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Health Corner- Myths versus Facts

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Preface: I was given a rather daunting task by one of my acquaintances to put down some tips on good health for general information to my fellow crowd and beyond to humanity at large. Naturally it was difficult to decide where to start from, since the target readers may be from all strata and communities of our society and of all age groups.

But let me begin somewhere….

In the beginning, I would like to put some very general lifestyle habits which should be followed by all people for general good health to one and all. Many of what I am about to unfold are known to public, but some new concepts will also he hereby known-to undo any faulty /wrong habits which the reader may have inculcated, inadvertently.

Let me suggest a listing of never do’s & don’ts:

Never to skip your Breakfast in the morning. This is the most important meal of the day.

              1. You may skip your lunch/take a light lunch.
              2. Never take a heavy dinner moreover with lots of spicy and oily food. Night is the time of metabolic house-cleaning. The less the task assigned to the body in the form of digestion and metabolism at night, the better the body gets self-cleansed and detoxified by the next day.
              3. Drink at least l0 glasses of water in a day. Maybe more in the hotter regions.
              4. Soft drinks are real nuisance consumables with lots of empty calories. They are never to be considered for replenishing the fluid content of the body.( I have found hardly anybody drinking water along with any food-it is invariably a soft drink to go along !!!)
              5. If milk is tolerated, one can go for it, it helps one to go off to sleep. But it should be avoided by people who are trying to get into shape and lose some weight! Dairy products in general are fattening with the exception of some skimmed milk, etc. All the same, rnilk is regarded as one of the compact forms of nutrition…for calcium supplementation .
              6. Eggs are nutritionally recommended for calcium/protein etc. and they do not contribute to high Cholesterol, unless one is predisposed to high lipids in the blood.. (as per recent research). The no. of eggs should be restricted to 1-4 in a week! Not to forget that eggs go into the making of a lot of confectionery products as well, at home. This should also be considered.
              7. Red Meat/Meat of bigger animals should be avoided at all cost. Mutton maybe very delicious to the taste buds and a gratification to cook at home and places of formal eating, but it is a strict no-no as far as good health is concerned. Its fibers arc very much loaded with fats.
              8. Country chicken is always better-they run around a lot and their flesh is tastier as well than poultry bred chicken!!! Chicken should always be taken with the skin removed preferably before cooking. Ideally eggs of such country chicken are good to taste and good for health also. Duck’s Eggs are tastier but rich in Cholesterol!
                Recently the eggs of Quail birds are available locally too.
              9. Green vegetables and at least one serving of fruits should be present in the platters of all meals. Bananas are good in conditions of constipation/diarrhea but they are fattening as well as they contain a lot of calories. ( Bananas are an item with high GI –Glycaemic Index–They can be taken in moderation from time to time. People suffering from ‘Acid Peptic Disorders’ should refrain from Oranges and all sour fruits.
              10. Dry fruits – recommended best ones are Almonds and Walnuts. Cashew nuts although are common and tasty, they are rich in lipids. Peanuts are very good as well.
              11. Chocolates in general should be taken occasionally-but the darker ones with cocoa are said to be now good for heart, as per recent research, although in moderation .Teeth must be brushed at all times after ingesting chocolates to avoid Dental Caries and related conditions by people of all ages, more so children.
              12. Microwave Cooking is to be discouraged-as it robs the food element of their nutritious values! Microwave ovens can best be used as Food Warmers.
              13. The pattern of eating should ideally be when you leave the dining table you feel as if you could have eaten some more………..!!!
              14. Brown Bread is better than White Bread. But Breads again should be taken in moderation, to keep a check on carbs.
              15. Visits to places like McDonald’s and KFC should be avoided in principle, particularly if children are there in the family. Deep fried junk food is just not advisable for good health for persons in any age group-particularly kids and adolescents.
              16. Not to hit the bed immediately after lunch/dinner. It is better to sit upright for about half an hour (watching TV can be done) before one retires tor the day. This prevents conditions of Reflux Oesophagitis/ Heartburn/Waterbrash etc. which are very common. One should not stoop down to do anything just after main meals!
              17. It is better to avoid eating in between principal meals-as this distorts the real appetite and calories cannot be controlled.
              18. Given the option between Tea and Coffee – it is better to go for Tea. Due to its Tannin content, it acts as a good anti-oxidant. (An anti-oxidant is a substance which mops up the potential carcinogenic radicals in the human body.)
              19. Salad dressing/salted preservative added food/fruit Cocktails/ Creamy pastries/ Pudding/ concentrated Kheer products/ Cheese/Butter/ Non-skimmed milk are better avoided.

