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20 Pradanya 2015
International Conference
on

Universal Health Coverage:


Road Map for 2020
3rd and 4th October, 2015

Technical
Sessions

Paper & Poster


Presentations

Pre-Conference
Workshops

Organized by

Institute of Health Management Research, Jaipur

th

20 Pradanya 2015
International Conference
on

Universal Health Coverage:


Road Map for 2020
3rd and 4th October, 2015

Technical
Sessions

Paper & Poster


Presentations

Pre-Conference
Workshops

Organized by

Institute of Health Management Research, Jaipur

Editorial Team :
Prof. A. L. Shah
Mr. Hem K. Bhargava
Mr. N. K. Sharma
Dr. Risho Singh
Designed By :
Mr. Chaitanya Dadhich
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Contents
Index

Page No.

Messages
The IIHMR University
Organizing Committees

A Glimpse into what the conference holds in store for us

Pre-Conference Workshop

Conference Programme

Pre-Conference Workshop Sessions

Conference Sessions

List of Abstracts :

11

Paper Presentation
Poster Presentation
Abstracts for Paper Presentations

18

Abstracts for Poster Presentations

54

The Pink City Jaipur

113

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Either write something


worth reading or do
something worth writing.
- Benjamin Franklin

The Visionary
Late Shri PD Agarwal
(01.01.1920 - 17.09.1982)
The late Shri Prabhu Dayal Agarwal (PD Ji) was born on Ist January, 1920, in Bari Nangal, a hamlet in the
desert district of Churu in Rajasthan. From humble beginnings, he rose by dint of sheer hard work and singleminded devotion to become an eminent entrepreneur, setting TCI group of enterprises. With time, he grew
in both stature and kindness and became a legend in his lifetime.
With his strong commitment to the virtues of hard work, truth and goodness, he won the love and trust of all
those who came into contact with him. His fair-mindedness, magnanimity and altruism, as also his
determination and rare confidence were proverbial. A self-made man, he continued to work hard through
his life, and became a synonym for success. In work, he represented a blend of energy and ambition.
He has been a great source of inspiration to his sons, employees and peers. The many growing TCI and
Bhoruka enterprises owe their stature primarily to his progressive outlook and his ability to think big.
***
It was to continue PD Jis missionary work that his son, Dr Ashok Agarwal, founded Indian Institute of Health
Management Research (IIHMR) in Jaipur in 1984. With a mission to make healthcare research, education,
and training accessible to all corners of the country, IIHMR Bangalore was established in 2004,IIHMR Kolkata
in 2010 and IIHMR Delhi was established in 2008 with the aim to spearhead education and training of
professionals looking for gaining a strong edge in Hospital and Health Management. The mission will
continue manifesting itself in future also. Philanthropy and altruism have a beginning but they never have an
end.
***
We dedicate our achievements during these three fruitful decades to Shri PD Ji because of whose vision
and mission we are what we are.
5

VASUNDHARA RAJE
CHIEF MINISTER RAJASTHAN

Message
I am glad to know that the IIHMR University, Jaipur is conducting the 20th International
Conference Pradanya 2015 on Universal Health Coverage- Roadmap 2020 on October 34, 2015.
It is imperative that the professionals working in government and private healthcare sector
discuss and exchange knowledge about the new researches made in various fields, so that
they are in a position to provide best healthcare services. I believe that the conference
through the exchange of ideas, knowledge and expertise between professionals,
academicians and healthcare researchers shall accentuate the health issues that need
immediate attention and care.
I hope that the outcomes of the conference shall be beneficial for preparing a roadmap to
provide quality healthcare services.
I wish the conference the very best.

(Vasundhara Raje)

Message
I am extremely delighted to know that the IIHMR University, jaipur is conducting 20th International
conference, Pradanya 2015. It is gratifying to know that the theme of the conference is Universal
Health Coverage-Roadmap 2020.
I am wished that this conference shall open new avenues for the healthcare organizations to
welcome new approaches and practices within the reach of every individual especially for the
senction of the society that struggles hard to make the ends meet.
Thesharing of ideas and expertise of renowned speakers and the illustrious efforts of the students
who shall be making a poster and paper presentations, will provide an insight in to the current
practices and what all can be done to tweak the services being offered at different levels.
I heartily congratulate the faculty for choosing this theme for the yearly event of Pradanya. I would
insist on capitalizing on the networking opportunities created by this two day conference on recent
trends in healthcare sector by the faculty and students and making the conference a big hit.

(Rajendra Rathore)

08

Mukesh Sharma
I.A.S.

Principal Secretary
Medical, Health &
Family Welfare Department
Government of Rajasthan
Secretariat, Jaipur-302005
Tel. : 0141-2227132
Fax : 0141-2227797
e-mail : sharmamk@ias.nic.in

Message
It is a privilege to know that the IIHMR University, Jaipur is conducting 20th International
conference, Pradany a 2015. It is gratifying to know that the theme of the conference is Universal
Health Coverage - Roadmap 2020.
It is wished that this conference shall open new avenues for the healthcare organizations to
welcome new approaches and practices within the reach of every individual especially for the
section of the society that struggles hard to make the ends meet.
The sharing of ideas and expertise of renowned speakers and the illustrious efforts of the students
who shall be making a poster and paper presentations, will provide an insight into the current
practices and what all can be done to tweak the services being offered at different levels.
I heartily congratulate the faculty for choosing this theme for the yearly event of Pradanya. I would
insist on capitalizing on the networking opportunities created by this two day conference on recent
trends in healthcare sector by the faculty and students and making the conference a big hit.
I wish the institution all the best.

(Mukesh Sharma)

ICMR

10

D. P. Agarwal
President, Management Board, IIHMR
CMD, Transport Corporation of India Limited

Message
th

I am extremely delighted that The IIHMR University, Jaipur is organizing the 20 International
Conference, Pradanya 2015. It is gratifying to know that the theme of the conference is Universal
Health Coverage - Road Map 2020.
Though prodigious efforts have been taken to improve the healthcare standards in India, problems
of paramount importance are yet to be resolved. Hence, it is incumbent upon us, the healthcare
professionals and the corporates under their CSR to work diligently to make adequate healthcare
facilities available to the poor and needy population.
I am sure that the deliberation in the conference will enlighten us with better measures to improve
healthcare.
I send my best wishes for the success of the conference.

D. P. Agarwal

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S. D. Gupta
President
The IIHMR University
Jaipur

Message
It is a matter of immense pleasure that The IIHMR University is organizing international conference
Pradanya 2015 on Universal Health Coverage Road Map for 2020 on 3 & 4 October, 2015. I take
this opportunity to congratulate the whole IIHMR team for the successful 20 years of Pradanya.
Over these years, it could provide a platform for all the healthcare leaders, professionals working in
this area and the industry leaders to come together and exchange their ideas and discuss strategies
on various issues. This, I believe that, could establish a prodigious efforts to improve the healthcare
standards of the country. This thought provoking platform also created a corporate social
responsibility among the healthcare professionals and their corporates to work diligently and make
adequate healthcare facilities available to the poor and needy population of the country. The IIHMR
University is committed to create health professionals with imbibed knowledge, skills and a positive
attitude.
rd

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I am sure, as in the past, this conference will also surely generate many useful ideas and enlighten us
with better measures to improve health delivery system in India. It is also a learning platform for the
IIHMR students in planning, organizing and delivering the conference successfully.
I am obliged to the luminaries for being supportive by their presence and messages that they have
imparted. IIHMR University is privileged on having them here. On this auspicious occasion, I would
like to express my heartfelt gratitude towards all our eminent speakers from India and abroad for
taking out valuable time to share their knowledge on crucial topics. I am sure that the participants
will be learning a lot from these inputs and effective interactions.
I, once again, take this opportunity to congratulate the students, faculty and the conference
committee for their tremendous efforts to make this conference a mega event.
I convey my best wishes for the success of this prestigious event.

(S. D. Gupta)

12

Col. (Dr.) Ashok Kaushik (Retd.)


Dean, Academic and Student Affairs
The IIHMR University, Jaipur

Message
Its my immense pleasure to congratulate Institute of Health Management Research Jaipur for
organizing an International Conference on Universal Health Coverage - Road Map 2020 on
October 3-4, 2015.
I hope this conference will go a long way in bringing awareness in health care professionals about
latest trends in the field. The event will widen the understanding of students and faculty members
of various branches for innovative work and help them in bringing qualitative changes in the
management of Health and Hospital Care organizations.
I take this opportunity to compliment the organizers and give my best wishes for the success of the
event.

(Col. (Dr.) Ashok Kaushik)

13

Sudarshan Jain
Managing Director
Healthcare Solutions
Abott Healthcare Pvt. Ltd.

Message
I am happy to learn that Indian Institute of Health Management and Research (IIHMR), Jaipur is
organizing a two-day international conference on Universal Health Coverage- Roadmap 2020.
We have made tremendous strides in the Healthcare & Pharmaceutical arena. This area is
knowledge driven and is at inflection point in our country. The theme chosen for the conference is
most relevant with respect to dynamic change in the Indian healthcare system. It is a time for the
healthcare and pharmaceutical professionals to assess the strength back and come up with
innovative way of thinking and implementing ideas to cater to the healthcare needs of the country.
I congratulate the Organisers for providing a platform for pharmaceuticals and other healthcare
leaders and professionals working in this area to share ideas, innovations, best practices and brain
storming on how we can achieve universal health care and way forward strategies for the benefit of
the society at large through interaction in this Conference.
I have no doubt that the thought provoking suggestions on increasing accessibility, affordability and
availability of healthcare in India made by the eminent speakers across the globe would be well
taken up to the policymakers and for further implementation by the authorities concerned for the
achievement of universal healthcare.
I wish the Conference a great success.

(Sudarshan Jain)

14

Dr. Manvir Singh


Administrative Director
Thumbay Group
Ajman, UAE

Message
It is a fascinating fact that our Institute, having been metamorphosed into University quite
gloriously, continues to be resilient and resonant. A strong bond created over the years by its
dedicated directors, deans, teachers, pupils, past pupils and well-wishers is undoubtedly the elixir
of this magnificent life. Its success bears out the truism that tough times never last; tough
institutions do.
I would like to quote Robert Frost
Two roads diverged in a wood, and I I took the one less traveled by, and that has made all the
difference.
I would like to thank our Director Dr SD Gupta for making all of us trek the one less traveled

Dr. Manvir Singh

15

Rajesh Varma
Director-HR
VPS Healthcare
Abu Dhabi, UAE

Message
It is a matter of immense pleasure to know that IIHMR University is organizing 20th Annual
International Conference-Pradanya under the theme Universal Health Coverage-Road map for
2020 on 3rd-4th October 2015 at Jaipur, India.
The theme of the conference indeed represents an agenda of topical interest. Pradanya 2015
represents a knowledge sharing platform with incredible scientific sessions, workshops and panel
discussions focusing trending challenges and innovative strategies in the goverance of healthcare.
IIHMR University, a pioneer organization in health sector continuous initiatives clearly reflects its
mission to improve the healthcare standards in national and global perspective.
I congratulate the organizing and scientific committee of the Conference and wish a grand success.

(Rajesh Varma)

16

Bijender Vats
Director - HR
MSD INDIA
Mumbai

Message
The conference theme is very apt and is need of the hour. Thanks to IIHMR for converging various
facets of the topic for fruitful and insightful dialogue. Feel privileged to be a part of healthcare
industry that touches lives of millions and of HR profession that touches careers of millions.

Bijender Vats

17

Joy Chakraborty
Chief Operating Officer
P.D. Hinduja Hospital & Medical Research Centre
Mumbai

Message
I am happy to know that IIHMR University, Jaipur is organising an international conference on
Universal Health Coverage Roadmap for 2020 between October 3th and 4th, 2015. The theme of
the conference is very appropriate with the need of the hour for our country and also adopted by
the Government for the benefit of larger society.
I am sure that the discussions and deliberations during this conference will be beneficial for the
participants and help all of us to develop some working plan to reach the goal by 2020. I want to
congratulate organisers for selecting and working towards the Alma matter.
IIIHMR as an institute has immensely contributed healthcare industry by producing many finest
healthcare leaders. I had the opportunity to interact and work with some of them. I am sure with the
back ground of research, education and training IIHMR will contribute the country in future too.
I wish you all for a very successful conference.

(Joy Chakraborty)

18

Dr. Mahendra B. Thakre


General Manager - IPR Legal
Mylan Laboratories Limited
Hyderabad

Message
I am happy to learn that IIHMR University, Jaipur is organizing two days event, 20thPradanya, an
rd
th
International Conference on Universal Health Coverage Road Map for 2020 on October 3 - 4 ,
2015. I am also delighted to see the theme of conference and topics incorporated in various sessions
regarding different issues revolving around healthcare system.
I congratulate the organizers on providing a platform to healthcare professionals working in this
area to share their ideas, innovations, how to protect it and brain storming sessions on how to reach
our mission by 2020 to provide better healthcare to the society at large.
I am confident that through two days sessions on various issues revolving around healthcare, the
emerging thought provoking suggestions on how to move forward for better healthcare by 2020,
would be taken up to the policymakers for effective implementation.
I convey my best wishes for the success of the conference.

Dr. Mahendra B. Thakre

19

Dr. Nirmal Gurbani


Professor
The IIHMR University
Jaipur

Message
it gives me immense pleasure that IIHMR University, Jaipur is organizing this glorious International
Conference on Universal Health Coverage- Roadmap 2020.
Access to healthcare has been recognized as basic human right and call upon all nations to set this as
the prime agenda in their health policy. This has also been identified as major goal under Millenium
Development Goals and consequently Sustainable Development Goals as well.
I am sure this conference will be successful in the augmentation of the perspectives of healthcare
professionals in India and will encourage students and faculty members of various streams to create
a thinking lens and to analyze as creative thinkers. This will probably ensure to bring quality changes
in the management of healthcare and hospital care organizations for the provision of universal
healthcare.
Making the most of this opportunity I would like to appreciate the commendable work done by the
organizers and convey my best wishes for the success of this prestigious event.

