The lack of safe and effective healthcare in the rural India is the primary reason behind India's loss of 50,000 children, on an average, every month from diarrhoea, pneumonia and other common illnesses – a silent ongoing tragedy that does not make the headlines of our newspapers. Most of these deaths could have been avoided by very simple treatments. Most of these remedies can be given at home or at the level of a primary health facility. And a major factor in these deaths is that the caregiver or health worker simply did not know what to do or when to seek help (WHO World Health Report 2006, p21).
Like all health professionals, each one of India's health workforce has basic needs in order to deliver safe, effective care. Each one needs appropriate skills; diagnostic and treatment equipments; relevant and reliable healthcare information; infrastructural support; access to essential medicines; motivating incentives; and communication facilities to make referrals, seek advice, and arrange transport.
Too many of India's health professionals – and especially those working in rural areas – are not having these basic needs met. As a result, too many of India's people – and especially the poor and disadvantaged in rural areas – are not getting safe, effective healthcare.
The lack of safe and effective healthcare in the rural India is the primary reason behind India's loss of 50,000 children, on an average, every month from diarrhoea, pneumonia and other common illnesses – a silent ongoing tragedy that does not make the headlines of our newspapers. Most of these deaths could have been avoided by very simple treatments. Most of these remedies can be given at home or at the level of a primary healthcare facility. And a major factor in these deaths is that the caregiver or health worker simply did not know what to do or when to seek help (WHO World Health Report 2006, p21).
About 50,000 deaths a month! Compare this with two recent calamitous events. On July 2006, India lost over 200 people in the Mumbai bombings; in December 2004, over 10,000 of its population perished in the tsunami. Both were unprecedented disasters that shocked the world and catalysed global action.
We are still, rightly, talking about these two events. But we are still, wrongly, silent on the larger death toll associated with poverty and lack of access to healthcare. Many of these deaths could be avoided by ensuring that all healthcare workers have the requisite information they need; to learn, to diagnose, and to save lives.
Death Cloa ked in Ignorance
Diarrhoea is just one of the many illnesses that kill large numbers of people,and what is more alarming is that it is easily treatable. Diarrhoea kills 1.6 million babies every year – most of these deaths are due to dehydration and would have been prevented if the carer had simply given the baby extra drinks to replace the fluids lost. But a recent study in rural India found that 4 in 10 mothers believe they should withhold fluids if their baby develops diarrhoea. Tragically they are unknowingly contributing to the deaths of their children!
For example, 80 per cent of caregivers in the developing world do not know the two key symptoms of pneumonia – fast and difficult breathing – which indicate the child should be treated immediately. Only half of the children with pneumonia receive appropriate medical care, and less than 20 percent receive antibiotics. (Wardow T et al. Pneumonia: the leading killer of children.' Lancet 2006;368:1048-50). A preliminary literature review by the Global Healthcare Information Network indicates similar deficiencies in knowledge and practice across all aspects of primary and district care, associated with lack of relevant and reliable healthcare information.
Furthermore, there is little evidence that caregivers and health workers at the primary and district levels, are any better informed than they were in 1994 (Fiona Godlee, Neil Pakenham- Walsh et al. Can we achieve health information for all by 2015? Lancet 2004;364:295-300). This lack of progress is directly attributable to ineffective coordination and communication among the many stakeholder groups involved at international, national and local levels. As a result, widespread and preventable loss of life and suffering continue, jeopardizing the achievement of the Millennium Development Goals.
Improving the availability of information will prevent death and suffering, and will promote more appropriate and timely referral to secondary and tertiary care. It will improve the cost-effectiveness of drug prescribing and use of diagnostic and other facilities, thereby increasing the efficiency of health systems and bringing social and economic benefits for communities and countries. The potential benefits for India in particular are huge in this regard.
An efective platform to facilitate healthcare
However, this colossal human tragedy is not singular to India but is very much prevalent among the less developed and developing countries to a greater or lesser degree. In this context, Healthcare Information For All by 2015 can serve as a ray of hope. Healthcare Information For All by 2015 is a global campaign with a specific goal. The goal is simple, challenging and inspiring. It aims that by 2015, every person worldwide will have access to an informed healthcare provider. We are working for a world where people will no longer suffer or die due to lack of basic knowledge of healthcare.
The campaign was launched in Mombasa, Kenya, in October 2006. HIFA2015 brings together over 600 professionals and organisations from over 80 countries across the globe, which comprises of health workers, trainers, publishers, librarians, researchers – all committed to improve the availability of relevant, reliable healthcare information. As Dr Tikki Pang (Director of Research Cooperation at the World Health Organization) has said, “HIFA2015 is an ambitious goal, but it can be achieved if all stakeholders work together.” HIFA2015 is supported by an increasing number of leading organisations, including the British Medical Association, International Federation of Medical Students Association, International Medical Corps, and Royal College of Nursing – among others.
Only half of the children with pneumonia receive appropriate medical care, and less than 20 percent receive antibiotics. (Wardow T et al. Pneumonia: the leading killer of children.' Lancet 2006;368:1048-50). A preliminary literature review by the Global Healthcare Information Network indicates similar deficiencies in knowledge and practice across all aspects of primary and district care, associated with lack of relevant and reliable healthcare information.
HIFA2015 facilitates a global e-mail space for dialogue about how to meet the healthcare information needs of isolated health workers and disadvantaged people around the world. We identify cost-effective solutions to tackle the menace of poverty in healthcare information, and also provide a meeting place to explore new ideas. And the ideas are many, leading to a rich online confluence of discussion and dissemination of knowledge, information and opinions with a sharp pragmatic focus. From India itself, many interesting new ideas to explore ICT for enriching healthcare information are emerging. An ENT surgeon from Kolkata is planning a project using mobile phones to deliver health information; a public health consultant from Delhi is looking at ways to expand and improve the training of rural health workers; and a journalist from Noida is reviewing the impact and potential of cutting-edge technologies on health information access. And there are many more; unknown soldiers of a very known war. Things are moving in the right direction… though the road is long, but our will has strong legs!n.
For further information visit: www.hifa2015.org
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