Few topics relevant to people with certain known disease conditions:

Persons known to have Renal/Ureteric Stores should refrain from eating tomato/related products. A lot of water should be consumed daily.

              1. Persons known to have Diabetes/with father or mother a known diabetic, should maintain a vigilant Diet Chart at home and also, as much as possible outside home. Everything can be taken but in moderation, depending on one’s body weight. What matters is the daily calorie consumption in the guidance of a Dietician or a Doctor.
              2. People with Diabetes should ‘keep their feet as clean as their face’. It is a very well believed saying, respected by Doctors and well educated patients alike. Diabetics are very prone to develop foot ulcers which do not show a tendency to heal can cause big problems to the patient and Doctors and many people have ended up losing their limbs (by amputation) simply arising out of sheer neglect of themselves and their Physician’s advice !!!
                A word of caution here – today children are also diagnosed to suffer from Diabetes simply out of leading an erratic life style!!!
              3. Elderly people with Diabetes for many years are typically prone to have some of the following. So their care takers should be aware of them:
                            1. Silent Heart Attacks – which has a high mortality;
                            2. Sudden Strokes ending up with paralysis of different grades;
                            3. Sudden infective episodes inside their system requiring urgent Surgery;
                            4. Sudden/Early Blindness arising out of a process called Retinopathy…even Cataracts;
                            5. Damage of Kidneys-causing renal failure and heading for dialysis etc. which are very expensive, even by Indian standards and the outcome is always grim;
              4. People with Hypertension (High blood pressure) should try to lead a stress free life, with regular checkup of BP) and medication from Doctors. Long standing improperly treated Hypertension can also lead to damage of Eyes/Kidneys/Heart etc. excess salt on the dining table to be avoided, salt may be used, albeit sparingly in the kitchen.
                ( Less than 5-6 gms a day)
              5. Persons suffering from both ‘Diabetes and ‘Hypertension’ need to be doubly cautious with respect to their day to day life, follow-up with Doctors, dietary habits and medications. All the potential complications of these silent killers get multiplied in such people, but with regular supervision from medical personnel they can lead very compatible normal lives.
              6. Persons known to suffer from a condition called as “Gout” need to have a real look into their diet and consult Doctors when they have episodes of acute pain in joints etc. This is usually due to a genetically inherited metabolic deficiency of an Enzyme, which takes part in Purine metabolism in the body. Simple analgesics after seeing a Doctor may be tried and usually the attacks subside within a few days, in some cases other medication are required and even to go on for life in resistant chronic cases. Beer is to be strictly avoided in such patients and Red Meat and certain leafy vegetables too, should be avoided from their Diet.

I think this has been a synopsis of handy health tips- which all good samaritans of this country need to know-.in order to lead a healthy life here . I have chosen this simplistic approach, as it is easy to be followed by lay persons, avoiding complicated terminology which might intimidate the readers and will defeat the purpose. The List is exhaustive and it goes on and on! It is only a humble effort to pick up a glass full of knowledge from an Ocean of the same . Parents should be rather strict on their children on many such issues. Working men and women must take care of themselves in an adequate manner as hinted above . Elderly people must be closely taken care of by their sons/daughters and taken to visit Doctors if something sinister really comes up with them.
Good Luck and Good Health to all my brethren & friends – young and old.

