PK Taneja, Commissioner of Health, Medical Services & Medical Education, Public Health & Family Welfare, Government of Gujarat, in conversation with eHealth, talks about how the strengthening of infrastructure through patient record system and IT based hospital services is leading to improvement in healthcare issues in Gujarat
What is your assessment of the health sector in Gujarat today?
The trend of using health indicators like CDR, MMR, IMR and TFR is on a declining phase and this indicates that there is overall improvement in the overall health status of the state. The MMR is reduced from 202 as per SRS (1997-2003) to 148 as per SRS (2007-09). The IMR is reduced from 60 as per SRS 2001 to 48 as per SRS (2009). Crude Death Rate is indeed a good tool for measuring standard of healthcare of the State and lower CDR as compared to well performing states like Tamil Nadu and Karnataka shows that Gujarat has excellent healthcare facilities. The state government is fully sensitised and committed to bringing further improvement in these health indicators.
Please share with us the Governments role and initiatives in primary, secondary and tertiary care. What is GDP allocation for health in Gujarat?
The state is providing primary, secondary and tertiary healthcare services through reasonably good infrastructure of SCs, PHCs, CHCs, DHs, medical colleges and super specialty institutions with optimal demographic spread all over the state.
The health department is taking up many interventions and initiatives like Chiranjeevi Yojana and Bal Sakha Yojana through public-private participation model to address certain constraints in terms of availability of doctors, nurses and paramedics. Further, the gap analysis in terms of availability and shortage of necessary manpower has been done and the same is being addressed on priority basis. The state has added1105 medical seats, 1210 nursing seats, 1095 physiotherapy seats and 800 dental seats in the last couple of years. 3 new medical colleges with 150 seats each have been set up during the current academic year. There are plans for setting up three more medical colleges having capacity of 150 seats under Gujarat Medical Education & Research Society (GMERS), an autonomous society set up for the purpose.
The Total outlay for Health is increased from 1615.51 crores in the year 2008-09 to present outlay of ` 3347.62 crores, registering an increase of 100 percent in last four years. The GDP allocation for health in the State is 0.53 percent in the year 2009-10 and increased up to 0.72 percent in the year 2010-11
What is the governments role in ensuring Health for All in the state?
The state is providing comprehensive maternal and child health services like ANC care, institutional delivery, PNC care and immunisation services with Mamta Abhiyan package and through private institutes involved in schemes like Chiranjeevi and Bal SakhaYojana. The Mamta Taruni Abhiyan for comprehensive healthcare services was started to take care of adolescent girls. The state has effectively controlled communicable diseases like HIV/AIDS, TB, Leprosy and Malaria with meticulous implementation of National Health programmes like RNTCP, NLEP, NVBCDP, GSACS and NBCP. The states success in controlling sickle cell anemia has been feted with the prestigious Prime Minister Excellence award for administration in Public Health Programme. Gujarat is associated with many high-end super-specialty institutes for heart, kidney and cancer treatment.
Gujarat had remarkable success in Health IT initiatives in recent years. What are the key ICT-based programmes in the State?
Hospital Management and Information System (HMIS) is a total hospital and patient care management solution to provide better care through patient record system and IT based hospital services. HMIS has reached out to 30 hospitals in Gujarat. Then there is E-Mamta, which has received the best jury award for care delivery through innovative use of technology and best public choice award for improving maternal health at e-world forum, e-Health world Awards 2011. BADEA System has been developed since 2005 to store and monitor statistical data of birth, death and stillbirth. Demographic analysis and various reports can be generated through this application. The state is deploying more than 100 mobile Health Units and Mobile Medical Units in remote and difficult areas .It is absolutely necessary to monitor and track these units through a tracking system, GPRS technology based tracking services are being outsourced for the purpose. The health department has a few projects lined up, such as 104 (Non-emergency Health Help Line). It will be set up for the people to get timely advice on health related issues available in three languages “ Gujarati, Hindi and English. Another project will be set up soon to connect health through the application of Information and Communication Technologies i.e. the Telemedicine Project. The key goal of this project is to provide citizens living in distant places of Gujarat with access to high standard health care services.
The state has increased 1105 medical seats, 1210 nursing seats, 1095 physiotherapy seats and 800 dental seats in the last couple of years. Three new medical colleges with 150 Seats each have been set up during the current academic year and there is a plan to set up three more medical colleges having capacity of 150 seats under GMERS, an autonomous society set up for the purpose
What is the secret behind their success?
The state has its own strong State Wide Area Network (GSWAN) up to Taluka level and this has provided us with high quality connectivity. Government officials have been provided with government e-mail IDs for faster communication and knowledge sharing. Most of the state health facilities are equipped with required hardware and internet facility. Government has framed policies and has made mandatory for every employee to get certain level of IT knowledge for promotion. A separate entity namely Gujarat Informatics Ltd. (GIL) has been set up to support all Government departments for ICT initiatives.
What are the initiatives being taken for making Gujarat a global Healthcare destination? The State has gone for NABH/NABL accreditation in a big way. Please share the status of the same with us.
Government of Gujarat (GoG) has introduced Total Quality Management (TQM) System in its key medical institutions. The system covers the states Medical College Hospitals, Medical College Blood Banks, Medical College Laboratories, Dental Colleges, Mental Hospitals, Paraplegia Hospital, District Hospitals, Community Health Centres and Primary Health Centres as per the NABH and NABL standards. The Health Department has a mission which states To enhance the patients quality of life by providing specialized medical treatment and preventive healthcare at free / affordable cost.
We have around nearly 6 centres accredited by NABH/NABL. These include Dist. General Hospital Gandhinagar, Primary Health Centre Gadboriad, Dist: Vadodara, Medical College Hospital Labs Bhavnagar, Blood Bank (BJMC Ahmadabad), Food & Drug laboratory Vadodara, Mental Hospital Vadodara. Indias 2nd NABH / NABL Accredited Govt. Facilities are Primary Health Centre Mahuwas, Dist: Navsari, Govt. Medical College lab (BJMC Ahmadabad), Civil Hospital Sola, Ahmedabad (Progressive) and Blood Bank (Government Medical College Surat). There are many others PHCs in the state, which are NABH and NABL accredited. The facilities which complete final assessments as per NABH / NABL are District Hospital Junagadh, Rajpipla, Panchmahal,Medical College lab-Surat and mental hospital, Amdavad.
Gujarat has received various accolades for their initiatives towards improving health facilities in the state. It was awarded to establish Quality Assurance framework in providing quality healthcare to the people of Gujarat in 5th National Quality Conclave, New Delhi. FICCI Health care Excellence Award to Dist Hospital Gandhinagar and PHC Gadboriad, Govt of Gujarat in FICCI Health 2010, New Delhi and FICCI Health care Excellence Award to Dist. Hospital Gandhinagar, Govt of Gujarat in FICCI Heal 2011, New Delhi.
What are the Plans ahead?
The state government is working towards improving the skewed child sex ratio by effective implementation of PC and PNDT Act including ICT based applications in the state and and substantial improvement in Immunization. The state government is fully determined to address the Malnutrition related issues and has decided to setup a state nutrition mission for convergence, integration, monitoring and uation of targeted interventions to bring about improvements in a time bound manner. The state has setup an autonomous society for Sickle Cell Anemia (SCA) related state interventions for full and faster coverage of tribal population in 12 tribal districts and plans are afoot for online tracking of such beneficiaries through ICT initiative.
We expect a substantial increase in budgetary outlays in the happening health sector in the next plan period and integrate various initiatives taken under NRHM with state health systems to sustain it for all times to come.