insurance is abysmally low.
Learning from the successful experience of developed countries like Germany, health insurance industry in
India is growing with more and more private and community based microinsurance scheme penetrating the
Indian healthcare market. The government has started various health insurance schemes including the
Employees State Insurance Scheme (ESIS), Rashtriya Swasthya Bima Yojana (RSBY) scheme and Central
Government Health Scheme (CGHS) at the central level. At the state level, the schemes include the Rajiv
Aarogyasri (Andhra Pradesh), Yeshasvini (Karnataka), Vajpayee Arogyashri (Karnataka), Kalaignar (Tamil Nadu),
RSBY Plus (Himachal Pradesh) and the proposed Apka Swasthya Bima Yojana (Delhi).
In the Indian context, this veritable wave of health insurance represents an alternative form of mobilizing
and allocating government resources for health care. In an environment challenged by low public financing
for health, entrenched accountability issues in the public delivery system and the persistent predominance
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of out-of-pocket spending, particularly by the poor, government health insurance schemes have introduced
a new set of arrangements to govern, allocate and manage the use of public resources for health to reach
universal coverage by first covering the poor. These arrangements are promising foundations for reaching a
positive consensus on reforming Indias health finance and delivery system. Moving close to UHC is not an
unattainable dream. Momentum is building and developing countries like India are on the right path to attain
UHC.
* Healthcare Systems: Germany Based on the 2001 Civitas Report by David Green and Benedict Irvine
* Draft National Health Policy 2015 and World Health Organization Global Health Expenditure database
Code - IP15A045
To introduce aspiring health care managers to themajor operations management techniques applicable
in healthcare systems.
To explain Quality Management Concepts, techniques and applications for healthcare process
improvement.
To explain the major innovations and contemporary approaches in Healthcare Operations Management,
like JIT, Lean & Six Sigma, NABH 4th Edition.
Methodology:
The study is descriptive and exploratory in nature. It is based on secondary data books, journals, Internet etc.
The study is descriptive as it illustrates the various OM techniques in hospitals and exploratory in natureis
exploratory as it is trying to identify the applicability of OM techniques in healthcare.
Key Findings:
PERT & CPM could be applied in managing and controlling project activities, costs, resources.
Quality Management Concepts; Six Sigma is one of the latest quality goalstrategy for errors occurring in only
3.4 times per million observations.Deployment of six sigma could be done using DMAIC or DMADV.The concept
of quality management is to transform poor health to wellness for patient through Diagnosis, Procedures
and Treatments with quality certification and awards like ISO 9000, NABH and JCI (set of standards of quality
management and quality assurance).Lean management principleconcept helps in reducing waste of money,
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time, supplies, or goodwill (e.g. Japan).JIT is an inventory management strategy aim at reducing or eliminating
inventory (i.e.goods arrive just before they are needed; best applied in expensive implants and medical devices).
Supply Chain Management encompasses the planning and management of all activities involved in sourcing
and procurement conversion, and all logistics management activities.
Conclusion:
Healthcare organizations are facing increasing pressures from consumers, industry, and governments to deliver
efficient and effective services and need to adopt these new philosophies to remain competitive.
Operations management (Scientific Management) methods called for eliminating the old rule-of-thumb by
replacing the varied methods with the best way of performing the work to improve productivity and
efficiency.
Code - IP15A046
that they felt either somewhat safe or unsafe. Notably, 41% of the survey respondents had experienced a
work-related injury in a year, and 48% had experienced an illness.Top concerns reported by respondents (1)
acute and chronic effects of being overworked; (2) a disabling back injury; and (3) being infected with a
needle stick. 76% reported that unsafe working conditions interfered with the delivery of quality nursing
care.
Conclusion:
India is faced with the double challenge of producing more nurses as well as maintaining their professional
safety to avoid the serious risk of withdrawal of qualified nurses due to their fear of an unhealthy career. This
study proves that nurses arent solely responsible for nurse-sensitive outcomes it is lack of safety
management practices in the hospitals. Potential interventions suggested were 6-Safety Structure Framework
and Health Facility Employer. Health and safety operations that should be integrated into daily workplace
activities.
Code - IP15A047
Code - IP15A048
Conclusion:
Strengthening public health interventions for malnutrition cases among the vulnerable groups with a focus
on socioeconomic development in the country are the prerequisites required to tackle malnutrition among
under-five children in India.
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C0de - IP15A050
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Code - IP15A051
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Code - IP15A052
Code - IP15A053
Working Towards Equity; The Inclusion of Persons with Disabilities (PWDs) in HIV/
AIDS Program Interventions in India
Dr. Neha Garg, Narendra Patel
Introduction:
India has the third largest number of people living with HIV in the world. The UNAIDS has identified twelve
risk groups that are especially vulnerable and have been left behind from the national AIDS response. Of
these twelve, one is persons with disabilities. Low awareness, sexual abuse, and lack of access to health
services are the major reasons for people with disabilities being vulnerable. The National AIDS Control
Organization has completely ignored this vulnerable risk group .Disability is both a public health issue and a
human rights issue. According to Census (2011) 21.9 million population are differently abled including 10
million visually impaired people. The situation regarding the disabled and HIV and AIDS needs more attention
because they are more susceptible to contracting HIV and AIDS compared to their non-disabled peers. Disability
cannot be looked in isolation.