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Taking on anemia by readdressing antenatal care in Karnataka

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Keywords: Anemia, Antenatal Care, Data analysis, cloud computing, MMR and IMR
 

Context:

The Burden of anemia in India is a major public health issue. More than 50% women and 20% children suffer from anemia and a leading cause of 40% maternal deaths in the country.
In the state of Karnataka, 79% of maternal deaths are found to occur due to anemia Karnataka State Health system 2015, 16). Antenatal period is crucial among pregnant women, lending adequate access to prevention, care and monitoring. However, rural communities in the region face several healthcare challenges, making pregnancy a high risk one,followed by poor pregnancy outcomes.
Anemia during pregnancy is preventable, if it is picked up well in time in the antenatal period through basic blood tests and clinical examination ( ).
How we contribute: In north Karnataka where many pregnant women face significant barriers to obtaining quality antenatal care, iKure is bringing care at the door steps of the rural people.
Through app. based diagnostic device, and innovative healthcare solutions, pregnant women are identified and regularly screened and monitored by trained health workers at the convenience of their home. They take health status assessment on their mobile app. perform blood tests and clinical examinations, organize health camps and message dissemination programs.
Patients who are at high risk of developing anemia or afflicted with the disorder are monitored frequently and supported by medical team to connect with doctors virtually through telemedicine platform or hospital referral system.
To provide patients with better healthcare outcomes, iKure using data analysis technology extracts useful knowledge with respect to anemia for better decision making and management. Through various technology innovations such as cloud computing, mhealth technology and smart applications supported by WHIMS, iKure is generating multiple data sources allowing doctors and researchers to make informed clinical and behavioural decisions, improving treatment processes and detecting anemia well in advance.
 

Impact:

The strategic antenatal care adopted by iKure provides the potential to significantly reduce the prevalence of anemia in Karnataka. In north Karnataka, with a sample size of 91 pregnant women, the insights collected in the Ist round of antenatal checkup reported 64% of the respondent with low haemoglobin count, which interestingly reduced to 57% in second round and 43% in third round checkup. Low blood pressure reduced from 24 respondents in the first round of health check up to 14 in third round. The programme is already demonstrating positive health outcomes, including raising health seeking behaviors among pregnant women who did not knew that they were at risk of developing severe anemia and other chronic ailments, increasing consumption of folic acid and iron tablets and reducing abortion rates.

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CHWs-Newfrontier to drive innovations in rural healthcare delivery

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The need:

Jayashree,is a Community Health Worker(CHWs) in her village called Hubli, in Karnataka. One day,while she visited a woman named Pushpa in her first trimester,she looked quite unwell. On enquiring Pushpa was found to suffer from Epilepsy. Her family also revealed, she has been prescribed with medicines by a local doctor, but she didn’t take them regularly. Epilepsy is a disorder of the nervous system and such patients during pregnancy have major concerns. Jayshree felt the need! She promptly captured her vitals on her smart phone loaded with Wireless Health Incident Monitoring Systems, (WHIMS), and pushed the patient’s vitals on to the cloud for a quick doctor reference. For the next few days, Jayshree monitored and screened her closely and counselled her and family about different preventive measures pertaining to her health conditions. Soon after,Pushpa recovered and gave birth to a healthy child. Like Jayashree, there are over 330 CHWs who are trained and strategically deployed across six states in rural India to become the frontier in iKure’s healthcare delivery system.
 

Context:

India faces large disparity in workforce distribution especially in rural regions where burden of diseases is high. With 44,000 doctors for 833 million people, the shortage of doctors in rural areas is severe where each doctor serves a community close to 19,000 people. The severe lack in rural areas has been attributed to lack of effective training and recruitment, ineffective distribution of workforce and failure to retain labour where needed the most.
With the urgent need of creating new cadres of frontline health workers that meets the demand of rural health, iKure implements strategic training, evaluation and monitoring programe with the judicious use of digital technology to address the gap. iKure has developed a cloud based platform called Wireless Health Incident Monitoring System (WHIMS) designed with an intuitive graphics user interface that health activists, with basic education can use. WHIMS is accompanied with instruments to measure vital statistics of patients, and for it to be a more reliable diagnostic tool, iKure created Medic Bags with low-cost POC instruments to assist CHWs to measure basic statistics. iKure has established ecosystem partnership with Public Health Care (PHC) system, and low-cost private healthcare providers, under which diagnostics collected by the CHWs are shared in real-time with doctors in these hospitals, who suggest treatments and prescribe medication through the WHIMS platform to the health workers, who relay this information to the patients. The evidence based data collected using WHIMS platform offer huge potential to drive policy and advocacy on the health status of the rural community.
 