(Dr. Nirmal Gurbani)

20

Dr. Vijay Pratap Raghuvanshi


Assistant Professor
The IIHMR University
Jaipur

Message
I deem it my fortune and privilege to be in a position to welcome all speakers, delegates and
members of the 20th International Conference - Pradanya 2015 with the theme, Universal
Health Coverage - Roadmap 2020 on 3-4 October,2015. This event is a prominent milestone for
healthcare managers, researchers & academicians and we IIHMR University, are proud to play host
this annual conference. We are certain that you will enjoy all the planned events, and we look
forward to meet you during the conference.
I fully acknowledge that the scientific sessions of the 20th Annual Conference - Pradanya 2015 will
reflect the evolution of Healthcare System Management, including state-of-the-art presentations
on various relevant topics.
Pradanya Conferences has always been a great venue for frank exchange of experience and
knowledge in a relaxed and convivial setting. We will continue this tradition at this 20th Conference.
I wish this conference brings together the Healthcare fraternity of National and International, and is
an excellent chance for networking. I welcome all Healthcare Professionals to join us at the
conference, to share and exchange ideas and to enjoy each others company. I wish everyone a most
beneficial experience.
Thanks & Regards

(Dr. Vijay Pratap Raghuvanshi)

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The IIHMR University


The IIHMR University is a specialized research university in the field of management research, postgraduate
education and training exclusively in the health sector. The University aims to generate new knowledge and
technologies to provide evidence and inputs for developing effective policies, health interventions and
strategies. The origin of The IIHMR University has its roots in the pioneering and significant contribution of
Institute of Health Management Research (IIHMR) Jaipur in the last three decades in policy and programme
management research and capacity development in health and hospital management in India and SouthEast Asia.
The IIHMR University has a mission to improve the standards of health through better management of
healthcare and related programmes through management research, education, training and institutional
networking in a national and global perspective in the health sector.
World Health Organization has designated IIHMR as a WHO Collaborating Centre for District Health Systems
based on Primary Healthcare for its significent contribution to strengthening health systems by promoting
and conducting health policy and program management research and capacity building. The Ministry of
Health and Family Welfare, Government of India has identified it as Institute of Excellence for training and
capacity building. A critical mass of professionally trained health, hospital and pharmaceutical managers
has been produced by IIHMR to better manage health systems. The Institute has been instrumental in a
paradigm shift in the management of healthcare programs and hospitals in India. For its significant
contribution to healthcare and pharmaceutical management education, it has received several leadership
awards. In addition, IIHMR has become a major destination for training and capacity development in
leadership and strategic management, hospital management, disaster management, quality management,
project management, health management information systems, and health economics and finance.

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Our Mission
The IIHMR University is dedicated to the improvement in standards of
health through better management of healthcare and related
programmes. It seeks to accomplish this through management research,
training, consultation and institutional networking in national and global
perspective.

Thrust Areas

Primary Health Care

Health and Hospital Management

Pharmaceutical Management and Rural Management

Population and Reproductive Health and Evaluation

Program Management

NGO Management and Networking

Capabilities

Management Research, Education and Training

Design and Conduct Management Training for Health Sector

Networking and Institutional Capacity Development

Project Management

Operations Research and Evaluation

Economic and Financial Analysis

Survey Research

Social AssessmentQuality Assurance Health Sector Reforms

Program Evaluation

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Organizing Committee

Top (Left to Right): Dr. Ajmal, Dr. Shubhankar, Mr. Banoj Mahanta, Dr. Akanshaa, Ms. Sneha Priya,
Dr. Sakshi Kushwaha, Dr. Priyanka Cherian, Dr. Risho Singh, Dr. Vikram Chopra, Mr. Kush Dua,
Mr. Chaitanya Dadhich.
Bottom (Left to Right): Dr. Vijay Pratap Raghuvanshi, Mr. Hem K Bhargava, Dr. Santosh Kumar,
Mr. Bajrang Lal Sharma, Brig (Dr.) S.K. Puri (Retd.), Dr. S.D. Gupta, Col (Dr.) Ashok Kaushik, Dr. P.R.
Sodani, Dr. Nirmal Kumar Gurbani, Dr. Suresh Joshi.

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A glimpse into what the conference holds in store for us


Healthcare reformation is a long, on-going process that requires significant experimentation and innovation
to determine what works in ones own country. The healthcare system in India has experienced rapid and
unprecedented changes owing to better facilities, overall improvement in healthcare and with contribution
from public and private health sector. Despite the on-going developments, the most pressing challenges faced
by the Indian health care system are:

Poor availability of medical and paramedical staff.

Rising prices of healthcare services

Limited innovations

Lack of sound governance and strategies.

Implementation of information technology slower than expected.

Healthcare professionals are constantly finding the need to rethink operations management, funding and
financing, staffing issues, quality management and assurance. The healthcare industry is also striving to
enhance hospital design and integrate technology to improve healthcare service and delivery. Opportunity is
being created both by developments in healthcare industry itself as well as increasing awareness amongst the
people for their own well-being. The result is rise in spending on healthcare products and services of all kinds.
Taking into account the opportunities and challenges faced now a days, the health care industry aims at
improving the quality of life, diagnostic and treatment options, as well as the efficacy and cost effectiveness of
the healthcare through proliferation of innovations.
Based on the concept of need of innovations and governance in healthcare in India, the IIHMR University is
organizing an international conference on innovations in governance & strategies: reimaging healthcare in
India and will try to address the questions regarding the need for good governance and innovative strategies
for betterment of healthcare in India.
Mission: Ourmission is to put good governance in implementation of sound and innovative healthcare
strategies.

Conference Schedule
Pre-Conference Workshop
02nd October, 2015 (Friday)
IIHMR University, Jaipur
Time

Topic

Speakers

10:30 am 01:00 pm

Road Safety & Injury

Dr. Maya Tandon


Chairperson & Managing Trustee Sahayta Trust

10:30 am 01:00 pm

Healthcare Governance

Dr. Ravindra Karanjekar


CEO, Seven Hills, Mumbai

10:30 am 01:00 pm

Healthcare Governance HR

Mr. Bijender Vats


Director Human Resources, MSD INDIA, Mumbai

Conference Programme
Day : 1
03 October, 2015 (Saturday)
rd

08:30 am - 09:30 am

Registration

09:30 am - 11:00 am

Inaugural & Theme Address - Dr. S.D. Gupta - President, IIHMR University, Jaipur
Chief Guest : Dr. Rakesh Kumar - Joint Secretary - MoHFW - GOI
Guest of Honour
Welcome Address - Dr. Ashok Kaushik
Conclusion of the Inaugural session/Vote of Thanks - Dr. Vijay P Raghuvanshi
Tea Break 11:00 am - 11:30 am

TECHNICAL SESSION - 1 (11:30 am - 12:45 pm)


UHC -Equity Lens : Increase Access, Affordability and Availability in Healthcare
11:30 am - 11:50 am

Dr. Irina Paipeva - Technical Officer WHO, India

11:50 am - 12:10 pm

Dr. Chandrakant Lahariya National Professional Officer-Universal Health Coverage, World Health Organization

12:10 pm - 12:30 pm

Mr. Paul Francis - Technical Officer-WHO Country Office for India*

12:30 pm - 12:45 pm

Question & Answer


Chair: Dr. Gayatri Singh - UNICEF, Jaipur
Lunch Break 12:45 pm - 01:40 pm

TECHNICAL SESSION - 2 (01:40 pm - 03:00 pm)


Drug Innovation and Patent Regime
01:40 pm - 02:00 pm

Mr. Sundeep Kumar - Head - Corporate & Public Affairs, Novartis India Ltd.

02:00 pm - 02:20 pm

Dr. Nanduri Srinivas - Associate Professor, NIPER, Hyderabad

02:20 pm - 02:40 pm

Mr. Vinay Sharma - Astra Zeneca

02:40 pm - 03:00 pm

Dr. Nirmal Kumar Gurbani - Professor - IIHMR University, Jaipur


Chair: Dr. S. K. Puri - Advisor, IIHMR University, Jaipur
Tea Break 03:00 pm - 03:30 pm

TECHNICAL SESSION - 3 (03:30 pm - 05:00 pm)


Reducing Cost of Healthcare and Financing
03:30 pm - 03:50 pm

Dr. Vivek Desai - Founder - HOSMAC India Pvt. Ltd., Mumbai

03:50 pm - 04:10 pm

Mr. Anirudha Chakravarty - Founder - Bottom line Consultants, Mumbai

04:10 pm - 04:30 pm

Dr. Anoop Daga - AIIMS Hospital, New Delhi

04:30 pm - 05:00pm

Question & Answer


Chair: Dr. Ravindra Karanjekar, CEO, Seven Hills Hospital, Mumbai

Day : 2
04 October, 2015 (Sunday)
th

TECHNICAL SESSION - 4 (10:00 am - 11:30 am)


Operation Management in Healthcare Systems
10:00 am - 10:20 am

Dr. Ravindra Karanjekar - CEO - Seven Hills Hospital, Mumbai

10:20 am - 10:40 am

Dr. Prateem Tamboli - Facility Director - Fortis Escorts Hospital, Jaipur

10:40 am - 11:00 am

Dr. Suresh Adwani - Dean - Faculty of Management Studies,


Mody University of Science and Technology

11:00 am - 11:30 am

Question & Answer


Chair: Dr. Vivek Desai - Founder - HOSMAC India Pvt. Ltd., Mumbai
Tea Break 11:30 am - 12:00 pm

TECHNICAL SESSION - 5 (12:00 - 01:30 pm)


Blue Ocean Strategies in Healthcare
12:01 pm - 12:20 pm

Dr. Ram Narain - Executive Director, Kokilaben Dhirubhai Ambani Hospital, Mumbai

12:20 pm - 12:40 pm

Dr. Saumitra Ghosh - CEO - WISH Foundation


(Wadhwani Initiative for Sustainable Healthcare), New Delhi

12:40 pm - 01:00 pm

Dr. Ashutosh Raghuvanshi - Managing Director, Vice-Chairman & Group CEO


Narayana Hrudayalaya Pvt. Ltd.

01:00 pm - 01:20 pm

Dr. Anil Agarwal - Health Specialist at UNICEF, Jaipur

01:20 pm-01:30 pm

Question & Answer


Chair: Brig. Dr. S.K. Puri - Advisor - IIHMR, Jaipur
Lunch Break 01:30 - 02:30 pm

TECHNICAL SESSION - 6 (02:30 pm - 03:45 pm)


Quality and Safety in Healthcare
02:30 pm - 02:50 pm

Dr. Satyajit Bose - Founder & CEO - Mission Hospital, Durgapur

02:50 pm - 03:10 pm

Dr. K. K. Kalra - CEO - NABH, QCI, India

03:10 pm - 03:30 pm

Dr. Saumitra Bharadwaj - Vice President, Medica Hospitals Pvt. Ltd., Kolkata

03:30 pm - 03:45 pm

Question & Answer


Chair : Dr. S.D. Gupta, President, IIHMR University, Jaipur
Tea Break 03:45 pm - 04:00 pm

04:00 pm - 4:30 pm

Closing Ceremony/Valedictory
Summarization of Conference - Dr. Anoop Khanna, Professor, IIHMR
Guest of Honor
Address - Dr. S.D. Gupta, President, IIHMR
Vote of Thanks - Dr. Vijay Pratap Raghuvanshi

Pre-Conference Workshop Sessions


Road Safety
Road traffic accidents, besides the non-communicable diseases are also the leading cause of death globally.
Nearly 3,400 people die on the worlds roads every day. Tens of Millions of people are injured or disabled
every year. India, along with other countries tops the global list of fatalities from road crashes. Rapid
urbanization, motorization, lack of appropriate road engineering, poor awareness levels, nonexistent injury
prevention programs, and poor enforcement of traffic laws has exacerbated the situation. Young people
under the age of 25 are the main victims of road traffic crashes worldwide. More young people aged between
15-29 die from road crashes than from HIV/AIDs, Malaria, Tuberculosis or homicide. This means that road
crashes are a serious threat to youth no matter where they are. 46% of road traffic deaths are pedestrians,
cyclists and motorcyclists. 90% of road traffic deaths and injuries occur in low-income and middle-income
countries which have only 48% of the registered vehicles. This raises the need for comprehensive road safety
measures.The present situation needs to have a point of contact between the healthcare system and the
aims and goals of road safety. The requisite for development of innovative and protective plans to improve
the road safety and preparedness for its implementation are needs to be discussed. This will involve sharing
of ideas and knowledge among various experts. Raising some of the issues pertaining to Road Safety and the
ways to tackle them will be addressed by the prominent speaker in the Pre-conference workshop.

Healthcare Governance
Healthcare is an integral operational component of a society. Good health indices reflect the strength and
plethora of a society. Governance is increasingly seen as the basis for good practice, successful organizations
and ethical behavior. Good governance is central to enhancing performance in any field and Healthcare
system is no exception. Whether the health system is meeting its objectives or whether the resources are
being used appropriately and if the priorities of the government are being implemented, all pertains to
effective health governance. There are, however many issues and challenges which needs to be taken care
off. The low healthcare expenditure by the government at the national level and underutilization of the
resources has always remained an issue in Indian healthcare governance. In developing countries with poor
governance, as incomes rise, the private sector steps in to replace public service, as in India. Even the poor
select to pay significant amounts of disposable income to obtain private care, as public services are substandard
and underutilized. Thus the issue of healthcare governance cannot be neglected in order to upgrade the
accountability of the Indian healthcare system.

Conference Sessions
UHC-Equity Lens : Increase Access, Affordability and Availability in Healthcare
Universal health care, sometimes referred to as universal health coverage, usually refers to a health care system
which provides health care and financial protection towards healthcare to all citizens of a particular country.
It is organized around providing a specified package of benefits to all members of a society with the end goal
of providing financial risk protection, improved access to health services, and improved health
outcomes.Universalhealthcareisnotaone-size-fits-allconceptanddoesnotimplycoverageforallpeople
for everything.
Many people do not receive basic healthcare facilities when required and even if metro-healthcare facilities
availed, many of them are forced to enter the BPL (Below Poverty Line) zone. There are many reasons which
explain the troublesome question about the inability of the government to meet the UHC objectives. This
creates a necessity of a roadmap to the healthcare industry driving it towards UHC which in turn needs an
equity lens to increase accessibility and availability with affordability. Thus bringing everyone to a common
horizon from the healthcare perspective and thereby creating a healthy society.