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To identify models and gaps of good HIV AIDS interventions currently in place or policy making where
people with disability are excluded from HIV/AIDS outreach efforts and service delivery.
Methodology:
Data reviewed on the basis of secondary data available on Sexually Reproductive health for persons with
disability, disability inclusive HIV/AIDS programs in India & Africa.
Findings:
Many programmes and campaigns have been set up to create awareness on how to prevent, manage and
live positively with HIV and AIDS but these programmes and campaigns however are rarely made accessible
to the visually impaired persons for instance, information is not provided in accessible formats like Braille
and large print, and they have limited or no knowledge of how to live with HIV and AIDS or how to care for
others with the disease. There are cases of illiteracy among visually impaired persons particularly in rural
settings. Lack of skills is also an impediment to health practitioners in providing HIV and AIDS services to the
visually impaired. As a result, support services are not modified to suit the needs of the visually impaired.
Additionally, the infected persons receive little support from the community due to social stigmatization
thus accelerating their immunity deficiency. In some circumstances, the vulnerability of the visually impaired
persons to HIV is exacerbated by traditional beliefs and myths which presume visually impaired persons to be
at no risk of contracting HIV and as a result they are excluded from voluntary counselling, testing and treatment
facilities.
Conclusion:
To efficiently close the gap, an integrated and disability-inclusive HIV response is needed so that people with
different types of disabilities, their caretakers, healthcare professionals and society are empowered to fight
the collective battle against HIV/AIDS.
Code - IP15A055
Key words:
Cold Chain Management, Healthcare delivery
Objective:
To find out the existing gaps prevailing in the vaccine management. To reduce the cost of health care by
channelizing cold chain management.
Methodology:
The literature survey was conducted by extracting data and relevant information from different review and
research articles related to cost on healthcare which were carried out in different hospital settings. The
databases which were searched include PUBMED, GOOGLE SCHOLAR and SCIENCEDIRECT.
Results and key findings:
One of the cross sectional study which was conducted in the UHCs reported some of the reasons for improper
cold chain management which are as follows: Absence of separate stabilizer for deep freezers and ILRs (icelined refrigerators), ill-maintained temperature-record register, lack of criss-cross pattern of ice packs in deep
freezer, presence of things other than ice packs in deep freezer and things other than vaccines in ILR .All
these factors indicate poor cold chain maintenance. In one more study which was conducted for temperature
monitoring and observing the Frequent exposure to suboptimal temperatures in vaccine cold-chain system,
it was concluded that exposure to temperatures above 8 C occurred at every level of vaccine storage, exposure
to subzero temperatures was only frequent during vaccine storage at peripheral facilities and vaccine
transportation.
Conclusion and Recommendation:
Efforts should be made in order to train the technical staff about the importance of temperature in cold
chain management so that the issue where vaccines are losing its potency could be resolved. It would ultimately
aid in reducing the health care cost. Systematic efforts are needed to improve temperature monitoring in the
cold-chain system in India.
Code - IP15A056
Our discussion therefore focuses the drives towards the improvement of quality as well as safety in healthcare.
Objective:
The objective of the discussion is two-fold:
i)
To realize the different dimensions of healthcare and how such diverse phenomena can actually work in
the untiring attempts towards sustenance of the patients.
ii) To study and analyze the changes that would help in achieving improved health outcomes for patients,
better performance of the system of healthcare and also improved professional developments.
Methodology:
Discussion on the quality and safety in healthcare involves a two-way approach
i)
The theoretical approach towards the spreading of awareness for safety and improved quality through
education initiating the efforts towards better performance.
ii) The other is delving into the practical steps of the united efforts of each and every individual involved in
healthcare industrywhich range from the professionals to the people to whom such care is actually
catered to i.e. the patients.
Healthcare providers have increasingly looked at methods of Six Sigma because variety of factors have propelled
this movement, including the need for a more rigorous approach to ensuring quality; one that extends beyond
the quality department.
Key Findings:
Our discussion on the improvement measures in healthcare explicates the following issues:
i)
The doctor-patient or the teacher-learner relationship lies at the centre of the much wanted attempts
towards betterment.
ii) Patients can only be benefitted if the safety and quality improvement culture is embraced in education
as well as the practice of the professional healthcare units.
Conclusion:
Finally, I would like to point out that the concept of healthcare implies morality therein.The boon of life can
only be sustained through good care of health. For the purpose, medical education for healthcare professionals
ought to take care of sustenance, maintenance as well as the scope for improvement. Until and unless the
quality is assured and the scope for safety measures are taken care of, the healthcare industry can never
succeed in its noble mission of safeguarding the health of human beings.