CHW’s MEDIC BAG:

To address the fragmented approach of primary care delivery in rural community, iKure establishes integrated care enabled by the CHWs at different levels of the delivery system. To ensure quality care at each level, we build the capability (both technology and clinical) of the CHWs as the first step, to build technology enabled health system support, improve health practices at the household level, and bring integrated actions for health at community level. These cadres will be mobilized by iKure for different handholding of their designated roles in performing household visits, community level outreach camps, and facility based concept clinics. CHWs equipped with a Medical Kit that consists of devices such as BP machine, Stethoscope, pulse oxy meter, Thermometer, First Aid Kit, Weight machine, Height measuring scale, gloves etc., they carry medicines for basic common ailments, non-invasive haemoglobinometer, Haemoglobin kit to measure Hb level, mobile phone based sphygmomanometer, urine analyzer, calorimeter, ECG, flipcharts/Hoardings & registers. Through these CHWs, every patient is also provisioned with Digital Health Card (DTH) encrypted with a QR (Quick Response) code and during home visits, DTH gets updated with latest clinical indicators. The health data obtained from the health cards is synced to a cloud for effective utilization in the upward heath chain at both secondary and tertiary levels.

Prior to working as CHW, these village women remained mostly confined as homemakers performing daily household chores. As iKure build their capacity both technologically and clinically to work as frontline health workers, they also gain respect and position from their communities in the long run. Further, their contact and association with the community helps iKure drive effective community mobilization measures and act as a catalyst to drive behavioural change. While they interacts and communicates the necessity on the ground and identifies appropriate health needs, they conduct street plays, demonstrates hoardings and facilitates automatic health nudges through mobile phones of the beneficiaries at different levels. They are also attuned to provide nutritional counselling, and spectacle services based on the community needs.

iKure also build sustainable model for its CHWs. Through robust supply chain model, these CHWs promote various lifestyle products such as sanitation pads, branded spectacles, hair care, skin care products etc, which helps them gain daily incentives apart from monthly income.

 

Conclusion:

The CHW model of empowering the women community and gender mainstreaming represents transformational change in rural healthcare delivery. As they champion tech-savvy cultural values in otherwise austere facilities, and limited supply of doctors, such effort has established inspirational leaders driving catalyst change in public healthcare delivery.

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DIABETES MELLITUS

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What is Diabetes Mellitus?

Diabetes is a condition in which an abnormality in the metabolism results in high glucose level in the blood due to defective insulin production, secretion or utilization.

Classic Symptoms

  1. Increased thirst
  2. Excessive urination
  3. Fatigue
  4. Delayed recovery from infections
  5. Increased hunger
  6. Sudden unexplained weight loss
  7. Delayed healing of wounds

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Integrated approach to healthcare

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Never sees how rich or poor you are or neither judge you being affluent or dissolute, but when it hits, it hits equally hard to all of us- helpless, clueless and money less! In India, where the healthcare is being the most neglected for decades, and accessibility, affordability and quality underpinned with political and policy discourses, people have little hope left, as they witness the deeply rotten system within.

While the govt. is making every amendment to make quality care and treatment available at fair and affordable price, the balance between public needs with commercial aspirations has failed to bring efficiency in the system.

But this can be solved, if we look at the healthcare system in totality but not in isolation and I am happy iKure has put the right step forward where it seems health as an outcome of a holistic and integrated effort. Though started at a minuscule level, iKure is looking at health in totality as against in silos. We are bringing path-breaking innovation, sustainable approaches and best players under one roof that are seamlessly integrated across and impact every levels of the larger system.

Though the clamor of the rising healthcare costs, inefficient system and highly compromised quality create havocs in one’s mind during any episode of illness, iKure serves its beneficiaries with a difference, where it not just treats illnesses but creates good health by acting in totality. This integrated approach will be the game changer in future bringing efficiency in the system to serve better and act responsibly.

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The Main Types of Vaccines

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Adapted from: National Network for Immunization Information) Copyright 2000, and the National Immunization Program of the Centers for Disease Control and Prevention (CDC).