Reducing Cost of Healthcare and Financing


Health care costs have been increasing at an indefensible rate in recent years. Therefore, making it unaffordable
to the middle income class and especially the low income class to profit with the healthcare services. This
creates the need for healthcare financing to reduce the cost of healthcare and thus reducing the burden from
the destitute. RSBY (Rashtriya Swasthya Bima Yojana) is one such National health insurance scheme by the
government of India for the Indian poor.
It is not only the healthcare seekers who are struggling with the increasing cost, but also the suppliers of
healthcare face the issue of providing quality care with reduced cost. With the financial pressures that
healthcare organizations are facing, many hospitals are using traditional cost cutting methods to save money
by looking at layoffs and staff reductions. Many more hospitals, however, are finding ways to reduce costs
throughleanmanagementmethodsthatdontrequirelayoffsandcanimprovequalityforpatients.

Blue Oceans Strategy in Healthcare


High quality at low cost Value Innovation, the essence of Blue Ocean Strategy. The cornerstone of Blue
Ocean Strategy is value innovation, according to Layton, which creates unprecedented value for the customer
while simultaneously creating high profits for the company.Blue Ocean Strategy describes a planning model
for envisioning and forming successful new businesses. This strategy also applies to the healthcare sector.
The hospitals and nursing homes across towns and cities in India take many routes to bring about differentiation
in their service offerings to retain and acquire patients. Blue Ocean Strategy is the most relevant and practical
of frameworks that can be applied for hospitals in an Indian context under the threat of large or highly
specialized hospitals. Applying Blue Ocean strategy can help the hospitals or any healthcare organization to
focus on the big picture, increase demand for services, reduce cost and bring value innovation (high quality
at low cost).

Quality and Safety in Healthcare


Quality is a central issue in health care at presentin our country. This is mainly due to the huge gap that still
exists in demand-supply of healthcare services. There is an urgent need to build up capacity in Indian Healthcare
9

Systems on all fronts i.e. availability, accessibility, affordability and finally the quality. Indeed it could be said
that quality is at the heart of medical practice.Whether you see patients at a hospital, private clinic, or other
setting, time is often limited. In order to make a patients visit efficient, a hospital needs to work on improving
the quality of service delivery by all means. This should be a continuous process coupled along with safety in
healthcare.Quality in healthcare is directly linked to patient safety and therefore it plays pivotal role in saving
of human lives.
Quality management standards include series like ISO 9000, 14000, 18000 and 22000. In this segment we
also cover quality tools like 5S, Kaizen, LEAN Health, Six Sigma, Balance Score Card etc. the government has
laid down a framework in the form of NABH for quality governance of hospitals based on above standards.

Operations Management
Operations Management involves the planning, scheduling, and control of activities that transform inputs
into finished goods and services. One reality that distinguishes operations management for the human service
industry versus the manufacturing sector is that services cannot be inventoried. Health services must be
provided on demand to the consumer.. As the size of a healthcare organization or a hospital increases, the
issues related to cost of medical treatments and quality of delivered care are likely to remain at the forefront.
Proper management of health care operations is essential for achieving operational excellence which is one
of the important ways of driving down costs of care while maintaining its desired quality. Operations
management covers all the healthcare functions that allow efficient healthcare delivery.
Delivering high quality and affordable healthcare to all its citizens is a huge challenge and in order to overcome
this, a sustainable management of all the operations in a prerequisite. The operations management includes
materials management, use of technology and proper use of capital. Nevertheless, there arise issues and
challenges which need to be addressed appropriately.

Drug Innovations and Patent Regime


Continuous innovation is one of the pharmaceutical industrys mostdefining characteristics. New medications
can be crucial for maintaining the qualityof human life, and may even affect its duration. The sales potential
is staggering: theglobal pharmaceutical market is expected to reach $1.1 trillion by 2015. The pressureto
succeed is tremendous. Yet, pharmaceutical innovation is hardly an orderly,predictable process. It follows a
technology-push model dependent on a meanderingpath of scientific breakthroughs with uneven timing
and hard to foresee outcomes.Technological competency, decades of rigorous research, and profound
understandingof unmet customer needs, while necessary, may prove insufficient for marketsuccess as the
critical decision for commercialization remains outside the firm.Drug innovation as a business process requires
savvy strategic, organizational, and managerial decisions. It is already enjoying intensive research coverage,
givingrise to abundant but relativelydispersed knowledge of the mechanisms drivingdrug discovery and
development.Because of its rich potential and high significance, research on drug innovation seems poised
to gain increasing momentum in the years to come.
Recent patent-law changes in Indias pharmaceutical industry provide opportunities to study changes of
institutional and regulatory environments on innovation and social welfare in lowincome markets. From
1972 to 2004 under its process-patent regime, Indias pharmaceutical industry grew to become the worlds
fourth largest. Indian companies are becoming globally competitive in generics and clinical testing, and
moving into product R&D.Indian pharmaceutical companies have changed their decision-making in response
to changed patent laws by moving from process to product research.

10

List of Abstracts (Paper Presentations)


No.

Topic

Code

Institution

1. Screening for work related Repetitive strain injuries


(RSI) in young adults- Operational Therapy
Perspective

B6

Kokilaben Dhirubhai Ambani


Hospital, Mumbai & Goenka
and Associates Educational
Trust, Mumbai

2. Caregiver Distress and its impact on Quality of Life

B7

Kokilaben Dhirubhai Ambani


Hospital, Mumbai & Goenka
and Associates Educational
Trust, Mumbai

3. Empowerment and engagement pf SHG women


against violence during sex/intimacy

B8

IIHMR, Bangalore

4. An educational Intervention to empower and


engage the SGH women

B9

IIHMR, Bangalore

5. Astudy on people availing the cardiac treatment and


out of pocket expenditure burden on their
household in Jaipur

IP15B01

IIHMR, Jaipur

6. Reducing cost in healthcare system

IP15B03

IIHMR, Jaipur

7. Fall out in the number of patients on implementation


of a software base appointment system : An analysis
through D.M.A.I.C. six sigma tool

IP15B10

IIHMR, Jaipur

8. Role of enterprise resource planning in changing


landscape of Public Health:
opportunities ang challenges

IP15B11

IIHMR, Jaipur

9. Nutritionalestimate of rural Adolescent girls of


Bellary District, Karnataka

B10

IIHMR Bangalore

10. Assesment of knowledge, attitude and practices


about oral healthcare among multipurpose health
workers of Block Sangat, District Bhatinda, Punjab

B13

Punjab University

11. India: A strategic location for medical tourism

B14

IIHMR Bangalore

12. 18C commandents: Indian model to improve and


develop hospital operation processes in a
Brownfield hospital project

B17

Soni Manipal Hospital, Jaipur

13. Patient reported adverse outcomes on treatment of


B18
type-2 diabetes mellitus and co-morbidity in South India
11

Ratnam Institute of Pharmacy,


Nellore, A.P.

No.

Topic

Code

Institution

14. Astudy on quality management practices in a


tertiary care hospital: Medication errors

IP15B12

IIHMR Jaipur

15. A look at hidden relationships with healthcare:


Real Pharmaceutical related tensions

IP15B13

IIHMR Jaipur

16. Cause Related Marketing: Impact and perception on


Over the counter drug consumers

IP15B14

IIHMR Jaipur

17. Palliative care: Reconceptualising Death

IP15B15

IIHMR Jaipur

18. Building momentum for UHC through an


integrated approach

IP15B16

IIHMR Jaipur

19. Health Financing and Health Insurance IP15B17


A study on BRICS Nations with special reference of India

IIHMR Jaipur

20. Brain Death Declaration - A Distinctive Part of


Human Organ Transplantation

IP15B18

IIHMR Jaipur

21. Impact of the billing related errors on the


cost in the hospitals

IP15B20

IIHMR Jaipur

22. Assessment of level of Diasater Preparedness of


Districts Hospitals in Chhattishgarh

B1

Punjab University

23. Healthcare Reforma throgh Technology

B2

H.N.G University, Patan

24. Awareness about MTP Act (safe & legal abortion)


among the women and the Frontline health workers
in the villages of Punjab, Haryana & chandigarh

B3

Punjab University

25. Financing healthcare by Government sponsored


health Insurance - A studyof RSBY in Odisha

B4

SMIT, Ankushpur

26. Treatment seeking behaviour of diabetic patients


with special emphasis on follow-up in the govt
health facilities

IP15B05

IIHMR Jaipur

27. Day care centres as capacity development in


elderly care: A need of the hour as India Grays

IP15B06

IIHMR Jaipur

28. A study to bring migrants under the equity lens

IP15B07

IIHMR Jaipur

29. Operations Management in healthcare system

IP15B08

IIHMR Jaipur

30. A study to assess the impact of education on


vaccination awareness among mothers coming
to immunization camp (of SEWA MANDIR) in
rural Udaipur, Rajasthan

IP15B09

IIHMR Jaipur

12

No.

Topic

Code

Institution

31. Futuristic aspect of universal coverage- Ward Sabha

IP15B22

IIHMR Jaipur

32. Hospital OPD Pharmacy :


Role in Improving Quality of Healthcare

IP15B19

IIHMR Jaipur

33. Hearing loss in patients attending the outpatient


clinic in an industrial tertiary healthcare centre

B11

Central Hospital, Kolkatta

34. Hearing loss and balance disorder causing mobility


impairment in elderly population

B12

Central Hospital, Kolkatta

35. Burden of Multiple Disabilities among the Older


Population in India:
An Assessment of Differential Factors

B19

Jamia Hamdard University

36. Will Personalised Medicine Transform the


Future Outlook of Healthcare?

IP15B04

IIHMR Jaipur

13

List of Abstracts (Poster Presentations)


No. Topic

Code

Institution

1. Study the impact of DOTS on accessibility, affordability


of Medical treatment for Patients

IP15A016

IIHMR, Jaipur

2. A study on reducing out of pocket expenditure in India


through Insurance

IP15A017

IIHMR, Jaipur

3. Emerging Trends:
Health Insurance in the Medical Tourism

IP15A019

IIHMR, Jaipur

4. Manual scavenging: Reasons for continuation of the


inhuman act and failure of act, government policies
and programs

IP15A020

IIHMR, Jaipur

5. Neonatal Care by avoiding medication administration


errors

IP15A022

IIHMR, Jaipur

6. Reducing cost of healthcare and financing

IP15A030

IIHMR, Jaipur

7. Human Resource in Indian Healthcare:


Current trends and the way forward

IP15A024

IIHMR, Jaipur

8. Primary Prevention in healthcareGateway to Financial Reforms

IP15A025

IIHMR, Jaipur

9. What we have and what more should be done to


improve the quality and safety of healthcare systems
through accreditation in India: An analytical study

A3

PGIMER,
Chandigarh

10. Swachh Bharat Abhiyans Impact in Chandigarh

A4

PunjabUniversity

11. Norms & Reality - The Sanitation and Hygiene Practices


among students of schools of Chandigarh

A5

Punjab University

12. Changing face of Indian healthcare industrty:


Opportunities and challenges

A7

IIHMR Bangalore

13. A study on drug inventory optimization:


Statistical approach

IP15A033

IIHMR, Jaipur

14. Medication errors and patient safety

IP15A034

IIHMR, Jaipur

15. Telemedicine: A network of easy reach for digital India

IP15A035

IIHMR, Jaipur

16. Patient safety in India: Issues and suggestions at a glance

IP15A036

IIHMR, Jaipur

14

No. Topic

Code

Institution

17. Delivering innovative solutions in maternal and


child health through Google Glass

IP15A037

IIHMR, Jaipur

18. Use of herbal products and potential interaction in


patients with cardiovascular disease

IP15A038

IIHMR, Jaipur

19. Statistical quality control chart: A six sigma initiative


to measure and control quality in healthcare operations

IP15A039

IIHMR, Jaipur

20. First 500 days of life- maternal malnutrition through


equity lens

IP15A040

IIHMR, Jaipur

21. Drug innovation and patient regime

IP15A041

IIHMR, Jaipur

22. Blue ocean strategy: healthcare perspective

IP15A042

IIHMR, Jaipur

23. Improving Pharmacy Dispensing Performance through


Time Management

IP15A043

IIHMR, Jaipur

24. Universal healthcare and sustainable healthcare


financing in India: lessons from German healthcare
market

IP15A044

IIHMR, Jaipur

25. A study of major operations management techniques


in healthcare systems

IP15A045

IIHMR, Jaipur

26. Occupational safety of nurses

IP15A046

IIHMR, Jaipur

27. A study on cost reduction of Cath lab procedures

IP15A047

IIHMR, Jaipur

28. The Hungry India

IP15A048

IIHMR, Jaipur

29. KHUSHI BABY: m-Health solution to increase


immunization

IP15A050

IIHMR, Jaipur

30. Quality: Utilization of operation theatres

IP15A051

IIHMR, Jaipur

31. Harnessing the demographic dividendthe future of healthcare in India

IP15A052

IIHMR, Jaipur

32. Working towards equity: the inclusion of PWDs


in HIV/AIDS Programme interventions in India

IP15A053

IIHMR, Jaipur

33. Quality improvement in healthcare delivery using


efficient cold chain management

IP15A055

IIHMR, Jaipur

34. Quality and safety in healthcare

IP15A056

IIHMR, Jaipur

15

No. Topic

Code

Institution

35. Application of Failure Mode Effect Analysis (FMEA) and


Root Cause Analysis (RCA) in reducing the patient
identification errors in a tertiary care hospital

IP15A058

IIHMR, Jaipur

36. Are children safe on Indian roads? The haddron matrix


approach for prevention of RTA and injuries in India

IP15A059

IIHMR, Jaipur

37. Blue Ocean Strategy for Corporate Hospitals Mobile Healthcare Services

IP15A063

IIHMR, Jaipur

38. Pharmacogenomics- The new trend for personalized


medicine

A9

Amity University,
Rajasthan

39. Investigating the patterns of creating an edge over


competitors in Healthcare Markets: A Systematic Review

A1

IIHMR Delhi

40. Exploring Blue Ocean Strategies for Health


Promotion in Low and Middle Income Countries:
Learning from the Malaysian example

A2

PGIMER,
Chandigarh

41. Universal Health Coverage for India

B5

IIHMR, Delhi

42. Pharmaceutical multinational corporations


diversification towards generic: Indian scenario

IP15A032

IIHMR, Jaipur

43. Portable E-Health record system: an initiative to


increase accessibility and affordability of
healthcare in rural India

IP15A027

IIHMR, Jaipur

44. Healthcare challenges faced by urban poor in Indian cities

IP15A028

IIHMR, Jaipur

45. Best healthcare at lower cost

IP15A031

IIHMR, Jaipur

46. A Model on delivering Primary Healthcare Services for


BPL Category in India

IP15A-001

IIHMR Jaipur

47. Need of Public Private Partnership in


Universal Health Coverage

IP15A-002

IIHMR Jaipur

48. Hospital Acquired Infection: Measuring its impact on


increase average length of stay and cost of care

IP15A-003

IIHMR Jaipur

49. Replacing Out of order Medical Equipment?


Mobile Mechanics: A cost-effective and feasible option

IP15A-004

IIHMR Jaipur

50. Is Rashtriya Swasthya Bima Yojana Indias plausible


approach of financing healthcare for BPL families?