Code - IP15A058
Application of Failure Mode and Effects Analysis (FMEA) and Root Cause Analysis
(RCA) in reducing the Patient Identification errors in a tertiary care hospital
Rachana Kashyap and Jasmeen Bawa1
Rationale:
Failure Mode and Effects Analysis (FMEA) is a prospective assessment that identifies and improves steps in a
process thereby reasonably ensuring a safe and clinically desirable outcomes. It is an operations management
technique to identify and prevent problems or errors in product or processes. Successful implementation of
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FMEA helps in improving the quality, reliability and safety in the processes of a hospital. Root Cause Analysis
(RCA)isamethodofproblemsolvingthattriestoidentifytherootcausesoffaultsorproblems.Accurate
patient identification is an important step in reducing mortality and morbidity rate in hospitals. Historically,
Accident prevention has not been a primary focus of hospital medicine. Previously, hospital systems were
not designed to prevent or absorb errors; they just reactively changed and were not proactive.
Globally it has been estimated that approximately 1.42 lakh people died in 2013 because of adverse effects
of medical treatments. Hence there is strong need to prevent medication errors and accurate patient
identification.
Objectives:
The objectives of the study are:
To apply Failure Mode Effects Analysis and Root Cause Analysis in order to reduce patient identification
errors in hospital.
Methodology:
The current study has been carried out in a super speciality tertiary care hospital in Patna, Bihar. The study is
descriptive, exploratory and cross sectional in nature. The data was collected from the duty doctors, nurses,
customer care staff, staff of the wards, and from the staff of radiology department. The data collection
technique was personal interview and discussions. The secondary data was collected from hospital records.
The sampling technique was judgemental and convenience method, however care was taken in selecting the
respondents. Process mapping was done during data collection. Templates of FMEA and RCA from Sigma XL
were used in the study. The data was analysed through SPSS, Excel, and Sigma XL.
Key Findings:
During FMEA analysis fifteen failure modes were identified in patient identification. In these failure modes
the maximum risk priority number (RPN) was of bed number used for the identification of patient. The
criticality i.e. severity x occurrence was also very high in the same failure mode. The second failure mode
having high RPN was the wrong X-ray film due to several potential causes. Both failure modes were considered
as vital few. RCA was carried out in identification of the causes of the failure modes.
Conclusion:
Failure Mode and Effects Analysis and Root Cause Analysis could be applied in hospitals in order to reduce
patient identification errors for improving quality of service. The process steps having high RPN should be
focussed for redesigning. In case of Root Cause Analysis, after identifying the main causes that leads to
errors, actions should be taken. The process having high criticality should be considered for intervention.
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Code - IP15A059
Are children safe on Indian roads? The Haddon matrix approach for prevention of
road traffic accidents and injuries in India
Shivika Chugh, Suchismita Mishra (The IIHMR University, Jaipur)
Abstract
Road traffic injuries have been recognized as a major global public health problem both by the World Health
Organization (WHO) and United Nations (UN) as one of the leading causes of death, disability and
hospitalization with severe loss of socio-economic costs, across the world. Road Traffic accidents are the 9th
leading cause of deaths accounting for 2.2% of the deaths globally (nearly 1.3 million people dying each
year). It is projected to be the fifth leading cause of deaths worldwide by 2030 as per the Global Status
Report on Road safety, 2013.Developing countries bear a large share of the burden, accounting for 85 percent
of annual deaths and 90 percent of the disability-adjusted life years (DALYs) lost because of road traffic injury.
India accounts for around 1.4 lakh deaths due to road crashes each year (Ministry of Road Transport and
Highways, GOI, 2013). The estimated GDP lost due to road traffic crashes in India is 3 % (2009, 10th Five year
plan).It is found to be the leading cause of death among young people, aged 1529 years. Children, pedestrians,
cyclists and older people are among the most vulnerable road users constituting half of those dying on the
worlds roads. India has one of the worst road accident records in the world, that too taking more of young
lives, particularly of school children. According to the National Crime Records Bureau, 20 children under the
age of 14 years die daily in road accidents in India. Thus, there is a pressing need to address the issue of road
safety and particularly child safety as there are no child safety laws in India. Preventive measures require a
multidisciplinary approach.The approach is based on The Haddon Matrix (1978, William Haddon Jr.) which is
a conceptual framework for understanding the origin of injury problems and for identifying multiple
countermeasures to address them. It is a 3x3 matrix in which a set of risk factors that increases a childs
susceptibility in road traffic is considered and wherein each cell offers opportunity for interventions. Our
study suggests some interventions such as use of child restraints (age appropriate child or booster seats),
standardized helmets specially designed for children, and putting school buses in a special class of vehicles
such as an ambulance. There should be enforcement of stringent child restraint law in India which already
has an evidence of effectiveness in reducing deaths by a huge number amongst children in high-income
countries.
Key words:
Road traffic injuries and deaths, Haddon matrix, Child safety, Child restraints
Code - IP15A063
providing a minimum basic level of healthcare. A large chunk of population is still not able to access the latest
technological advancements made in healthcare industry.