The safety and effectiveness of a vaccine depends on how it is made and what it contains. There are four main ways to develop vaccines:

 

Live attenuated vaccines contain bacteria or viruses that have been altered so they can’t cause disease. Killed vaccines contain killed bacteria or inactivated viruses. Toxoid vaccines contain toxins (or poisons) produced by the germ that have been made harmless. Component vaccines contain parts of the whole bacteria or viruses.

 
 

Live Attenuated Vaccines

Live attenuated vaccines usually are created from the naturally occurring germ itself. The germs used in these vaccines still can infect people, but they rarely cause serious disease. Viruses are weakened (or attenuated) by growing them over and over again in a laboratory under nourishing conditions called cell culture. The process of growing a virus repeatedly-also known as passing–serves to lessen the disease-causing ability of the virus. Vaccines are made from viruses whose disease-causing ability has deteriorated from multiple passages.

 

Examples of Live Attenuated vaccines:

Measles vaccine (as found in the MMR vaccine)
Mumps vaccine (MMR vaccine)
Rubella (German measles) vaccine ( MMR vaccine)
Oral polio vaccine (OPV)
Varicella (chickenpox) vaccine
Inactivated (Killed) Vaccines
Inactivated (killed) vaccines cannot cause an infection, but they still can stimulate a protective immune response. Viruses are inactivated with chemicals such as formaldehyde.

 

Examples of Inactivated (Killed) vaccines:

Inactivated Polio Vaccine (IPV), which is the shot form of the polio vaccine
Inactivated Influenza Vaccine
Toxoid Vaccines
Toxoid vaccines are made by treating toxins (or poisons) produced by germs with heat or chemicals, such as formalin, to destroy their ability to cause illness. Even though toxoids do not cause disease, they stimulate the body to produce protective immunity just like the germs’ natural toxins.

 

Examples of Toxoid Vaccines:

Diphtheria Toxoid Vaccine (may be given alone or as one of the components in the DTP, DTaP, or dT vaccines)
Tetanus Toxoid Vaccine (may be given alone or as part of DTP, DTaP, or dT)

 

Component Vaccines

Some vaccines are made by using only parts of the viruses or bacteria. These vaccines cannot cause disease, but they can stimulate the body to produce an immune response that protects against infection with the whole germ. Four of the newest vaccines are made this way.
Examples of component vaccines: Haemophilus Influenzae Type B (HIb) Vaccine/Hep B Vaccine/Hep A Vaccine/ PCV (Pneumococcal Conjugate Vaccine)

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Meshing of Big Data, AI And ML in Cardiac Care Continuum

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Introduction:
Every year 2.1 million patients die due to heart ailments in India. We have just 1 Cardiac Specialist for every 3 lakh patient. Although secondary and tertiary health care providers are engaged in doing ECGs and several other vital collections to analyze heart health conditions, but none of the existing solutions can identify high-risk cases from such reports and respond in time.

To address this gap, iKure combining Big Data, AI, and machine learning works on ECG signal anomaly detection & Patient risk model using stank ranking & deep learning that can assist cardiologists to offer preventive care much faster in the human life cycle. In association with IBM data science, iKure’s integrated platform provides seamless automation and interpretation of patient data to enable instant feedback for high-risk cases and offers high quality and cost effective continuity of cardiac care both for rural and semi-urban population.


Timely interventions can reduce the time span between critical and stable heart health conditions. However, failure of such gets magnified typically in last mile populations that constitute over 16 million cardiac patients out of total 30 million people. It has been observed that over the year from 2000 to 2015, the age-standardized rate of mortality (per 100,000 person-years) due to coronary heart diseases increased among rural men by 40% and for female it rose to 56%, whereas decline was registered among urban residents. Cardiac care in rural India is limited and inaccessible due to major shortfalls like shortage of doctors, diagnostic centers, equipped facilities, coupled with lack of awareness.

