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An 11-Step Guide To Improving The Public Health System In India

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The Indian public healthcare system is facing enormous challenges, and to address these, India adopted the National Health Policy 2017 which has the vision of ‘Ayushman Bharat’ (Healthy India) through Universal Health Coverage. India will not able to realise this vision if it doesn’t strengthen certain important parameters:

1. Bottom-up approach:

By forming health committees to address people’s concerns, the Gram Panchayats can build a framework that can be shared with and implemented by the District Planning Committee. With the involvement of health superintendents or health officials, MLAs and MPs, local governments, private medical institutions, district administrations and CSR initiatives, the shortcomings of health facilities and infrastructure can be addressed.

2. Change of attitude among young doctors to serve in villages:

Most young medical graduates usually prefer working in private institutions especially in the city because of better salaries or facilities. The government should try to encourage these medical graduates to work in rural primary health centres. This could be done by amending their syllabus to bring up the problems of village health centres, their inability to get emergency medical services due to poverty, major health problems faced by the people, schemes brought in by the government, etc. This could make young doctors more compassionate towards poor people in backward areas and work for them.

3. Controlling or checking private hospitals:

The Government of India, various state governments and employment organisations provide medical insurance facilities for the common people, employees and various citizens to reduce out of pocket expenditure upto a certain limit on health expenditure. Taking this as an opportunity, private hospitals across India are charging more to extract the money provided under insurance from patients even for small diseases or injuries. The state governments should strictly monitor these hospitals and regulate the prices for various services through policies.

4. Recording daily details about available facilities made available to patients:

You might know about the tragedy in Gorakhpur last year, where lack of oxygen killed several young children at a government hospital. To stop inadequacies like these, the availability of medicines, oxygen, unoccupied beds, the number of patients admitted and the number of patients visiting each hospital should be recorded daily. This could help in monitoring the process strictly and take preventive measures spontaneously.

5. Confidence building among people:

To improve the image of public hospitals and create confidence among the people, elected leaders and administrative heads should avail treatment only from government hospitals. During her last days, former Tamil Nadu CM, late Jayalalithaa was taken to Apollo Hospital and doctors from foreign countries were flown in for her treatment. Incidents like these show a lack of confidence in government hospitals and make the public lose trust in them.

6. Early comprehensive new-born screening:

Kerala State Government has recently started a unique initiative that will help in the early identification and management of all deficits in infants at appropriate ages so that the state’s burden of developmental delays and disabilities can be reduced in the long run. Under the CNS initiative, it plans to converge all newborn screening programmes under a single umbrella on a web-based platform, with a unified reporting system and link-ups with District Early Intervention Centres (DEICs) so that every infant is tracked. Thus, newborns will be assessed under four domains – visible birth defects, functional deficits (hearing issues, congenital cataract or heart diseases), metabolic disorders and neurodevelopmental issues. All Indian states should start similar initiatives to improve child health.

7. Efforts to be made towards a public-private partnership in setting up medical institutions:

Since it is not always easy to set up healthcare facilities in different parts of the country, the government can look into public-private partnerships. These institutions can serve as teaching centres for medical aspirants and also provide subsidised healthcare to the people. This step could also ensure an improvement in the doctor-patient ratio.

8. Learning from other states:

Regular transfer of knowledge should happen among the states to know how effectively services are being provided. Capacity building programs should also be conducted for doctors and nurses in emergency response. For example, after the outbreak of Nipah virus in Kerala, the state took immediate steps to contain the spread of the disease.

9. Employ more counsellors and psychologists:

As cities continue to expand, there is a huge pressure building among citizens, especially the youth. Local governments and municipal administrations should provide counselling centres for citizens. This would help address the extremely worrying rise of mental health issues in the country.

10. Enhancement of research activities in medical science:

There has been a lot of research in the field of cancer, tuberculosis, diabetes, etc but we have not been able to implement their findings and recommendations due to a lack of support from the government. So the government should encourage innovative research by providing fellowships and also provide more infrastructure for research.

11. A feedback mechanism should be brought into effect:

An app can be developed by the Government to take feedback from patients to know about the quality of services provided by government hospitals. They should be able to share whether the doctor came on time, about hospital cleanliness, whether the patients were able to get medicines easily, etc.

This automatically triggers performance appraisal of the doctors and makes them committed towards their duty. It also improves non-medical issues such as accessibility, waiting time, privacy, time with a doctor, administrative efficiency and other services such as food and lodging for families.

The hospital environment will be maintained clean and it creates a better opinion among the people.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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