In India, particularly private sector plays an important role in the countrys healthcare segment with its share
of 68% in spending. But running a fully fledged hospital requires an enormous investment thus its viability
considerably reduces in lesser dense populated areas. The cities where running such hospitals is viable, there
is a cutthroat competition among the existing hospitals. This makes it imperative for any corporate hospital
to come out of the red ocean and include new or untouched population with minimal costing possible.
Objective:
Create and capture new demand by focusing on unaddressed groups of customers (non-customers),
with a strategic offering that creates a leap in value for both the buyers and the company.
Increase awareness among the population about the possible treatments available.
Providing services with quality and precision, addressing the need of the consumer.
Methodology:
Secondary data was extensively referred to in finding the important new age factors affecting their choice of
individuals while selecting amongst the hospitals or healthcare options. A blue ocean strategy was formed
for a new generation hospital which provides customer friendly services and achieve maximum market share.
The idea floated is to develop a network of specially designed vehicles able to provide telemedicine facilities,
blood work and immunization. Each Vehicle would be deployed in a particular Locality with a team consisting
of Medical officer, Paramedic and a driver/helper within the allocated radius from the hospital. An affiliation
will be required with local hospitals which are able to conduct lab tests which would help in reducing the
transportation costs.
Key Findings:
The Model is convenient as the elite patients get the services at their doorstep thus non value adding processes
to the patient are reduced greatly.
It provides a comprehensive platform in reaching out to the untouched population, marketing of the hospital
as well as its doctors, opportunity of creating new referral points, conduct corporate social responsibility and
building rapport & trust among its patients. .
The model would cut the competition and provides a hedge from overdependence on hospitals physical
facility. A first well executed model by a corporate will be hard to replicate, and would provide great future
opportunities and revenue.
Conclusion:
The model is sustainable and efficient in delivering both acute and preventive care. The model is beneficial to
the patients as well as the organization.
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Code - A9
Dr. Vikram Kumar Yadav, Asst Professor-Pharmacology, Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur
Pharmacogenetics and pharmacogenomics are two major emerging trends in medical sciences, which influence
the success of drug development and therapeutics. In current times, though pharmacogenetic studies are
being done extensively for research, its application for drug development needs to get started on a large
scale. The major determinants of success of a new drug compound, viz safety and efficacy, have become
more predictable, with the advent of pharmacogenetic studies. There is a need felt for pharmacogenomic
studies, where the effects of multiple genes are assessed with the study of entire genome.
Pharmacogenetic studies can be used at various stages of drug development. The effect of drug target
polymorphisms on drug response can be assessed and identified. In clinical studies, pharmacogenetic tests
can be used for stratification of patients based on their genotype, which corresponds to their metabolizing
capacity. This prevents the occurrence of severe adverse drug reactions and helps in better outcome of
clinical trials. This can also reduce attrition of drug compounds. Further, the variations in drug response can
be better studied with the wider application of pharmacogenomic methods like genome wide scans, haplotype
analysis and candidate gene approaches. The cost of pharmacogenetic testing has become very low, with the
advent of newer high throughput genotyping systems. However, the cost of pharmacogenomic methods
continues to be very high. As the treatment with several drugs is being more and more pharmacogenetically
guided (e.g. warfarin and irinotecan), the FDA has laid down guidelines for pharmaceutical firms regarding
submission of pharmacogenetic data for their drug products in labelling.
Code - A1
Methodology:
A systematic review of articles was done by using databases from websites like Pubmed, Medline, Lancet etc
in context of the purpose stated. The article also discusses diverse examples from healthcare, airlines, package
delivery and jet engines.
Findings:
Of the many potentially relevant studies identified, only few met all criteria and were included in this review.
The authors inferred that the healthcare environment is highly competitive and hospitals continue to fight
for market shares and profits. Using examples from other industries; the authors illustrated how new ideas
can provide differentiated value for customers at a low cost to companies
Conclusion:
An innovative framework is needed by healthcare managers that enables them to think out of the box and
maintain a competitive advantage and strong profitability.
Key words:
# Innovative Strategies in Health # Unique Business Ideas # Niche Markets # Blue Ocean in Healthcare
Code - A2
Exploring Blue Ocean Strategies for Health Promotion in Low and Middle Income
Countries: Learning from the Malaysian example
Kirti Kataria*, Poonam Yadav*, Rupinder Kaur*
*MPH Scholars, Post Graduate Institute of Medical Education and Research, Chandigarh
Rationale:
The concept of Blue Ocean Strategy has been proved as a successful model in distinct fields. However, its
application in the health sector is yet to be explored to optimum level. The study tries to explain the possibilities
that various blue ocean strategies may have for health promotion activities in low and middle income countries.
Objectives:
1. To study the concept and methodology of Blue Ocean Strategy.
2. To study the Malaysian Governments National Blue Ocean Strategy(NBOS) initiatives in health sector
and their impact
3. To explore the possibilities of implementing blue ocean strategies for health promotion in India on the
analogy of Malaysias NBOS
Methodology:
We studied the concept of Blue Ocean Strategy, the National Blue Ocean Strategy Initiatives by the Malaysian
government and the current gaps in health promotion in India which can be addressed by implementing such
strategies.