Cardiac diseases can be addressed through effective treatment plans, constant screening, and monitoring. Artificial Intelligence(AI) and Machine-learning(ML) can provide life-saving care in general and CardioVascularDiseases(CVD) specifically as high risk conditions can be identified early, impending strokes and heart attacks spotted in advance. Studies have established that AI is set to revolutionize cardiac care. This is particularly relevant in today’s context, as India is home to 16% of the global population, 25% of the world’s Coronary Heart Disease (CHD) burden, 120 million hypertensives, and a large number of individuals with Rheumatic heart disease (RHD). CVD will be the leading cause of morbidity and mortality in the country by 2020. Researchers have started meshing up Big Data with AIand machine learning algorithm to predict the anomalies quickly, cheaply and accurately without using the invasive methods.However, implementation of such advanced technology in primary healthcare delivery is still in its nascent stage in last mile communities. iKureusingAI and ML into their primary healthcare delivery, has taken cardiac care to advanced level of treatment.

The Cardiac Risk Model: The initiative is jointly done by iKure and the IBM Data +AI elite team that work on ECG signal anomaly detection and Patient risk model using stack ranking & deep learning. By leveraging iKure’s cloud based platform, it brings the power of AI with respect to patient’s clinical data stored in an AWS, MySQL data store to develop high risk pattern and can predict cardiac arrest in patients in much earlier stage.

Data is knowledge and when big Data from EKG signals coupled with a large volume of patient data from IBM cloud, cardiologists will get empowered to deal with cardiac problems through risk ranking of cardiac patients. It could also classify the EKG data as normal or with anomalies and present a prioritized list of patient cases to the call center physician for review based on potential acuteness via a cloud-based web application. It will help them to treat patients based on acuteness. In that way resources are utilized in the best possible way. Proof of concept is already developed that demonstrated that the platform can bring the power of AI to iKure’s data stored in an AWS, MySQL. The pilot project is showcased at IBM’s technology conference, Think 2019 in San Francisco. Accuracy of this model is already proved using patient clinical and demographic variables and physician feedback with the added benefits of rapid model development, publication and iteration.

Analysis of arrhythmia anomaly to predict cardiac arrest

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Conclusion: The analytics help screening of vital parameters including Heart Rate monitoring, a disorder in application sequence, arrhythmias, an electric axis of heart, myocardial ischemia and infarction and cardiac rhyme diagnosis vital for the prevention of early cardiac arrest. Leveraging iKure’s integrated model together with machine learning algorithm and Artificial Intelligence will enable specialists to have a more logical approach to diagnosis and treatment of cardiac arrhythmia. The output of such effort will enhance continuity of cardiac care even in last mile communities.

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What Causes High Prevalence of Anemia in Rural Hinterland- A case study to assess the gap

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Anemia is most prevalent in low-resource settings, where it goes undetected until becomes severe. Despite the implementation of several initiatives by the Government, India has made only 13 percent progress in eradicating anemia (Global Nutrition Report, 2017).1

Periodic screening and early diagnosis are the keys to controlling anemia. The conventional Hb tests involve invasive methods with the requirement of hygienic infrastructure and skilled healthcare providers. But with the huge gap in basic health infrastructure, rural community members have very little provision for diagnostic facilities.

In Kenduapal Village of PaschimMedinipur, West Bengal shows 88 percent of reproductive-age women have undergone Hb tests for the first time in their lives. They were not aware, if they are prone to a high-risk pregnancy or not. It also indicates the behavioral risk factor which contributes to delay in Anemia detection.

According to WHO recommendation, a non-invasive hemoglobin device is proved to be a good addition. Non-invasive point of care devices can eliminate the potential contamination, bio-hazard handling and can even enable frontline health workers with basic education to perform Hb Test.2 Joseph et al. (2016) also affirm that non-invasive methods are safer than invasive methods and improve patient satisfaction.3Bandyopadhyay S., Neogi, and John D. et al. (2019) further contributed to the fact that as most of the anaemia screening happen in outreach settings, where provision for laboratory support seems difficult, the device ought to be tested in field settings with health workers, non-invasive diagnostic provides viable accuracy.4

iKure’s non-invasive anemia screening initiative started with the vision of reaching out to the last mile community. Members are chosen from the community and are technologically and clinically trained to use them for screening patients. The community health workers are further mobilized to collect other health parameters important to understand the risk of the patients. Instead of using a paper-based format, CHWs use WHIMS that is able to collect patients’ vitals on a cloud server. The data available on the cloud are further sent to medical professionals for referral and counseling.