IP15A005

IIHMR Jaipur

16

No. Topic

Code

Institution

51. Home Care : Patient care model of the future

IP15A006

IIHMR Jaipur

52. Health Care : Reducing Cost Burden not Quality

IP15A007

IIHMR Jaipur

53. Integrated m-Health strategies to achieve UHC

IP15A009

IIHMR Jaipur

54. Telemedicine - A revolutionary approach for


effective diabetes management in rural setup

IP15A010

IIHMR Jaipur

55. A descriptive study on Consumer Protection Act (CPA)


and medical negligence in hospital

IP15A012

IIHMR Jaipur

56. Queuing& capacity planning in Central Registration


Counter for a large tertiary care hospitalAn Operations Improvement Initiative

IP15A013

IIHMR Jaipur

57. Prevention of Medical Negligence and Risk Management


in Hospitals

IP15A015

IIHMR Jaipur

58. Emerging opportunity in healthcare sector

IP15A066

IIHMR Jaipur

59. Innovation in Hospital: m-Health

IP15A067

IIHMR Jaipur

60. Role of PPP in capacity building of Healthcare

IP15A068

IIHMR Jaipur

61. Crisis in healthcare: Non-communicable diseases

IP15A069

IIHMR Jaipur

62. Stepping into unknown:


Innovating Indian Healthcare Industry:
Lessons from Non-Healthcare Industry

IP15A062

IIHMR Jaipur

63. Successful cost reduction strategies:


lessons from established giants

IP15A057

IIHMR Jaipur

17

Abstracts for Paper Presentations


Code - B6

Screening for Work related Repetitive strain injuries (RSI) in Young adultsOccupational Therapy Perspective
Dr. Preetee Gokhale
(Master of Occupational Therapy-Neurosciences) Occupational Therapist at Goenka and Associates Educational Trust, Mumbai

Dr. Parag Sawant


(Master of Occupational Therapy-Neurosciences) Occupational Therapist at Kokilaben Dhirubhai Ambani Hospital, Mumbai

Rationale:
Work-related musculoskeletal disorders (WRMSDs) are worldwide problems that affect worker class in a
wide variety of occupations, causing workers disability. Poor posture at work is a major cause of back pain,
workplace stress, repetitive strain injury; resulting in lost time, reduced productivity, poor employee health,
low morale, and higher costs. Thus, early screening of employees is necessary to prevent &/or lower the
incidence of work related Repetitive strain injuries.
Objectives:
To identify early signs and symptoms that can lead to RSI and suggest ergonomic guidelines to employees at
risk for acute low back pain using Preventive Occupational Therapy.
Methodology:
125 randomly selected healthy individuals were screened using Acute low back pain screening questionnaire
and Fatigue Severity Scale.The study was conducted on 100 individuals, both males and females in the age
group 20-40 years from two Private Banks and one Government organisation. Subjects with medically
diagnosed history of low back pain or any other orthopaedic problems were excluded from the study. 25
subjects dropped out and data of 100 subjects was analysed statistically.
Key Findings:
Mean age of the sample was 29.0 years The sample was inclusive of 24 males and 76 females. Mean score on
acute low back pain screening questionnaire was 90.82
And 30 individuals scored more than 105 which suggest they were at risk for low back pain.
The data also suggested that intensity of low back pain increases with advancing age.
The mean fatigue score on Fatigue severity scale was 30.88 which were related to physical as well as mental
stress experienced at work by the employees.
Conclusion:
Employees working for more than 8 hours a day and attaining a sustained posture for long are at a high risk
of developing Work related musculoskeletal disorders.
Thus, regular screening of employees is essential for the benefit of employee health and work productivity.
Key words:
Work related musculoskeletal disorders, Repetitive strain injury, Back pain, Fatigue

18

Code - B7

Caregiver distress and its impact on Quality of Life


Dr. Parag Sawant
(Master of Occupational Therapy-Neurosciences) Occupational Therapist at Kokilaben Dhirubhai Ambani Hospital, Mumbai

Dr. Preetee Gokhale


(Master of Occupational Therapy-Neurosciences) Occupational Therapist at Goenka and Associates Educational Trust, Mumbai

Rationale:
Family caregivers are essential partners in the delivery of complex health care services and this study
exemplifies the associated caregiver burden and stress during cancer treatment. Unlike professional caregivers
such as physicians and nurses, informal caregivers, typically family members or friends, provide care to
individuals with a variety of conditions, most commonly advanced age, dementia, and cancer. As more and
more evidence suggests that caregiving is deleterious to ones health, increased attention is being paid to the
day to day well-being of caregivers. Compared to non-caregivers, caregivers oftenexperience psychological,
behavioural, and physiological effects that can contribute toimpaired immune system function and coronary
heart disease, and early death.
Objectives:
Screening for early signs of distress and impaired Quality of Life in caregivers.
Methodology:
70 caregivers (Relatives of Cancer patients) were screened for distress using Caregiver Burden scale and were
assessed for Quality of Life using Caregiver Quality of life-Cancer Questionnaire. There were 20 drop outs.
The data of 50 subjects was statistically analysed.
Key Findings:
The mean age of the selected sample was 42 years. The scores on the Caregiver burden scale suggest high
level of distress in relatives of cancer patients in all the scale components namely burden, disruptiveness,
positive adaptation and financial concerns. Also, there score onCaregiverQuality of life- Cancer
QuestionnaireSuggested reduced Quality of life in these individuals.
Conclusion:
The distress was more in older caregivers, especially spouse of cancer patients. The distress had direct impact
on caregivers Quality of Life which was decreased. If the signs of distress are tapped early, it can be beneficial
in reducing or stabilizing depression, burden, stress and role strain. Thus, regular screening can help health
professionals to educate and counsel caregivers to lead a healthy life using various individualized interventions.
Key words:
Distress, Caregiver burden, Quality of Life

19

Code - B8

Empowerment and engagement of SHG women against violence during sex/intimacy


Abhinav V., Dewesh Dubey, Dr. Manoj K. Gupta
Post Graduate Diploma in Healthcare Management, Institute of Health Management Research, Bangalore
e-mail: vijayvargia30@gmail.com

Introduction:
More than two decades of research has shown that sexual violence and intimate partner violence within or
outside marriage are major public health problems with serious long-term physical and mental health
consequences, as well as significant social and public health costs. Internationally, one in three women have
been beaten, coerced into sex or abused in their lifetime by a member of her own family. However, in a
conservative society like India, talking about sex and other gynecological problems of women is a taboo.
Across all strata of the society, these issues are not discussed with the girls before marriage.In this regard a
culture of silence prevails that inhibits women from revealing their private problems to others due to various
social factors. Development and use of IEC material along with active participation by the community ensures
delivery of appropriate information and knowledge to people which in turn empowers them to make informed
decisions about their life. Health care workers in rural areas act as change agents and are trained to
communicate the information contained in these materials to the community.
Objective:
To empower and engage the Self Help Groups (SHGs) women against violence during sex/ intimacy with the
use of IEC strategy so that they can act as change agents for others women in the community.
Methods:
This was multi-centric Action Research Demonstration Study. Funded by Indian Council Of Medical Research
(ICMR), to sensitize, mobilize and engage women through the SHGs, to take care of their reproductive health,
including cervical cancer, and act as change agent for other women in the community. The Kolar district in
the Karnataka was the primary intervention site from Kolar district an intervention taluk (Bangarpet)was
selected from eleven taluks of Kolar district by simple random sampling geographical, climatic, development
and health indicators was selected as control by adopting purposive sampling. As an intervention, a total of
fifteen workshops, each consisting three days, targeting 75 SHGS in each were conducted in Bangarpettaluk.
Sample size was 400 household (200 from Bangarpet and 200 from Malur) of SGH women were interviewed
for baseline and end-line each.
Results:
The intervention was found effective in the form of a significant change in the level of perception among SHG
women that violence during sex or intimacy is abnormal, improvement in awareness about womens right to
decline the partner form having sex while encountering violence from him and significant reduction in their
experience of facing violence during intimacy or sex in last one year.
Conclusion:
This study provides experience of the feasibility; efficacy and impact of health education interventions and
an insight into the development and implementation of effective interventions against violence during sex or
intimacy in India.

20

Code - B9

An educational intervention to empower and engage the SGH women [Post Graduate
Diploma in Healthcare Management, Institute of Health Management Research,
Bangalore] against cervical cancer
Dr. Neeraja Lakshmi, e-mail: drneerajaangel7@gmail.com
Dr. Rachana Ramesh Chandra Amaliyar, Dr. Manoj Kumar Gupta
Introduction:
Cervical cancer is second most frequent cancer among women next to breast cancer in India. Control and
prevention of cervical cancer largely depends upon the level of awareness of the disease itself. Self-help
groups women are seen instruments for empowering women in the community. Realizing this, it was
hypothesized that if the strategy that if the knowledge of the study population, then this strategy may be a
financially sustainable and practicable method for creating awareness about cervical cancer in rural India.
Objective:
To empower and engage the SHG women against cervical cancer by creating awareness and sustaining interest
through lesson plans in the IEC material so that they can act as change agents for other women in the
community
Methods:
This was a Multi-centric Action Research Demonstration Study which was intended to sensitize, mobilize
and engage SHG women as agents for generating awareness among village women on reproductive health,
including cervical cancer. The study was conducted for a period of one and half year (from May 2012 to
October 2013). From Kolar district an intervention taluk (Bangarpet) was selected from eleven taluks of Kolar
District by simple random sampling. To establish an adequate counterfactual, a nearby taluk (Malur) with
similar geographical, climatic, development and health indicators was selected as control by adopting purposive
sampling. As an intervention, a total of fifteen workshops, each consisting three days, targeting 75 SHGS
were conducted in Bangarpettaluk. Sample size was 400 households (200 from Bangarpet and 200 from
Malur) of SHG women were interviewed for baseline and end line each.
Results:
Only 38.5 percent of SHG women (49.7 % in intervention taluka and 27.5 % in control taluk) reported that
they have ever heard about cervical cancer. With the help of planned intervention almost all (98.0%) the SHG
women could make aware about cervical cancer in the intervention taluk. Besides that, this educational
intervention could also make significant improvements in their awareness level about the various symptom
of cervical cancer like abdominal pain, abnormal vaginal bleeding, vaginal discharge and pain during sexual
intercourse. Majority (95.9%) of the SHG women in Bangarpettaluk and nearly two thirds in Malurtaluk were
considering cervical cancer as a lethal disease. On the other side of coin, nearly 15 per cent of the respondents
were either not aware or were not considering cervical cancer as life threatening condition. This intervention
was successful to change their wrong perception or unawareness in this regard, which is very crucial to
change the mind-set in the direction of prevention efforts and treatment seeking behaviour of the community.
Conclusion:
Despite the government efforts to increase the awareness about cervical cancer in the community, the
awareness in the study area was highly unsatisfactory and the planned intervention could bring significant
changes in this regard.
21

Code - IP15B01

A study on people availing the Cardiac treatment and out of pocket expenditure
burden on their house hold in Jaipur
Vikash Kumar, Md. Ataullah, Kumari Swati Sinha
Introduction:
Out of pocket expenditure in health is a main component of the house hold expenditure of health services
users and sources of concern especially for India. About 80% of public financing of healthcare comes from
state government budgets, 12% from the union government and 8% from local government of the total
public health budget. About 10% is externally financed in contrast to around 1% prior to structural adjustment
loans from the World Bank and other agencies. Private financing is the mostly out of pocket with a large
proportion, especially for hospitalization which is coming from savings account Countries having universal or
close to universal access to healthcare generally have single payer mechanisms in which either a single
autonomous public agency or a few coordinated agencies pool resources to finance healthcare.
Rationale:
In India, health-care expenditures aggravate poverty, resulting in about 39 million people falling into poverty
every year as a result of such expenditures. Therefore, identification of the key challenges for achieving the
equity in health service provision, equity in financing and financial risk protection in India is an immediate.
The Planning Commission too accepts that OOP to pay for healthcare costs is a growing problem in India.
(Times of India - May 17, 2012). It says 39 million Indians are pushed to poverty because of ill health every
year. In urban areas, 20% of ailments were untreated for financial problems the same year, said a recent
study in the Lancet. About 47% and 31% of hospital admissions in rural and urban India, respectively, were
financed by loans and sale of assets.
Objectives:
To assess the out of pocket expenditure on house hold in cardiac treatment in Jaipur district.

To analyze the shift in economic transition while availing the cardiac treatment from various hospitals of
Jaipur district.

Methodology:
Study type: Descriptive study

The convenient sampling has been done having sample size 100.

Study area: Two tertiary hospitals one government hospital (Swai Maan Singh hospital) and another
private hospital Narayana Hrudayalaya of Jaipur district.

Study Population: Patient attendants who availing the cardiac treatment.

Inclusion criteria: Patient for cardiac treatment of all age groups.

Study tool: A pre designed, pre tested, semi structured questionnaire with open ended questions.

Study period: 1st July to 1st September 2015

Data collection Technique:


The method adapted was purposive sampling.
Data analysis: By chi square test using SPSS.
22

Key finding and conclusion:


Out of 100 respondent 65percent patients from government hospital and 35percent are from private hospital.
The family category in government hospital is 77percent are BPL (below poverty line) and 23percent are
general category in private hospital. The medical insurance facility 25percent people are using and 75percent
dont have insurance coverage. Huge average cost in cardiac treatment. Lack of medical insurance system or
awareness about insurance is very low. Work load is very high due to which the patient not able to get
treatment on time and many times they have to wait for many days which leads in huge indirect cost. Even in
government hospital, BPL patient have to incur lots of indirect cost in the treatment, due to which again they
are pushed back into the debts and financial crisis. The patient who having treatment in private hospital
instead of medical insurance they have are bound to pay money by which they also bear huge out of pocket
expenditure.
Key words:
Out of pocket expenditure, cardiac treatment, household burden, Direct and indirect cost.