Key Findings:
The Malaysian Government had introduced the National Blue Ocean Strategy in various sectors. Their initiative
in healthcare, the 1 Malaysia Family Care, has delivered quality services to the elderly, persons with disabilities
and single mothers in the country. Its inter-sectoral approach uses cost effective measures to provide screening,
consultation and referral (if required) along with quality treatment services. The programme functions by
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tying up with NGOs and roping in volunteers to facilitate the implementation. Apart from health benefits, the
strategy aims to provide them financial and emotional support in a family like environment.
Conclusion:
The scope for blue ocean strategies to be adopted in health sector is enormous. Drawing example from the
analogy of Malaysia, Indian health sector can tap this unexplored potential. There are several sections of the
society like elderly and persons with disabilities in India which such blue ocean strategies can target. The
study provides the evidence to policymakers of low and middle income countries that such strategies if
implemented well can reduce the burden of the health sector in a cost effective way.
Code - B5
Key Finding:
Prevent individual member inform bearing the financial burden of hospitalization
Conclusion:
Through the universal health insurance coverage will help India for prevention of diseases and promotion of
good health through cross sectorial action, Developing human resources for social and economic development,
Encouraging medical pluralism, Building the knowledge base required for better health and Financial protection
strategies.
Code - IP15A032
that it is not cost effective for them to have their own field force in such locations. The expenses made by
pharma MNCs on promotional& marketing strategy have also increased, with the result that the operating
margins of the pharma MNCs operating in India have shrunk, although they are still largely within the range
of comfort.
Conclusion:
Enforcement of Drug Price Control Order is the biggest steps taken by the government to ensure availability
and affordability of quality drugs for the masses.With the pressure of increasing healthcare costs serving to
drive up volumes in the generics business across markets, this segment is becoming increasingly relevant for
all players in the industry, including the large innovator companies. In this context, markets like India are
especially attractive, given their potential for higher growth.
Code - IP15A027
To provide improved Interactive Client Centric Communication to facilitate actions at the community
and Family Level.
Methodology:
This model is proposed based on Janswasthya which is an android-based application developed for National
Health Mission Rajasthan, by an innovation hub set up at State Institute of Health and Family Welfare (SIHFW)
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with the technical support of UNICEF, Rajasthan, which has transformed the functioning as well as thoughts
of the ANMs from number to quality.
This was initiated with 15 ASHAs in one of the most deprived district called Barmer and then advocated with
the partners and district administration of various districts. This pilot intervention is running successfully in
Dungarpur, Pali, Jhalawar and now nearly 400 ANMs are using it across Rajasthan.
Conclusion:
This innovation will take the public health care delivery at a different level of quality and access as it has the
power to the reach the unreached area. This will certainly contribute in bending the curve of Neonatal, Child
and Maternal mortality and morbidity and lead to development.
Code - IP15A028
Since slums are usually illegal areas, local government tend not to acknowledge their existence except when
they are demolishing them and no money is invested in country on MAPPING. For instance in Agra only 215
slums are officially declared and there is no account of 718 unlisted slums.
Suggestions:
After literature suggestions review, the article has come with likeCommunity based institutions like MAHILA
AAROGYA SAMITI and ROGI KALYAN SAMITIS should be encouraged. Public Private Partnership should be
increased. Relationship with NGOs can rapidly expand health services to underdeveloped slums.Innovation
of urban health programmes, Policy advocacy, focus on policy implementation should be developed.
Conclusion:
By this we can conclude that the inhabitants of slums are unable to get subsidised health care. Women
health is especially neglected. 1 million Indian children are born in slums every year with little or no medical
assistance. So, we should achieve the goal of universal health services to all urban population that should
ensure free, high quality geographically and socially accessible, respectful and comprehensive health care to
the target population.
Code - IP15A001
Methodology:
Data was developed from the reviewed information extracted from the contribution of different articles and
then it was analysed and synthesized into the current article.
Action Plan:
Initially this is for primary healthcare services which consist of preventive services which will launch in tier3
cities of India. Under this model seven scopes of speciality health services through preventive and curative
care will be given. Firstly one time amount of rupees 500 for each person for six month coverage and copayments structure of rupees 10 for each and every individual visit. Through the private partnership the
health infrastructure and services will be given by private local or particular renowned clinical doctors of
those cities. For sustainable business this model has three channels of revenue generation as well dispersion.
First one each doctor will paid per patient consultation charge, secondly we have our own generic medicine
shop or outlet in the city lastly the partnership with diagnostic and screening centre which will provide
affordable subsidized rate rather than market value. The model has its own call centre by which patient can
give details and ask about their health problems .Then after according the patient need, the patient get their
prior appointment. The whole concept of this health services is to reach maximum number of selected people
groups. At time of launching this model, the masses will sensitize by various channels of communication and
from future prospect the model having expansion plan to increase in services and financing partners.
Key words:
Primary Heath Care, BPL, Health Coverage, Affordability, Availability.