However, while iron deficiency is the main cause, micronutrient deficiency, inflammations and inherited disorders also contribute to anemia. A baseline report of mother and child health camps reveals that 64% of pregnant women were anemic and 30% with milder anemia. Nutritional experts suggested that a large section of the community are found to be anemic because of women’s ‘‘non-compliance/non-adherence” to the consequences of the anemia and fear and anxiety towards invasive blood drawing.5 Also, women’s consumption rate of IFA supplements are low since they complain of suffering from gastrointestinal upset. Altering such behavior requires regular counselling. iKure’s CHWs are deployed to spread awareness and bring positive health-seeking behavior among pregnant women, new mothers, and adolescent girls.

iKure’s non-invasive anemia testing initiative has been rolled out successfully in school health program and mother and child health camps catchment areas. Within few months, it has gained significant traction such as:

 

  • In West Bengal and Karnataka more than 50% population are found to improve IFA tablets consumption rate.
  • Regular awareness and counseling by iKure medical team during health camps have altered care-seeking behaviour with a reduced percentage of anemic patients
  • The introduction of non-invasive screening devices has improved patients’

    footfall with more women willing for Hb tests

While priorities and approaches may differ according to geographic settings, but strategies to curb anemia remain the same. At iKure, we believe in bringing the desired change soon in India’s rural villages.

Reference :

1. “From promise to impact ending malnutrition by 2030”,Global Nutrition Report,2017,
2. Ma’ayan L., Choppe L., Tikva P., Israel, Lausanne, “Non-Invasive Hemoglobin Screening for Diagnosis and Monitoring of Anemia”, Read More
3. Josheph, Bella., Haider, Ansab., Rhee, Peter., “Non-invasive hemoglobin monitoring”, International Journal of Surgery, 33 (2016):254-257
4. Neogi SB, John D, Sharma J et al. Cost-effectiveness of invasive devices versus non-invasive devices for screening of anemia in field settings in India: A study protocol [version 1; peer review: 1 not approved] F1000Research 2019, 8:861 Read More
5. “Nutritional Anaemias: Tools for Effective Prevention and Control”, World Health Organization, 2017, Read More

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Population Scale Impact Through Societal Platform Lens

iKure’s journey started in 2010 to address the inadequate and inaccessible primary healthcare for the last mile using technology. We have impacted 12 M population across 8 states in India. We have the data capability powered by AI and machine learning algorithm for actionable research interventions and many more. With a full proof model, we began at a small scale. But soon, we learnt the limitation of the model that could reach only a fraction of the population when the problem was common for 70% of the India’s rural villages.

We wondered, can iKure solve the problem individually? Can we create doctors overnight or build infrastructure to solve the problem at scale? The answer was no. The problem is dynamic and multivariant in nature. On one hand, we have primary health centres that remains ineffective and less utilized due to the shortage of staff, resources and quality care and on the other hand, India with a vast population of 1.3 billion needs to build 200,000 health and wellness centres to address the demand and supply gap. In this context, iKure with 200 centres was insignificant to match up to the need.

Societal Platform thinking was important for us to reflect that technology can be the key enabler to scale, but it cannot bring different actors co-create solution together and amplify at a population scale. iKure aimed to build a shared infrastructure for multiple actors to come together to solve the common goal. We wanted to create such infrastructure, where people can access the health system with hope and newer possibilitiesThe Naga telehealth was an effort to introduce the platform thinking of co-creating together with the Government, technology partners, research partners, NGOs and grassroot members. The system opened access to healthcare, prevention and wellness for the entire state of Nagaland leveraging 192 sub health centres and 19 primary health centres.