Code - IP15B03

Reducing Cost in Healthcare System


Dr. Neha Raisane, Dr. Sneha Gupta
Introduction:
In the midst of a massive global financial crisis, Indias economy continued to grow. It can boast of a growing
middle class and advanced technological developments in the industries but there is inequitable access to
healthcare which occurs due to a myriad of factors, but is rooted in a low overall financing of healthcare by
the State. India spends only 5% annual gross domestic product (GDP) on health care. Of this, most of the
expenditure (about 80%) is private out-of-pocket. High out-of-pocket costs make health services inaccessible
to a significant proportion of Indian households. Among those who decided not to seek medical care for an
ailment, nearly 20% of urban and 28% rural households cited financial constraints as the limiting factor.
Among many of those who had to purchase health care, out-of-pocket expenditures prove catastrophic.
Rationale:
The poor in low and middle income countries have limited access to quality health services for a variety of
reasons. This produces significant gaps in health care delivery among a population that has a disproportionately
large burden of disease. The study of existing models would help identify effective approaches and unleash
the potential of innovative delivery models to transform health services for the poor.
Objectives:
The objective of the study was to examine the present health care models and propose a new model.
Methodology:
The data was collected from secondary sources such as research papers and reports from renowned health
organisations. Tool review of literature.
Proposed findings:
After doing the secondary data analysis, assessment was done regarding feasibility and success of the existing
models, a new universal model was created using the key features of the existing ones which will help in
reducing the cost and financing issues in health care. It incorporates Hub and Spoke model by establishing
23

urban hubs in which they concentrate high-quality talent and sophisticated equipment. Spoke facilities are
then arrayed around the hubs to reach underserved patients in far-flung towns and villages. It put greater
emphasis on the spoke rather than the hub. The Spoke facilities may consist of telemedicine centre, Daycare centres and small hospitals pertaining to that area. In his case, that means a focus on ambulatory care
units and other outpatient facilities. The government can support this model by increasing penetration of
health insurance as well as reducing tax on medicines, providing land at subsidized rates and collaboration
with companies for providing medical equipments at lesser rates in India, etc.
Conclusion:
Maximising value at the lowest cost possible should be the aim of healthcare providers. Some innovative
Indian for profit health care providers have successfully proven that the delivery of high quality, low cost
medical care is not a myth. A comprehensive model can help in universalizing low cost medical care which
will not only reduce the cost of care but also minimize the hospital expenditure.

Code - IP15B10

Fall out in the number of patients on implementation of a software base appointment


system - An analysis through D.M.A.I.C. six sigma tool
Dr. Roopali Raghav
Introduction:
Patient waiting times and waiting-room congestion are two of the few tangible quality elements. Well-designed
appointment systems (AS) have the potential to increase the utilization of expensive personnel and equipmentbased medical resources as well as reducing waiting times for patients. Surveys indicate that excessive waiting
time is often the major reason for patients dissatisfaction in outpatient services (Huang 1994), and reasonable
waiting times are expected in addition to clinical competence (Jackson 1991). A health care manager can
examine the trade -off between capacity and service delays using queuing analysis. Specifically, when
considering improvements in services, the health care manager weighs the cost of providing a given level of
service against the potential costs from having patients wait. The Out-patient department at, Bengaluru
Hospital adopted a Software base appointment system Qikwell. This step was taken as a quality effective
approach and to adapt to a newer technology for streamlining the process flow at the various OPDs.
Objectives:
To study the pre and post impact of implementation of a new appointment system.
Methodology:
Six Sigma - Define Measure, Analyze, Improve and Control (D.M.A.I.C.) tool was used to study the project
which was carried out from 1st April- 31st May 2015
Primary Data:
a. The problems faced by the previously used appointment system was analyzed by conducting a
questionnaire survey on 25 OPDs where the OPD staff was asked to fill the questionnaire form consisting
of 10 questions.
b. Qikwell assessment survey was done on 100 patients from 5 Qikwell OPDs
24

Secondary Data:
a. Information about the previous appointment system was obtained and analyzed through the Bay
Management Report of March 2015.
b. Information about Qikwell was analyzed with the help of Qikwell monthly and daily generated report,
provided by Qikwell
Key Findings:
Based on the root cause analysis done, it was evident that the implementation of a new software based
technology experiences a lot of glitches operationally.

Proper training of the patient care provider is mandatory for the success of the implementation of the
software.

Software should have a leeway and scope for customization according to the client usage and comfort.

Software based appointment systems helps in efficiently managing the patient queue.

Conclusion:
An operationally well working appointment system helps to manage the patient queue in the most efficient
way possible. It gives a psychological satisfaction to the patient that he is going to be seen by the doctor on
time, this in turn acts in favor of the organization and helps in retaining its patients. It acts as an important
tool in positioning themselves in the patients minds since it act as a parameter on which patients judges an
organization. As rightly said
Time is the scarcest resource, and unless it is managed nothing else can be managed Peter Drucker

Code - IP15B11

Role of Enterprise Resource Planning in Changing Landscape of Public Health:


Opportunities and Challenges
Eshna Srigyan, Dr. Neha Sardana, IIHMR University
Introduction:
As the present scenario of government hospitals are overburdened with patients and unmanageable data,
they require an integral system for better quality and at the same time optimizing back end operations with
minimization of cost. Enterprise Resource Planning (ERP) systems represent a newclass of information system
designed to help integrate allthe key areas of activity of a hospital, particularly the patient management,
supply chain management and human resource functions. It also offers numerous configuration options that
help the hospital to customize the software according to their unique needs.
Rationale of Study:
In traditional healthcare management system, the departments are unintegrated with lack of systematic
flow of information resulting in delay of services, increasing operational cost thereby reducing overall
effectiveness. Enterprise Resource Planning (ERP) system in place offers healthcare the opportunity to integrate
and coordinate the information and processes using a common database and shared management reporting
tools. According to Monge et al (2010), an ERP system essentially represents a means of homogenising the
work procedures utilised by its units, which should lead to greater agility in responding to market demands
andreduced inventory levels.
25

Objective:
To explore the effectiveness of Enterprise Resource Planning system on the patient, human resource and
supply chain management of government hospitals.
Methodology:
This is an exploratory study to explore the need of Enterprise Resource Planning system in the government
hospitals in respect to different contexts such as monitoring of supplies, patient and human resource
management. Data was gathered from the reviewed information extracted from the contribution of different
authors who are interested in understanding the effectiveness of ERP system in healthcare sector. It was
then structured, analyzed and synthesized into the current article.
Conclusion:
The review indicated that the implementation of Enterprise Resource Planning in the government hospitals
will help in streamlining and standardizing the process of human resource, supply chain and patient
management, thereby leading to significant reduction in the operational cost and improving the efficiency
and effectiveness of the system.
Keywords:
Enterprise Resource Planning, healthcare sector, government hospitals

Code - B10

Nutritional Estimate of Rural Adolescent Girls of Bellary District, Karnataka


Hiamsnhu V., Ananad K., Dr. Manoj K.G.
(Post Graduate Diploma in Healthcare Management, Institute of Health Management Research, Bangalore)
e-mail: Himanshu.vashishtha91@gmail.com

Introduction:
With the adoption of western life style the problem of overweight and obesity is gradually increasing in
adolescent age group. While the problem of malnutrition is still persisting continually in the country and thus
leading to double burden of malnutrition. With this background this study was planned to assess the nutrition
status of adolescent girlsage(10-19) in rural area of Bellarydistrict, Karnataka.
Method:
This study was conducted for 4 months (form May 2015to august 2015). This was a community based crosssectional study in which anthropo-metricmeasurements were done of adolescent girls in the study area. A
total of 400 adolescent girls where included in the study. BMI of study subject where calculated and assessment
of nutritional status was done in reference to WHOs BMI percentiles. The data was analysis using SPSS v.16.
Results:
On Appling the BMI percentile criteria nearly 46% of adolescent girls where underweight. The proportions of
under nutrition where significantly (P <0.05) higher in early adolescent age group, girls belonging to Muslim
religion and who were illiterate.
Conclusion:
Besides having concentrated nutritional interventional efforts, the malnutrition was prevalent in study area
among adolescent girls and there is need and scope to tackle this issue on priority bases.
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Code - B13

Assessment of Knowledge, Attitude & Practices About Oral Health Care Among
Multipurpose Health Workers of Block Sangat, District Bathinda, Punjab
Kaur Harmanjeet* (shinharman@gmail.com), Gupta Saurabh Kumar*, Sharma M.K.**
*Students of MPH 2nd year (Panjab University,Chandigarh), **Assistant Professor (Centre for Public Health, Panjab University)

Introduction:
In developed countries the decreased prevalence of oral diseases is due to paradigm shift of oral health
services from being mainly curative to preventive care. In under-resourced countries, i.e. developing countries,
the use of non-oral health care workers in the promotion of oral health, can contribute substantially to
improving oral health and the adoption of a multidisciplinary team approach in oral health is highly
recommended.
Aims & Objectives:
Aim - The aim of the study was to assess the knowledge, attitude and practices about the oral health care
among Primary Health Care workers (Multipurpose Health Workers).
Objectives To assess the level of knowledge about basic oral health care among Multi Purpose Health Workers

To assess the attitudes of health workers towards oral health care.

To know whether they get training on oral health care and they practice it or not

Materials & Methods:


A cross sectional study was conducted in the Sub-centres of Block Sangat, District Bathinda, Punjab (India).
The study period was from 1st June to 15th July 2015. In this study an attempt was made to include all of
MPHWs of Block Sangat, District Bathinda. Data was collected by using structured questionnaire through
interview method.
Key Findings:
In this study, about 52% MPHWs were unaware of the benefits of fluoridated water. About 65% of MPHWs
do not know number of teeth in primary and permanent dentition. About 93% of MPHWs think that Nurses
can have important role in oral health care delivery. Near about 72% of MPHWs said that they have studied
some basics of oral health during training. More than 82% of MPHWs agreed that they would like to get more
training on oral health care.
Conclusion:
The study showed that most of the multipurpose health workers had less knowledge about the oral health
but at the same time they were keen to learn about oral health practices and also to imply the same.

27

Code - B14

India : A strategic location for medical tourism


Meghana G1, Shirin Patil2, Manoj Kumar Gupta3
1 & 2 - Students of IHMR- Bangalore, Karnataka, India , 3 - Department of Research, Institute of Health Management Research
(IIHMR), Bangalore, Karnataka, India

Introduction:
Epidemiological transition has given the opportunity to grow the traditional system of medicine across the
world. Indian healthcare system which is already famous for providing quality of medical services at affordable
cost as compared to developed countries took advantage of this opportunity and created a basket of services
by merging traditional medicines in existing allopathic system to attract patients across the borders.
Government has made efforts in the direction of promoting medical tourism in the country and this has been
fueled by the private players both nationally and internationally. Recently this medical tourism has proved a
major growth factor for expansion of Indian economy. India has a 2% share of global health tourism market.
However, the growth in this sector is underscored in terms of market share and cost advantages due to
various challenges. There is also a need for proper diversion of revenue by a clear cut mechanism to strengthen
the nations healthcare sector.
Objectives:
This study tries to explore potential of medical tourism industry in India and an overview why India has
emerged as destination for medical tourism.It tries to evaluate strategies in order to promote medical tourism
in the country. The study has also tried to analyze the Indian medical tourism industry based on its strengths,
weaknesses, opportunities and threats in its current state.
Methods:
The following paper is based on articles collected from various search engines like Pub Med, J- Gate, Google
scholars, proquest and websites pertaining to medical tourism, from 2008 onwards. A systematic review was
done pertaining to the pre-decided objectives.
Result:
The success of medical tourism in India lies in its cost advantage, shorter waiting periods, technical expertise
and cutting edge technology. In order to promote medical tourism in the country, the government of India
has introduced a new category of medical visa (M visa), and campaigns such as Incredible India!, wellness
campaigns. Further, at state level, associations like Bangalore International Health City Corporation have
been initiated by the Government of Karnataka. India covers high level of tertiary care at affordable costs
without compromising on service quality. Availability of alternatives such as yoga, meditation, Ayurveda and
other systems of medicine, provide a strong opportunity to India in order to boost medical tourism.
However, India lacks in: uniform pricing policies in hospitals, co-ordination between healthcare and tourism
industry and hygienic conditions. Thus, it is being threatened by competing countries like Thailand, Malaysia,
Singapore and Phillipines.
Conclusion:
Although India has been successful in medical tourism, there is still a need to put efforts to handle weaknesses
and threats. Besides that, a mechanism to divert the revenue generated through medical tourism, should be
in place, to provide affordable and quality healthcare for the betterment of the community.
Key words: Medical tourism, quality, affordability, healthcare industry
28

Code - B17

18C commandments : Indian Model to Improve and Develop Hospital Operation


Processes in a Brownfield Hospital Project
Dr. Deepak Yaduvanshi
Consultant In charge, Department of Respiratory and Critical care, Manipal HospitalsJaipur, drdeepak98@hotmail.com