Code - IP15A002
Methodology:
Secondary Data review from different articles and Papers.Benefits -Contracting Management of Super
speciality hospitals, Community Health Centres,Primary Health Centres. Free services like diagnosis, treatment,
drugs, 40% beds for poorpatients and free OPD services to poor. Except selected surgeries all the surgeries
are free forpoor. Institutional deliveries through private obstetricians, primarily for women from poorfamily.
Strengthens Yeshashwini co-operative farmers healthcare scheme. Contractingmanagement of CT Scan/ MRI
Diagnostics which is free for all poor and subsidized rate forothers. Clinical and Radio diagnostics through
health camps, Lab tests free to all BelowPoverty Line cardholders. Mobile health care units.
Conclusion:
By implementing UHC with its unique reach and scope of healthcare delivery,India stands to gain the political
goodwill and support of 1.2 billion potential beneficiaries.The provision of free healthcare and medicines for
both in-patient as well as out-patient carethrough financial protection, can be expected to significantly reduce
or reverse the highprivate out of pocket spending. A healthy population in turn can contribute to
economicgrowth through increased productivity and higher earnings. There are other benefits as
well.Promoting health equity also contributes to increased social cohesion and empowerment andby joining
the global movement towards UHC India now has both the capacity andopportunity to emerge as leading
force for equitable healthcare of all.
Key words:
UHC (Universal Health Coverage), Yeshashwini co-operative farmers
Code - IP15A003
2% who did not acquire infection in hospital. Surgical site infections are most frequent in developing countries,
with incidence rates from 1.2 to 23.6 per 100 surgeries. The cost was higher for the hospital as well as for
patients due to HAIs. Antimicrobial drugs formed a major part of the extra cost due to HAIs which is five time
higher as compare to non infected patient. Ventricular Associated Pneumonia ranked first with respect to the
economic burden.
Conclusion:
HAI lead to functional disability and emotional stress to the patient that reduce the quality of life. Prolong
stay not only increase the direct cost to the patient as well as the indirect cost due to loss of work. HAI add to
the imbalance the recourse allocation between primary and secondary health care by diverting scarce fund
to the management of potentially preventable condition.
Key word:
Hospital acquire infection (HAI), Average Length of Stay (ALOS), Cost
Code - IP15A004
To determine the operational feasibility of deploying Medical Mobile Mechanics at grass root level.
Methodology:
The study involved research approach with both primary and secondary data to find out the possibilities of
improving the conditions of basic medical equipments with the help of Medical Mobile Mechanics. For this,
a pilot study had been conducted at 15 SCs/PHCs/CHCs of Jaipur District. A multi-stage sample design was
adopted with simple random technique. A questionnaire was prepared and dependent and independent
variables were selected. From this, comparison of costs of idle equipments was estimated with the audit
results and operational feasibility of Mobile Mechanic was determined.
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Key Findings:
In non-functional infrastructure, 4 criteria were selected i.e. Basic Equipments of CHCs/PHCs, Labour
room/OT Equipments, Laboratory & Diagnostics Equipments and I.T and additional areas.
The estimate of idle equipments was calculated. The equipments worth Rupees 20 Lacs were found idle
in pilot study.
Repairing of these equipments would cost 60% less than the cost of replacing them with the newer ones.
Deployment of Mobile Mechanics in accordance with Hub and Spoke Model- - would be a feasible
solution.
Conclusion:
In rural India, due to shortage of skilled mechanics, delay in treatment occurs even for even minor procedures
like B.P. measurement, Blood sugar etc. For this, we can create Medical Mobile Mechanics for the
maintenance and repair of such medical equipments. This grass root level solution will save both time and
money. It will strengthen internal capacity, infrastructure, avoid brain drain and provide job opportunities.
Key words:
Medical Mobile Mechanics, Grass root level, Hub and Spoke Model, Cost-effectiveness, Operational feasibility.
Code - IP15A005
Methodology:
Secondary Data review from different articles and data from RSBY of GOI. Numbers of BPL are obtained from
data of Planning Commission of India. District-specific premiums are weighted to obtain national average
premiums. Using the BPL estimates and national premiums, we calculated overall expected costs of full rollout of the RSBY per annum, and compared it to Union government budget allocations.
Results:
By March 31, 2015, RSBY enrolled about 50 per cent of the number of BPL households. Theaverage national
weighted premium was 530 per household per year in 2015. The expected cost of premium to the union
government of enrolling the entire BPL population in financial year (FY) 2015-16 would be approximately 19
billion representing about 0.08 per cent of the total unionhealth budget. The RSBY budget allocation for FY
2015-16 is only about 0.005 per cent of thetotal union budget, sufficient to pay premiums of only 7 per cent
of the BPL households enrolled by March 31, 2015.
Interpretation & Conclusions:
RSBY could be the platform for universal health insurance when the budget allocation will match the required
funds for maintenance and expansion of the scheme and the scheme would ensure that beneficiaries rights
are legally anchored.
Key words:
Below-poverty-line, Health insurance, Healthcare, India, RSBY, GOI (Government of India), MOHFW.