The prototype model is adapted in Khunti District, Jharkhand with JICA to transform the ineffective health system into a dynamic one. It is serving the district hospitals, community sub-centres, and primary health centres. This has set an example for other state governments to follow, where we are partnering with 5 State governments to leverage the shared digital infrastructure for greater utilization and access to health and wellness centres and promote prevention and awareness at the community level through frontline health workers. The platform is also available in hybrid model to drive rapid adaption and evolution in local context using physical health workforce presence at patient’s door-steps. The shared digital infrastructure has co-created network of engagement at different levels. It has enabled remote health monitoring services through NGOs and self-help groups and addressing the behavioural and cultural barriers that cause vaccine hesitancies in rural villages through frontline health workers. It will bring 200,000 frontline health workers using the shared infrastructure at a mass level. In all these cases, the architecture design needs to foster trust and ownership. Use of AI model can only find relevance, if the platform ensures data privacy for all the actors in the ecosystem. Towards this, iKure is working with ODI-Microsoft to develop an automated open data platform ensuring right data reaches to right hands. A shared and collective understanding of different stakeholders can solve the problem of healthcare in totality. Through our shared infrastructure, we aim to reach out to our beneficiaries irrespective of where they are.  iKure through SP lens believes the power of shared infrastructure can amplify its potential to serve at a population scale.

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Staff Picks, Travel

The untold story of iKure beyond the narrow trails

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We were at the first mile in the last mile. Our car driver whom we lovingly called Nattu was in high spirits praising the new road which has recently found a new shape after the smoothen pitch. Soon his sunlit smile faded when the road started getting narrow after taking first few turns from the NH6  Highway. The journey continued, and my heart sank, more we drove in. The road was getting narrower and almost disappearing now and then. However, the golden wheat fields, field laden with marigold flowers, and the untamed river that followed us assured me of the hope that there is a way beyond. I was led by two team members who drove the motorbike, carefree but determined of the road ahead and the founder of the ‘Unicorn’, acknowledged as the ‘100 most Influential Leader 2020’ continuing his untiring efforts of handling the venture’s responsibilities over the phone, while I waited impatiently for the journey to get over through the narrow trails.

Finally, the stop arrived at a primary school in an unknown little village in Gologram in West Bengal. iKure’s mobile medical team was already in full gear attending the patients that have gathered for the eye and medical check-up. Two Doctors, with a Paramedicine staff, Health Worker, and Program in- Charge were busy registering patient’s vitals using AI enabled health tech devices.

Locational factors have an important bearing on the potential of healthcare supplies. In urban poor and remote locations, it is difficult for healthcare systems to attain the demands of critical services. Most of the journeys made by our beneficiaries are at substantial risk of fatal outcomes during emergency cases. Therefore for iKure, it is important to provide access to primary healthcare facilities through mobile medical teams that are usually set up in schools or in local administrative offices.

The pandemic in India is witnessing its second wave, people are creeping out of their shelters, still hesitant to explore beyond their safe zone, but this medical team has a message for all of us. Inspiring as they accept risk as part of their chosen job roles, hardly exhibiting concerns on their routine door-step schedule, at iKure’s medical camps and in hubs. The immense accreditations and support to fulfill the mission of iKure ‘Creating zero mortality in primary healthcare’ through their hands and the unwavering determination of their hearts is enough to bring smiles to our beneficiaries during the challenging times of the COVID-19.

Primary healthcare is the first line of defense to keep people safe. The primary healthcare system has the capacity to diagnose, track, and contain community outbreaks while providing essential services.

iKure is prioritizing its regular services through technology innovations, mass screening operations, and research interventions that use primary data to help identify and address the gaps and laying a strong foundation for primary healthcare to protect people from the next health threats.

iKure has treated more than a million patients with plans to open 200 clinics in the next three to four years. It is already offering health-tech solutions in Vietnam with plans to serve in other South-east Asian countries like Cambodia, Philippines, and Indonesia.

The journey way back home was different. I found Nattu’s face lit up again while he shared one of his journeys with the iKure’s medical team in Keshiary, in remote West Bengal. He recalled, he had to carry back home the team through a bamboo bridge that was half immersed due to the flood. Fearing the car might not find its way underneath the water, they waited till 2:00 am for the water to subside. And finally, when they returned, it was time again for another journey.

It might come across for many that Ratan Tata’s investment has been easy for iKure. But the immense trade-off, patience, and teamwork go without saying, they haven’t had it all yet. While the team is gearing up to scale-up and expand its operations, this investment is a huge encouragement for iKure as they believe, iKure’s services will make the real difference for the people who need it most, as access to primary healthcare will be the corner stone to confront the pandemic and the situation beyond it.

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