Akshita Shah, Incharge Hospital Operations, Soni Manipal, Hospital


Introduction:
The hospital industry in India over the last few years face major issues and challenges, the patients aspire
world class health care quality delivery while health insurance companies demand the delivery at the lowest
cost possible. Lean and six sigma which are complementary quality improvement tools can help to achieve
these goals however the application of the same is a long drawn process, we at Manipal hospital devised a
refined form of 18 Commandments to improve the hospital operation activity. The rationale of the study was
that hospital operations and performance all over the world is based on a basic set of parameters bench
marked against evidence based guidelines however an Indian version of the scaled down is lacking we locally
developed 18C commandments in a family run traditional hospital being taken over by a corporate chain of
hospital. This study comprises of in depth analysis of various clinical and non-clinical hospital operations
from all areas with monthly reporting in a structured format. As significant number of hospital operation
services are perishable and intangible. The studies had revealed that the subjective and extensive clinical
operations under taken have higher co-relation with the frustration of the management, hence a scaleddown 18C may be better alternative.The lean principles have been now successfully applied to the delivery of
health care over the last few years. Lean management primary begins with underlying principle of eliminating
waste so that all work adds value and serves the customers needs. Identification and recognition of valueadded and non-value-added (waste) steps in every process is the beginning of the journey toward lean
operations in the organization. Just like in lean methodology to be successful and able to enhance the
operations we first created asset leaders as custodian of the 18C parameters. Just as commitment of
organization to go lean must flow from the top and all staff should be involved in helping to redesign processes
to improve flow and reduce waste we also undertook a comprehensive process of involving all departments
and striving for CQI, Whether building a car or providing health care for a patient, hospital workers must rely
on multiple, complex processes to accomplish their tasks and provide value to the customer or patient.
Waste of money, time, supplies, or good will decreases value. It is an widely held dictum that once the
lean principles are applied rigorously and throughout an entire organization, can have a positive impact on
productivity, cost, quality, and timely delivery in a resource limited settings of Indian Sub-continent. In hospital
industry the operational efficiency means rapid access to care, minimum waiting time while at the same
time delivering defect free quality care at the minimum cost. These parameters was taken care of while
giving the recommendations for the improvement of the process efficiency. Based on all the observations
and data collection performed during the study,a SWOT analysis was also done for all the operations at Soni
Manipal Hospital Jaipur. Finally, after examining the various parameters analytically using the CQI models,
measures were suggested to improve the hospital operations and make the service system more efficiently.
In order to undertake service improvement in any dimension it is necessary to use a standard method that
enables us to undertake the current process, determine the desired changes and thereby improve it and 18c
served as commandments in our journey.
Key words:
Lean, hospitals, lean health management, six sigma, Total Quality Management (TQM), Continuous quality
improvement (CQI), lean six sigma.
29

Code - B18

Patient Reported Adverse Outcomes on Treatment of Type-2 Diabetes Mellitus and


Co-Morbidities in South India
Y. Siva Shankar Reddy*1, Dr. B Kumar1, Dr. Umesh Kamarthi2, Dr. M. Gobinath1
Department of Pharmacy Practice, Ratnam Institute of Pharmacy, Nellore, A.P., India
2
Clinical Pharmacist, BGS Global Hospitals, Kengeri, Bangalore, Karnataka, India

Objective:
To evaluate patient reported adverse outcomes in type 2 diabetes mellitus with or without co-morbidities in
South India. Mainly to contact the study subjects using mobile phones, to record patient reported adverse
outcomes including ADR, AE and Unresolved Condition, to ensure medication adherence and to evaluate the
role of active surveillance in reporting of events.
Methods:
This Pharmacovigilance study was a prospective Cohort study design with 3 follow ups on active surveillance
to improve the passive reports form diabetic patients who are taking medicine from BGS GLOBAL hospital.
We included ADR, AEs, unresolved problems and medication adherence in surveillance to conduct PROs.
Results and Discussion:
Data on 133 diabetic patients were included in the study and data were collected for first 3 months and
followed by 3 active surveillance. Totally we our tem got 171 outcomes, (126) (73.68%) was through Active
surveillance and (45) (26.31%) was through Passive surveillance. Active surveillance repots were received
while an interventional enquiry as passive reports was received voluntarily. Many patients are interacted
with us for asking counseling regarding diet, exercise and medial information in regular follow ups. They are
totally 35, in which 9 diet, 6 exercise, 17 medical information and 3 other.
Conclusion:
We expected more passive reports from patients but very few are shown interest to report and share their
medical information with medical staff. We can conclude that many of the patients in line of medical adherence
are risk zone, can chance to exposure ADR. By the study our team says that, its very difficult to improve and
apply PROs system in developed areas likeBangalore, Hyderabad, and Chennai. Because patients dont bother
about medical induced problems and they wont show any interest and responsibilities in reporting. Patients
need to encourage and given value added basic information and tips in process of reporting in medical induced
issues. In future we are planning to provide education to patients along with leaflets to improve patients
reported outcomes system for better patients medical improvement.
Key Words:
Diabetes, Glibenclamide, patient reported outcomes, active surveillance, and passive surveillance

30

Code - IP15B12

A study on Quality Management Practices in a Tertiary care Hospital : Medication


Errors
Sheeba, Sharma Varidhi, Patial Varsha
Medication error is defined as the failure of planned action to be completed as intended or use of a wrong
plan to achieve an aim. These are unintended mistakes in prescribing, dispensing, and administration of
medicines that could cause harm to a patient. These kinds of errors tend to decrease the patients confidence
in healthcare systems and increase healthcare costs. These may prolong the patients hospital stay and also
tend to increase the risk of death almost 2 fold. The different types of medication errors are prescription
errors, transcription errors, indenting errors, dispensing errors, administration errors and omission errors.
The objective of the study was to quantify the number of errors occurring in the hospital, to find out major
causes that lead to errors in medication and to, hence, suggest a few measures to reduce the occurrence of
errors in medication administration.
The study is a descriptive cross sectional study conducted in the in-patient and pharmacy departments of a
tertiary care hospital of Delhi, for a period of 6 months (from December 2014 to may 2015). In order to
determine the causes of errors, a sample of 70 staff members including nurses, physicians and pharmacists
were interviewed using a structured questionnaire.
It was found out that about 61% of the total errors were drug administration errors, about 31% were
prescription errors and the rest were dispensing errors. Also month-wise , speciality-wise and ward-wise
distribution of errors was calculated. For the causes of errors, work overload and untrained nursing personnel
were the major causes of administration errors. For prescription errors, special needs of patients (paediatrics
, geriatrics) and use of ambiguous abbreviations are the most important causes.In case of dispensing errors,
dispensing wrong medication (while working with LASA drugs) and dispensing incorrect dose were the major
reasons of errors. Overall for the medication errors, about 53% of the errors occurred because of personal
faults of the staff and rest occurred because of the system defects. Hence in order to reduce the number of
these errors,in addition to providing training to the staff the staff members, efforts have to be made to make
the culture of the hospital. Also, Incident reporting policies and procedures and appropriate counselling,
education, and intervention programs should be established in all hospitals. This would help to reduce further
occurrence of errors by establishing a cause for the error.
This study has only been carried out in a tertiary care healthcare setting with the only interest to gain an
insight into some factors that may cause MAEs in hospitals. The study relies only on the perceptions of
nurses, physicians and pharmacists and thus determination of actual reasons because of which errors occur
are beyond the scope of this study.
Key words:
Medication errors; medication safety; quality use of medication; nursing and medication; patient safety;
incident reporting; quality improvement safety, workload effects, barcode medication

31

Code - IP15B13

A Look at Hidden Relationships with Healthcare : Real Pharmaceutical related


Tensions
Tripathi Piyush, Sharma Spardha, Priya Sneha, MBA Pharmaceutical Management, IIHMR University, Jaipur, Rajasthan
Rationale:
The paper is about real-world core tensions between healthcare professionals and pharmaceutical industries.
Healthcare professionals have a plethora of opportunities to work with the pharmaceutical industry, although
very few exceptions, these professionals are ethical, patient-centred who are strongly dedicated to improve
the lives of patients. In the collaborations with drug companies on developing effective treatments, healthcare
professionals are not without conflicts & controversies while they both have similar goals towards the
improvement of peoples health.
Objectives:
Healthcare professionals have ethical duties as well as legal ones and they must understand the business
forces, marketing tactics & ethical standards. Here, highlighting the productive & collaborative efforts being
followed together by pharmaceutical industry and healthcare professionals in developing innovative therapies
and providing the best medical care, the objective of the paper is to discuss real pharmaceutical tensions
that arise because of unethical financial relationships between healthcare professionals & pharmaceutical
companies.
Methodology:
A major point of contact between the doctor and the pharmaceutical companies is the visit of the company
sales representatives. The marketing practices of pharmaceutical companies are mainly done through sales
persons by building the relationship with the doctor through visits that include the product information, as
well as gifts & pleasant offers. Gift giving is extremely entrenched in healthcare world. The voices of reform
believe that nominal gifts even have the potential to corrupt.
Another aspect of relationship includes Preceptorship in exchange for a fee from the drug company.A
common and effective marketing tool, utilized by pharmaceutical companies, is the provision of free samples,
provided by sales representatives to doctors, and also a form of an advert & an attempt to mislead where
patients continue on the product by prescription once their free supply is gone. Continuing education,
generally, is required as doctors attend medical meetings & CME conferences; they might be exposed to both
overt & covert drug company marketing.
One more aspect that its not so difficult for a reputed physician to bring lots of bucks from such patients
enrolments. Financial persuasion from pharmaceutical companies to healthcare professionals also include
payments for enrolling patients in drug trials, mainly in PMS/seeding trials, may be an unethical issue.
Key Findings:
Healthcare professionals, pharmaceutical industries, ethical standards, financial relationships, preceptorship
etc.
Conclusion:
No healthcare professional wants to face the negative publicity, professional embarrassment and personal
struggles that inevitably come with having the relationships with pharmaceutical companies challenged in
the courts. So they not only need to avoid illegal activities but should also avoid those that are unethical. Any
32

professional society or other medical organization should not accept any grants that are tied to conditions
that could provide a marketing advantage to the donating company.
The bottom line is that in their relationships with industry, health professionals must be focused exclusively
on scientific purposes, not marketing tactics. The government must aggressively target the pharmaceutical
and device industrys marketing practices to physicians, as well as physicians themselves in some instances.

Code - IP15B14

Cause Related Marketing: Impact and Perception on Over the Counter drug
consumers
Kush Dua; Bhavana Ghughtyal, Dr. Sakshee Kushwaha
Cause Related Marketing (CRM) a strategy in use since 1974 is a marketing strategy wherein a product/
service/brand or a company is marketed in association with a designated cause. This cause is usually a
problem that is prevailing in customers setting. The cause can range from being a social one like women
empowerment, child welfare, health and hygiene, environmental like global warming, wildlife conservation
or even abstract motivations like friendship, family bonding, patriotism etc. according to IEG Sponsorship
Report, Cause sponsorship is predicted to reach $1.92 billion in 2015, a projected increase of 3.7% over
2014.
Cause Related Marketing is a successful strategy as far as branding and marketing of segments like FMCG but
it a relatively new concept as far as Over The Counter drugs segment is concerned. Therefore the study was
carried out with an aim To identify Over The Counter consumers perception towards Cause Related Marketing;
To determine the impact of Cause Related Marketing on buying behavior of Over The Counter consumers
and To identify a prominent factor that motivates a consumer to opt for a brand associated with Cause
Related Marketing.
A Descriptive (Cross-sectional) research design was selected for which, a structured questionnaire on 5 point
scale was constructed and administered to a total 100 respondents including both the gender and across
four different age groups. Approximately 66% of respondents were found to a have a positive perception
towards Cause Related Marketing. As far as impact was concerned, 55% of respondents were found to switch
to a brand associated with Cause Related Marketingand companys involvement in supporting a social cause
and a company which gives preference to a Local cause instead of International one were found to be the
prominent factors motivating consumers to opt for a brand associated with Cause Related Marketing.
It was concluded from the study that though respondents of different age groups had a positive perception
towards Cause Related Marketing and 88% of respondents believed that every organization should be involved
in supporting a local cause, still there is a population (45% respondents) who consider Cause Related Marketing
to be merely a marketing strategy. A need for creating awareness for Cause Related Marketing was therefore
observed.

33

Code - IP15B15

Palliative care : Reconceptualising death It isnt about dying, its about living
Dr. Priya Bhat, Dr. Priyanka Bhat, Dr. Priyanka Sharma
Introduction:
Palliative care doesnt deliver on its aim to value people who are dying instead making death and dying a
natural part of life. It is an important and essential part of cancer care therapy and 12th five year plan makes
a special provision for it. Atleast 10% of the budget needs to be earmarked for it. In April,2008 Kerela became
the first state in India to announce a palliative care policy. Effective palliative care services needs to be
integrated into the existing health system at all levels of care, especially community and home based care is
the need of the times.
Objective:
To determine the prevalence of pain among cancer patients.
To explore different palliative care interventions for pain alleviation in cancer patients
Rationale:
In India, every year 6 million patients are estimated who need palliative care and these figures are likely to
grow because of increasing life expectancy and a shift from acute to chronic illnesses. It is estimated that
around 60% of people dying annually will suffer from prolonged advanced illnesses.
Methodology:
A cross sectional descriptive study was carried out on cancer patients in a cancer hospital in Jaipur for a
period of two months. A systematic literature review was carried out and a questionnaire was prepared.
Key findings:
From the study it was found that around 52% to 77% patients suffered from pain in the terminal stages. Also
from the literature review we came to know that around 24% to 60% patients on active anticancer treatment
suffered from pain.
Conclusion:
The palliative care is not merely a treatment, it is what a terminally ill persons want at the end of their lives.
Palliative care is an example of how health services can go well beyond the biomedical model of health and
can be a compassionate tool for terminally ill patients to live with dignity and accept death as an inevitable
part of life.

34

Code - IPB15016

Building Momentum for UHC Through An Integrated Approach


Dr. Swati Mittal
Introduction:
India, worlds fastest growing economy with an annual growth rate of 7%, dwindles severely on the parameter
of health standards internationally. It faces a spectrum of public health problems that still remains unresolved
despite of varying level of exhaustive efforts by the government and other stakeholders. One such being
malnutrition among children under five years of age which might result in an economic downturn in the long
run by adversely affecting the cognitive capacity of the potential workforce. Thus, strengthening public health
interventions to fight malnutrition among vulnerable groups become prime concern for public health
authorities. Keeping in mind the multifactorial etiology of malnutrition, a comprehensive approach with
effective intersectoral integration and implementation of strategies becomes the need of the hour to deal
with the problem.
Integrated nutrition project implemented in tribal blocks, Kherwara and Girwa of Udaipur district, aims to
increase the reach of every child to quality care and a more fulfilling life by targeting specific interventions at
every stage of the life cycle combating malnutrition in a holistic manner. By engaging diversified service
delivery platforms, it provides a complete package of promotive, preventive, curative and rehabilitative
facilities at camps and community centers, thus providing a universal coverage against malnutrition.
Objectives:
To assess the nutritional status of children under five years of age after implementation of Integrated
Nutrition Project in the two tribal blocks of Udaipur district.

To determine the existence of any bottlenecks in the working strategies of Integrated Nutrition Project.

Methodology:
A cross sectional descriptive census study was carried out using a structured questionnaire and anthropometric
measurements for height and weight. The primary data on 280 children is obtained by directing the
questionnaires at the mothers or care takers of the children.
Data thus obtained was analyzed using WHO Anthro software.
Key Findings:
Based on the review of data obtained from the study, clear evidence for the following exists:

A noticeable uptake of antenatal care services by availing the facilities at immunization camps especially
consumption of vitamin A and Iron Folic Acid supplements.