Code - IP15A006
100
Rationale:
The upcoming trend in healthcare points to the the provision of home based health care especially catering
the elderly population in India, which very soon would form a major chunk of population(18% by 2050).
Therefore, to identify the need and advantages of home care to hospital care lays the core foundation of
carrying out this study. Since not much has been dealt with this issue, there is a need to assess the pros and
cons of applying this strategy on national level.
Objectives:
1. To identify the need for home care in india for old age patients.
2. To identify the advantages of home care to hospital care.
Methodology:
The findings of the paper are based on literature review and internet research of journal reports and relevant
organizations working in the area of elderly care.
Discussion:
Hospital at Home allows patients to opt the option of receiving hospital care at home. Patients, particularly
older ones, are more vulnerable to infections and complications like bed sores in the hospital, and are actually
safer at home, as per experts. Moreover studies have reported that treatment of acutely ill older adult patients
diagnosed with chronic conditions such as coronary heart disease, cancer, chronic respiratory diseases and
diabetes has many benefits at home rather than in a hospital. Next important fact to be considered is the
reduced costs, shorter duration of hospital-equivalent treatment, fewer procedures, reduced geriatric
complications, improved activities of daily living, and better patient and caregiver satisfaction.
Code - IP15A007
inexpensive services, greater attention to prevention and wellness, staff replacement, decrease avoidable
hospital readmission.
Conclusion:
One thing is very obvious and certain that more spending can never translate into better functioning health
care system. Increasing health care expense is now an important issue and a lot of activities are already being
undertaken in public and private sectors to obtain better value for money.
Key words:
Epidemiological transition, demographic transition, never events.
Code - IP15A009
phone apps for client self-management; hotline and interactive voice response (IVR) based approaches
that facilitate client-initiated, structured information content retrieval; and access to counselling, diagnostics,
and referral mechanisms.
Conclusion:
For m-Health strategies to be recognized as integral to the achievement of UHC, the field needs to invest
intellectual and financial resources to move beyond vertical solutions addressing single problems. Horizontal
solutions are seldom easy to develop or adopt, especially in the public sector, but guiding frameworks such
as this one can help governments set realistic expectations and prioritize investments across critical health
system layers. Modified Tanahashi model facilitates a systematic approach toward constructing integrated
m-Health strategies that together address multiple gaps in the pathway to UHC, improving performance in
the quality, cost, and coverage necessary to provide care to all in need.
Code - IP15A010
Code - IP15A012
Level of education : Undergraduates are more aware than post graduates and
2. It was also observed that due to unawareness about CPA many suits are filed to harass doctors or are
filled to evade the payment of bills. This generates the need for understanding the proper definition of
gross negligence.
Conclusion:
CPA has filled in the void for consumers and has provided a transparent legal system with many positive
aspects which have added to the social well-being for which it was enacted. The growing awareness among
consumers is evident with the increasing number of complaints and grievances the Hospital Managements
are receiving. This act has been able to safeguard the interests of both the parties involved. Therefore both
the hospital and the consumers need to update their understanding on CPA and its amendments to be on a
legally safer side.
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Code - IP15A013
Queuing & Capacity Planning in Central Registration Counter for a large tertiary
care hospital - An Operations Improvement Initiative
Harshul Atul Gautam, Madhukara Majji, Jasmeen Bawa2, MBA-HM (BATCH-19), IIHMR University, Jaipur
Rationale:
Generally central registration counter/front desk services in majority of hospitals have queuing and waiting
time problem. Hence it is important to reduce the waiting time. Queuing theory is a mathematical approach
to the analysis of waiting lines. The goal of queuing is to minimize total costs. The two basic costs i.e. Waiting
Cost and Capacity Cost are those associated with patients or customers having to wait for service and those
associated with capacity. Capacity costs are the costs of maintaining the ability to provide service.
Objectives:
The objectives of the study were :
To analyze the waiting time at the central registration counter by applying queuing theory.
To estimate the service capacity for minimum queuing cost of the registration process.
To identify the reasons for high waiting time at the registration counter through a fish bone diagram.
Methodology:
Study Design and Approach: Prospective study and approach is direct observational study.Sample Size(n)
and Type n = 160, Purposive sampling. Tool and Technique -Direct observation of the patient from entry to
exit at the registration counter.
Data collected was analyzed using Microsoft excel and QM for windows software. 5 parameters were
considered while evaluating service system:
1. Average number of patients waiting (in queue or in the system)
2. Average time the patients wait (in queue or in the system)
3. Capacity utilization
4. Costs of a given level of capacity
5. Probability that an arriving patient will have to wait for service
Key Findings:
The Waiting time for the patients was found to be 10 minutes and the study shows that 39% (62 out of 160)
patients wait for more than 10 minutes at the registration counter and it was observed that longest queue
was observed in the morning. During morning (peak hours 10:30am to 11:30am), the waiting time increased
to even 20 minutes. Amongst these 62 patients, maximum were those who visited the hospital on Mondays
(16) and Saturdays (18) as compared to other weekdays. Capacity analysis results showed that the optimum
utilisation was when 3 servers were used. There were many reasons for the increased waiting time but the
main reason was that the process was not streamlined.
