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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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