Reduction in the loss to follow up in immunization from BCG to DPT 3.

Improved nutrition status of children enrolled at balwadis when compared to children who do not go to
balwadis.

Adoption of soft WASH (water and sanitation hygiene) techniques by the respondents.

Conclusion:
INP has been adequately placed to address the major causes of malnutrition. More attention has been laid
on increasing the coverage and distributing food as compared to quality of services and changing home
based feeding patterns, somehow limits the impact of the programme. Immediate measures needs to be
taken to bridge the gaps existing in the policy intentions of the programme and its actual implementation.
Continuous strengthening the programmatic link between service delivery (balwadis)and community
participation (children enrollment at balwadis)may further enhance the reach of the program.
35

Code - IP15B17

Health Financing and Health Insurance - A study on BRICS Nations with special
reference of India
Dr. Naveen Kumar, Dr. Narendra - IIHMR University Jaipur
Universal Health coverage, as a concept, is about people having access to needed health care without suffering
financial hard ship, thus, encompassing improvement in access, quality and financial protection. Indias health
sector has been challenge by overall low level of public financing, entrenched accountability issues in public
delivery system and persistence dominance of out of pocket expending. For reducing financial hardship of
the people and to make health care delivery a accessible and affordable process, Health insurance is a viable
alternative available to policy makers for reducing cost of healthcare.
In India due to high medical expenses, out of pocket expenditure on healthcare is very high,which leads to
the exclusion of a large section of the population from availing quality healthcare services .Now onward
effective distribution channel and a good network of banking services in Tier 2 and Tier 3 cities will enhance
the insurance penetration in these cities. Today Good and attractive health insurance scheme are available in
market, but various issues like uniformity in various company policies regarding benefits, waiting periods,
age entry ,exclusions etc, required to be addressed. With the changing consumer behavior, insurance industry
is coming with many innovativeproducts targeting specific disease, age, area, etc, toattract more stakeholders
in the insurance sector
Rationale:
To study the out of pocket expenditure in India and other BRICS nations on healthcare and to do an analyses
of health insurance to reduce the cost of healthcare financing
Objectives of Study:
- To identify the Private prepaid plans as a percentage of private expenditure on health
-

To find out State Wise Health Insurance Penetration and Density in India

To analyse Segment wise Premium, Policy, Person of Health insurance in India

Methodology:
Secondary data from 2005-2013 on National Health Account and Health Insurance data taken from WHO
portal of National Health Account, and IRDA Publication and was entered in Microsoft Excel for analysis.
Firstly the raw data was organized and was checked for completeness and consistency after data cleaning
data was analyzed using appropriate statistical methods in Microsoft Excel.
Findings:
Health expenditure as a share presented in this table with various regions, Global and India. Total expenditure
on health on percentages of GDP in India all most not to much differ from 1995 to 2012 better than south
East Asia region but lower than Africa and Global, see Government expenditure on health as a percentage of
total expenditure on health its increase 7.1% but lower than Africa and Global ,Private expenditure on health
as a percentage of total expenditure on health its reduce by govt. efforts by good scheme and preventive and
ability of public health facility, Out of pocket expenditure as a percentage of private expenditure on health its
to high than other 40% above than global ,reduce 5% its good than other , in private prepaid plans as percentage
of private expenditure on health its increase than 1995 to 2011 but see global % ,so insurance sector lots of
opportunity to grow in market in India.
36

Conclusion:
In last five years ,Health insurance sector has made a significant progress in India, Private players in insurance
sector are growing fast by doing lots of innovations in aspect of customer behavior, product innovation and
market research. As compared to other BRICS nations our penetration and density is low but its growing
significantly from last 5 years, still lots of new initiatives are required like In aspect of universal health coverage
the RSBY policy should be expanded and its premium should be rationalized to improve the insurance
penetration, Comprehensive health insurance policy covering both life and non-life aspect of insurance should
be implemented on priority basis and new innovative schemes like family floater plan providing comprehensive
health insurance coverage should be promoted.

Code - IP15BI8

Brain Death Declaration - A Distinctive Part of Human Organ Transplantation


Dr. Sushma, R. Pathak and Diwanshu Sharma (IIHMR University, Jaipur)
Introduction:
Organ transplantation has been one of the greatest advances of modern sciences that have resulted in many
patients getting a renewed lease of life. It was included in the top 5 medical miracles of the last century.
Organs can be donated by a living person, after natural death and after Brain Death. Brain death is a relatively
new concept of death, first recognized in Paris in 19591a.
Rationale:
Supporting Organ Donations helps in identifying all potential end stage donors who could act as boon in
saving lives of huge population. Almost, 85% of all transplants done across the world originate from brain
dead donors1b.
At any given time, there are 8-10 brain dead patients in different ICUs in any major city of India. There are
140000 deaths from road traffic accidents every year. In 2014, 75000 youth died with Road Traffic accidents.
67% of these patients suffer from head injuries that lead to brain death in many instances2.Thus, India has
potentially a huge pool of brain dead donors.
Objectives:
To review Brain Death Declaration and THOA (Transplant of Human Organs Act) with amendments.

To compare and critically analyses the State-wise variations in Brain Death Declaration.

To assess the future scope of Cadaveric Transplant based on a survey at a tertiary care hospital ofNew
Delhi.

Materials and Methods:


A review study involving both secondary and primary data was analysed to test various hypotheses relating
to the above mentioned objectives. While the information available in published sources was obtained and
used, the major part of the data required for the study was generated from a tertiary care hospitals Organ
Transplant Unit.
Key findings and Discussion:
There are currently over 300 transplant centers in India doing approximately 3500 to 4000 kidney transplants
annually3. Currently few hospitals are doing well but the deceased organ donation program has the potential
37

to take care of the majority of demands of kidneys, liver, heart, other essential organs and tissues. Brain
Death Declaration is discussed below as: Origination, Types and Sources, Present Scenario, State wise
comparisons in India, Issues and Challenges and Medico legal Implications
Conclusion:
Currently, THOA has put leverage to various legal and ethical challenges that led to more ease of cadaveric
donation.State Level and National Level Organ Registry Systems are being formed.National Organ Donation
Dayconcept with Donation Cards has been introduced. There is a strong need for NGOs and Community
Participating Bodies along withinclusion of Medico legal cases.
Key words: Brain Death Declaration, THOA, Non-heart beating donors

Code - IP15B20

Impact of the billing related errors on the cost in the hospitals


Dr. Ramandeep Kaur, MBA-HM 19 Batch (Student of IIHMR University)
Rationale:
Financial communications between patients and hospital is an important aspect of patient satisfaction and it
depicts the picture of the cost spent on the health care. Billing projects helps in differentiating the well
performing hospitals from the poorly performing hospitals in terms of patient satisfaction and financial
performance. Proper documentation of the records including medications, diagnostics, consultations helps
in cross checking the bill with the services provided to the patient that ultimately ends up in preventing over
and undercharging which is need of the patients and hospitals both.
Objective:
To analyze the financial impact of the billing related errors specific to clinical services.
Methodology:
A retrospective study is conducted on 440 files along with their final bills from the finance department, in
which on an average 40 files have been audited from each monthstarting from June 2014 to April 2015.The
sampling technique used was the probability sampling in whichsimple random sampling is used. Simple random
sampling has been done through the simple random generator software. Through the random generator the
40 files selected randomly for every month from June 2014. The auditing of the closed files from the MRD
department has been done. The auditing of the bills is done with the closed (discharge) files to detect the
billing errors. A checklist containing all the parameters has been provided. All the entries are recorded into
the checklist. The data is collected month wise and recorded into the excel sheets and analyzed and results
are drawn.
Key findings:
Disparity is observed in the financial counselling. Only half of the cases lies in the estimated amount, rest
show variance from the estimated amount. There were errors related to medication charges that included
both undercharging and overcharging (that is decided on the basis of comparing the drugs administered
from the medication card with the final bill). Nearly on an average 60% of the cases show medication charge
related errors. After medication, the next billing errors incurred in consultation related charges. Few billing
errors also noticed regarding bed side procedures but their share is minimal. On ward wise distribution of the
data, it shows major billing related errors were in male general ward and female general ward.
38

Conclusion:
Billing related errors is a common finding in the hospitals but this is directly affecting the patient and the
hospitals financially. Errors in the billing is related to the medication charges, they can occur at any stage of
medication process: at dispensing and administration level.

Code - B1

Assessment of Level of Disaster Preparedness of Districtshospitalsin Chhattishgarh


Gupta Saurabh Kumar* (saurabhgupta751@gmail.com), Kaur Harmanjeet*, Singh Parvinder*, Sharma M.K.**
*Students of MPH 2nd year (Panjab University), **Assistant Professor Center for Public Health

Rationale:
Disasters have an uncanny ability to bring to the forefront vulnerabilities of systems, structures, processes
and peoples which in turn cause large scale damages; and hospitals are no exception in this matter. In the last
two decades, countries across the world have suffered a huge loss of confidence, as well as economic losses
on account of damages incurred by hospitals from disasters. On the behalf of that Hospital Safety Audit was
conducted in 16 district hospitals and 3 medical colleges of Chhattisgarh State. The audit was conducted by
State Health Resource Center, Raipur Chhattisgarh Facilitated by Directorate Health Services, Chhattisgarh.
The audit aimed to know the disaster safety levels may be external or internal of hospitals and to give
recommendations to improve the same in government hospitals. This assessment in hospitals is first such
initiative in Chhattisgarh.
Key objectives:
1. To assess the level of preparedness of district hospital for disaster management
2. To identify gaps in Structural, Non-structural and Functional parameters
3. To give recommendation for further improvement of disaster preparedness in district hospitals
Methodology:
A cross sectional study was conducted during a period of 22 days in month of June and July 2015, in 16
districts hospital and 3 medical colleges hospital of Chhattisgarh. Data was collected on the basis of structured
questionnaire (WHO safety checklist) filled with the help of hospital consultant or authorized person of district
hospital. Study based on check list which includes (structural, non structural and functional) part total no. of
question is 19(major points). Data collected and analyzed by Microsoft Excel.
Key findings:
Results shows that there is no system of planning, monitoring, control and coordination during any type of
disaster (external or internal). There are no procedures developed that are to be followed in case of a serious
and imminent danger. Employees are not provided with any information on dealing with such eventualities
and responsibilities.
Conclusion:
To improve safety levels in hospital, there is a need of better management regulation, fix possible sources of
fire that are through electrical wirings, equipments and safe storage of acids, basis and chemicals in
laboratories, and training of staff on disaster management, possible mitigation measures that could be taken
including usage of fire extinguishers, water sprinklers and putting up of fire alarms. The improvement in
workplace regulation, formation of protocols and responsibility sharing among the staff can go a long wayin
mitigating the risks arising out of various hazards and in preventing such disasters.
39

Code - B2

Healthcare Reforms through Technology


Dr. Bhupinder Chaudhary, Ms. Baljit Saini
Assistant Professor, Department of Hospital Management, H.N.G. University, Patan- 384265 (Gujarat), Mob: +91-9727767700, email: dr.bhupinder82@gmail.com
Lecturer, Department of Computer Engineering, K.D. Polytechnic, Patan- 384265 (Gujarat), Mob: +91-9727820562, e-mail:
sainibaljit@gmail.com

Abstract:
With a population of approximately 1.3 billion, the second most populous country in the world also leads in
sharing the global burden of diseases. There is a huge momentum in the global healthcare industry with
regards to Universal Health Coverage. The planning commission of India has constituted a High Level Expert
Group (HLEG) on Universal Health Coverage (UHC) in late 2010. The sole purpose was to develop a model for
availability of easily accessible and affordable health care to all Indians. Though the prime objective of this
initiative was financial protection it was established that the delivery of Universal Health Coverage also needs
the availability of adequate healthcare infrastructure, skilled health workforce and access to affordable drugs
and technologies.
A strengthened health system under Universal Health Coverage will result in better outcomes. Increased use
of Information Technology to link health care networks will improve health surveillance in the country with
the establishment of a health information system that will generate valuable data on various health and
disease trends and outcomes which can be used for effective policy initiatives. Developing a robust system
by integration of technology will ensure access to essential drugs, vaccines and medical technology by
enhancing their availability and reducing cost to the end user.
This paper is an attempt to bring forth the significant roles; technology can play in healthcare reforms under
Universal Health Coverage.
Key words:
UHC, HLEG, Information Technology

Code - B3

Awareness about MTP Act (safe & legal abortion) among the women and the
Frontline health workers in the villages of Punjab, Haryana & Chandigarh
Alampreet Kaur*, Garima Bhatt*, Sukhmanpreet Kaur*
*

MPH students 2nd year, Centre for Public Health, Panjab University, Chandigarh.

Rationale:
Unsafe abortion is defined as an induced abortion as a process either conducted by unskilled personnel or
performed in a non- accredited facility. In third World countries, unsafe abortions are attributed to maternal
mortality and morbidity. In India, the majority of these events remain concealed initially, thereby further
complicating the scenario.
Unsafe abortion represents a preventable yet major cause for maternal mortality in India. A majority of
these abortions are performed confidentially. Patients and their relatives often fail to disclose the abortion
40

despite the critical state of patient. This scenario creates considerable confusion for diagnosis and treatment
and can lead to further complications.
Objective:
To find the awareness about MTP Act (safe &legal abortion) among the women and the Frontline health
workers in the villages of Punjab, Haryana & Chandigarh.
Methodology:
Sample size:
25 women & 5 frontline health workers from each village respectively.
Sampling technique:
Simple random method.
Study time period:
5th June to 15th July 2015
Study area:
Vill. Kaimbwala (Chd), Vill. Mataur, District Mohali (Pb), Vill. Saketri, District Panchkula.
Study tool:
Pre tested Performa filled through face to face interview, observation and counter checking.
Also we tried to understand the awareness level about safe and legal abortion among the adolescent girls of
each village through conversation.
Key findings:
Only 10 - 15% people were aware about the MTP Act (safe & legal abortion). Even the frontline health
workers who have the responsibility of imparting awareness regarding the health issues and rights to the
public are very less informed regarding this act. Among them 47 % were aware about the MTP Act which is
very less. The frontline health workers include ANM, ASHA workers, Aanganwadi workers (AWW).
Conclusion:
Also the people consider abortion to be a crime and a sin even if its safe and legal. People did not talk
freely and openly about this topic due to the stigma attached to it. Very few women know that safe and legal
abortion is their right. And can take the decision of terminating the pregnancy on their own without any
consent from her husband and family. During survey we observed that out of 75 women whom we interviewed,
65 wereaware about the PC-PNDT Act, 1994 (which regulates sex determination and disclosure of sex by
medical professional to the women and her family members). Which is more known and popularised among
the people through television, radio and newspapers. People confuse the MTP Act with the PC-PNDT Act and
as a result the benefits of MTP Act are not utilized.