Conclusion:
As society is becoming more and more time-pressed, patients are less willing to spend time waiting in lines.
Queue waits/ Pre-service delays have a negative, forwardcarry-over effect on the evaluation of the service
that follows the wait, unless the wait is well managed.
Application of queuing theory analysis can improve movement and reduce the waiting time of patients. It
also helps to examine the trade-off between capacity and service delaysand helps in providing decision for
an appropriate balance between the cost of service and the amount of waiting.
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Code - IP15A015
Rationale:
Health care errors are the 8th leading cause of death in the world. One in 10 patients is harmed while receiving
hospital care. Over 7 million people across the globe suffer from preventable surgical injuries every year
(WHO). The focus in this study is to find the influencing factors of medical negligence practices.
Methodology:
The data was collected from secondary sources such as research papers and reports from renowned health
organisations like World Health Organisation. Tool- FMEA Failure modes and effects analysis.
Proposed Findings:
The malpractices followed in hospitals range from reuse of syringes or needles without sterilisation in 70%
cases, wrong drug dose in 40% cases, wrong choice of drug in 20% cases, avoidable delay in treatment in 14%
cases, physician practicing out of area of expertise in 5% cases, etc. A proper risk management system should
be followed in the hospitals wherein a risk management committee should be formed. It should be headed
by a Risk Management Officer who should identify the risks and decide upon objective steps to minimize
their impact on the patient and the hospital. If such a system is developed in India, it can reduce mortality
and morbidity and average length of stay in hospitals, thereby reducing the wastage of healthcare resources.
Conclusion:
Health-care system not only cures disease and alleviates pain but also often causes harm and suffering. This
is not an acceptable cost of providing health care. Our study suggests that much of this harm can be prevented.
Reducing harm will require greater understanding of its causes and risk management. Risk management can
surely reduce the financial burden and prove to be a boon to patient safety and quality in healthcare. With a
continuous and sincere effort, we can ensure that health care is a balm to human suffering and less often a
cause.
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Code - IP15A066
Code - IP15A067
in IT development and IT-enabled innovations. An area of innovation with the high potential to make a huge
difference is M-Health the use of mobile phone communication technologies to deliver healthcare
services.Examples of existing M-Health innovations are: SMS to remind patients to take their prescribed
drugs at the right time, Remote diagnosis and treatment for patients who do not have access to a doctor or
physician, Remote health monitoring (RHM) devices that track and report patients conditions and progress.
This Poster briefly describes the state of the global healthcare sector, illustrates the methodology used in our
recent Health-related research, identifies ways in which mobile technology might play a role in innovating
healthcare delivery systems and healthcare system cost management, and lays out the requirements for
implementing RHM one of the applications with the highest impact potential in a scalable manner.
Code - IP15A069
Code - IP15A070
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Code - IP15A062
Methodology:
Methodology includes review of literature from various articles and journals focusing on blue ocean strategies
in non-healthcare industries and their possible incorporation into healthcare industry.
Key Findings:
There are ample of strategies adopted by other industries which have led to their success and their
incorporation into healthcare industry is possible in India. Adoption of such successful strategies into healthcare
industries will not only create a new dimension but also a new market space. Use of technology in
implementation of such strategies plays a vital role and thus provides a picture of the future of healthcare
industry.
Conclusion:
Blue ocean strategies could be a game changer in healthcare industry as far as providing affordable and
accessible care is concerned. Learning from other industries enables you to take decisions confidently as
those strategies have been implemented successfully in their respective market space.
Key words:
Blue ocean, Innovation, Healthcare, Strategies.
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Code - IP15A057
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Code - IP15B04
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The western skyline is dominated by extensive parkotas (walls),watch towers and gateways and Jaigarh, the
fort which is widely known for the giant mounted cannon-the Jai-Ban, one of the largest cannons in the
country. Beyond the hills of Jaigarh stands the fort of Nahargarh, providing the most rapturous view of the city
below. In the vicinity lie the cenotaphs of the rulers of Amer, still preserving the traces of paintings that once
embellished their inner and outer walls.
It is not only the static architecture, but the dynamic festive move of the energetic people of Jaipur, that
reflects in the traditional fairs and festivals, and gives the city its vigour.
October-November is marked by the sparkling ceremony of Dusshera and Diwali. The ceremonial burning of
giant effigies of Ravan, the mythical villainous character, on the day of Dusshera, is followed a few days after
the festive occasion of Diwali which is celebrated with colourful fireworks.
The cool breeze makes the pink city a shoppers paradise in the winter season. Jaipur is recognized all over the
world for precious and semi-precious stones, gold and lac ornaments and jewellery, and bluepottery. Bandhej
(tie and dye) and block printing textiles are unique to this part of the country. Rajasthani paintings, a dinstinct
art style in themselves, glorify the rich past of the place.
Jaipur, in all its aspects is an attractive creation worthy of universal admiration.
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Mahesh Kumar
Chandra Prakash
Years in
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International Conference on
www.iihmr.edu.in