41

Code - B4

Financing health care by Government sponsored health Insurance A studyof RSBY


in Odisha
Dr. Raj Kishore Sahu*; Sachala Sahu**
(*A graduate in Medicine, Post graduate in Hospital Administration and RuralManagement; currently with SMIT, Ankushpur
e-mail: captionraj2003@yahoo.co.in; **Consultant Psychologist. e-mail: jinusahu14@yahoo.com)

Abstract:
Medical or health care expenditure is a leading cause of poverty in the developing countries.
Lack of universal health insurance scheme and unaffordable private health insurance premium are the measure
cause of financial distress due to disease or dissability. The worst and prominent sufferers are the worker
group and the BPL people who cannot afford a space in hospital. For social security of the poor and
marginalised, RSBY (Rashtriya Swasthya BimaYojana) was launched by the Ministry of Labour and Employment,
Govt. of India, whichentitles cashless in patient treatment (both surgical/medical) in empaneled hospitals
(Public/Private) with RSBY; even the cost of transportation of the patient is also borne by the scheme. It is a
boon amounting to 62 million BPLs of India including around 52 lakh BPLs from Odisha. The insurance benefits
are extended to five members of a family on floaterbasis by an investment of rupees thirty a year as premium.
The insurance provision covershealth intervention up to a maximum of thirty thousand per year. The objective
of this study is to find out the beneficiary satisfaction level in terms of health standard improvement and
quality accessible and available medical care, reasons behind under utilization of health services by smart
card holders, status for out of pocket expenditure after implementation of RSBY, identify the gaps in framework
of scheme, fraud management at different level of operation.
The data were collected by Household survey; Focus group discussion (FGD); In-depthinterviews (IDI) of
different involved stake holders like doctors, RSBY protocol managers, data entry operators and beneficiaries
residing in various districts of Odisha and Somesecondary data of various sources (Census, RSBY site) were
used.
The study revealed that beneficiaries are satisfied with quality medical care asthere is a option to choose a
public or private hospital for their treatment. There is considerable improvement in the health status of rural
poor. Some were not enlisted in RSBY due to their absence during enrolment days in their locality, people are
still unaware of RSBY scheme due to improper IEC (Information education communication) activity, there is
a fear of people that unnecessary surgeries are undergone in private hospitals to lure more money,some
were asked money after surgical procedures, most hospitals are not providing the transport incentive to the
beneficiary and out of pocket expenditure is notably decreased. Stake holders are active in operating the
scheme successfully, frequent failure of internet connectivity and less human resource in hospitals are some
gaps to propagate the scheme. Random visit to hospitals, on site audit, tracking Bio-metric smart cards for
blocked amount for a particular procedure, Indoor patient strength of hospital, cross-checking prescription
of patients at field level are key ways for fraud identification and management. RSBY drastically changed the
scenario by minimising the fear of financing expenses on health.
Key words:
RSBY, bio-metric smart card, cashless treatment, hospital expenses.

42

Code - IP15B05

Treatment seeking behavior of diabetic patients with special emphasis on followup in the government health facilities A case study of Pudukottai district, Tamil
Nadu, India
Dr. Gopinath Thirugnana Sambandam, MBBS
MPH Candidate (2014-16), Cooperative program of: Johns Hopkins Bloomberg School of Public Health, Baltimore &Indian Institute of
Health Management Research University, Jaipur.

Introduction:
In an effort to address the Non Communicable Diseases (NCDs), the Government of Tamil Nadu has
implemented the NCD Screening, Prevention and Treatment Program in all the 32 districts of the state in
2012 through the World Bank funded Tamil Nadu Health Systems Project (TNHSP). The program aims to
screen people aged 30 years and above visiting the government health facilities for Diabetes Mellitus. Once
detected positive, they are followed up every month.
Rationale:
The importance of regular follow-up of diabetic patients with the health care provider is of great significance
in averting any long term complications. The number of patients lost to follow-up after is alarming and is a
serious concern to both the implementers and funders of the program. This study tries to identify the treatment
seeking behavior of patients which will further provide valuable information for policy makers to improvise
the program.
Objective:
The study has the following objectives with a diagnostic approach rather than a prescriptive approach for the
problem stated above.
To study the proportion of diabetic patients on regular, irregular and lost to follow-up during treatment
of diabetes in the particular government health facility where they got enrolled during the months of
Jan, Feb and Mar, 2014.

To find out the motivating factors for patients who are on regular follow-up.

To find out the major reasons for patients who are either irregular or lost to follow-up during treatment
of diabetes in the government health facility where they appeared during the months of Jan, Feb & Mar
2014.

Methodology:
The methodology has two distinct parts. The first part involves a group discussion meeting of all NCD staff
nurses of Pudukottai district to find out their perspectives of treatment seeking behavior of patients. The
second part is a telephonic survey of patients who visited the government health facilities in Pudukottai
district during the months of January, February and March of 2014. Patient clinic cards of all patients are
collected and 300 cards are randomly selected. All the patients having valid phone numbers from these 300
cards are interviewed using a semi-structured questionnaire. The responses are fed into SPSS and data analysis
is done.
Results:
The study is in its last stage of analysis and interpretation. Therefore, final results will soon be arrived. A
major learning from the study as of now is that there are gaps in updating patients clinical records on a
regular basis. Most of the patients who are noted as irregular or lost to follow-up are actually regular visitors
in the government health facility.
43

Conclusion:
Considering the increased burden of Diabetes Mellitus and therefore increased state health expenditure, it is
important to ensure that the services of screening, prevention and treatment for Diabetes are utilized to the
maximum. The results obtained through this study will give a new perspective of policy issues to program
managers.
Code - IPB1506

Day care centres as capacity development in elderly care: A need of the hour as
India grays
Dr. Vidya Chandran1
Do not go gentle into that good night, Old age should burn and rave at close of day, Rage, rage against the dying of the light. Dylan
Thomas

Rationale:
Withering of joint family system has contributed to the challenges faced by elderly where they are forced to
live alone and are exposed to various kinds of problems. Their often poor financial condition, lack of affordable
health care and the general neglect by society calls for an effective system for their well-being at the dusk of
their lives. Census 2011 suggests that India is home to over 75 million elderly, contributing 7.5% of the total
population, which is projected to reach 10.7% in 2021 and 12.4 % by 2026. Hence, government has to be
prepared for the additional strain this will put on families and health and welfare services
Objectives:
To assess the need of having elderly day care centres to cater to the geriatric care essential for the elderly
population in Indian slums.

To understand the bottlenecks in availing the services provided by Sandhya Kirana, a day care centre for
the elderly.

To assess the benefits generated by those who are availing the facilities of Sandhya Kirana day care
centre.

Methodology:
Quantitative Study:

Qualitative Study:

Study type

Cross sectional study

Cross sectional study

Duration

Two months (April-May 2015)

Two months (April-May 2015)

Area

Urban slums of Bengaluru

Sandhya Kirana, Shantinagar, Bengaluru

Sample size

100

20

Respondents

All the elderly above the age of 60.


The existing beneficiaries of Sandhya
Kirana were excluded from the study

All the beneficiaries of Sandhya Kirana who


had more than 80% attendance in the month
of April 2015

Sample selection

Simple random sampling

Simple random sampling

Data collection approach:


Data source
Primary data

Primary data

Type of data

Qualitative

Quantitative
44

Technique

Face to face interview

Face to face key informant interview

Tool

Structured questionnaire

Semi structured interview

Key Findings:
1. The dire need for a day care centre was suggested by the profile of the elderly in the slums where over
half of the sample was the younger elderly, who were healthy enough to avail the facilities at a day care
centre. Almost four fifth of the sample was deprived of the meagre elderly pension that the government
provides.
2. There were several bottlenecks that the potential beneficiaries of Sandhya Kirana face that can be resolved
by spreading more awareness about the services provided and also by providing a few more services to
combat the bottlenecks.
3. The qualitative study suggested that the reasons for the beneficiaries joining SK and their interests keep
over one third of the beneficiaries fully satisfied with the services provided.
Conclusion:
Providing direct services rather than monetary benefits can prove more effective in elderly care in a country
like India. Hence, a day care centre for the elderly can solve most of the unmet needs of the elderly and
prove to be an efficient social security in India. Such centres could include nutritional supplements for the
elderly along with basic medical care, a platform for socialization and to keep them engaged through economic
empowerment as is seen at Sandhya Kirana.

Code - IP15B07

A Study to Bring Migrants Under The Equity Lense


By Neha Garg, Shruti Sachdeva, Mahima Yadav
Health resources are scarce in developing countries like India and there is intense competition between local
residents and interstate migrants. Migrants roughly account for one third of Indias population but tend to
remain on fringes of society, living in deplorable conditions due to long working hours, low wages, unsafe
environment, social isolation, food insecurity, poor access to education, water sanitation, preventive and
curative health services and are subjected to gender based discrimination at work place. Themigratory status
of the laborers puts them in a precarious position that predisposes them to unique. Health problem which
makes them fall outside safety net of Public Distribution System, Maternal and child health packages, due to
insufficient documentary evidence of residential status as well as absence of a local identity card
Undernutrition is a major problem among migrant population, especially among women and children. Most
common causes of undernutrition includes faulty infant feeding practices, impaired utilization of nutrients
due to infectionsandparasites,inadequatefoodandhealthsecurity,poorenvironmentalconditionsand
lack of proper child care practices. Migration further perpetuates this cycle of poverty, ill-health and
malnutrition.
Objectives:
To assess the nutritional status of children under five years of age in three resettlement colonies of Delhi.

To assess the Knowledge, Attitude and Practices (KAP) and identify gaps related to the nutrition and the
health-seeking behavior of mothers (of children under 5 years) in three resettlement colonies of Delhi.
45

Methodology:
Primary data wascollected using a structured questionnaire and anthropometric measurements were recorded
using standard tools. A sample size of 280 households was obtained in three resettlement colonies of Delhi
(Sanjay Camp, Dwarka & Dakshinpuri) .Study respondents comprised of mothers of children under five years
of age.
Findings:
Nutritional status of the children was analyzed by using WHO anthroplus and further parameters like breast
feeding practices, health seeking behaviour, health facility utilization, water and sanitation practices, awareness
and utilization of government schemes were analysed using advanced applications of Excel.
Data shows evidence of improper breastfeeding, water and sanitation practices, gaps in health seeking
behaviour and exclusion of respondents from public distribution system and lack of proper identification
system for optimal utilisation of government services.
Conclusion:
It is very necessary to address the cultural and social determinants hampering the overall growth and
development of children in such resettlement colonies. This can be done effectively through inclusive planning
of health service delivery in urban areas with special reference to migrants,provision of dedicated outreach
clinical services for migrants at work sites, allocation of dedicated budget for migrant welfare and identification
of migrants for improving health seeking and resource utilization.

Code - IP15B08

Operations Management in Healthcare System


Isharjot Kaur, MBA-HM 20, IIHMR Jaipur
Background/Rationale:
Health operation management is concerned with identifying the needs of the patient and providing them
with different services to meet their needs in the most effective and efficient manner. According to the IPHS
(Indian Public Health Standards) Health Centers are setup with an objective to provide essential health services
to the patients. This attempt has been made to study the issues in the health care systems at rural areas i.e.
in different Community Health Centers.
Objective:
The objective of the study is to focus on the issues that are seen in CHCs which effects the health care system
of the center.
Methodology:
The study for this paper was done at five different Community Health Centers in Rural areas of Jaipur district.
CHCs were selected purposely and five different groups were send to different CHCs. They were provided
with the observation checklist which includes all the services that should be provided at the health centers.
The data for this paper was collected from all the five groups. These observations were done in the month of
August, 2015. An informal conversation was also done with the patients at CHCs to find whether they face
any problem in the treatment or services provided to them at the Health center.
46

Key Findings:
There were many issues that were found at Community health centers. The most important and common
issues were shortage of resources like manpower, equipments, supplies and rooms etc.
There were no properly setup operation theaters with proper instruments and if there was properly setup
operation theatres there were no general surgeons and anesthetist. No surgeries were done including
caesarean sections. Ante-natal or Post-natal clinics were also not available. There was no pediatrics was
there for sick children. There were not even providing 24 hour emergency services. There were no eye surgeons
or dentists. Equipments like surgical instruments, dental chair, Ultrasound machine etc. were not provided.
There were no proper transportation facilities.
Many patients were not satisfied with the services provided especially pregnant women that undergo their
deliveries at CHCs. There were no facilities to handle special delivery cases.
Conclusion:
There were many issues that were found at the health centers. The ineffective and inefficient services at
health centers will affect the health system. Because of these issues patients are unable to get proper
treatment. These issues should be taken into consideration by health managers and they should try to solve
them for the betterment of patients who require proper treatment. Health managers should visit the CHCs
regularly.

Code - IP15B09

A study to assess the impact of education on vaccination awareness among mothers


coming to immunization camps (of Seva Mandir) in rural Udaipur, Rajasthan.
Dr. Aman Preet Kaur, Doma Sherpa, Dr. Shirish Dhore and Dr. Vijendra Banshiwal
UHC: Equity lens
Introduction:
Despite a reduction in disease burden of vaccine-preventable diseases through childhood immunization,
considerable progress needs to be made in terms of ensuring efficiency and equity of vaccination coverage.
It is known that mothers education and literacy is crucial for childs well being, however the status of the
same in Rajasthan is gloomy.
Udaipur is a predominantly rural district of southern Rajasthan, with a population of 26, 33,312 (Census
2001). It traditionally had lower immunization estimates than national levels while also performing poorly in
other key developmental indicators, IMR of 63 per 1000 born infants and MMR of 265 per 100,000 women
of reproductive age The most recent immunization estimates for this area were assessed in 2013 by the
DHLS-4 survey, but data is incomplete for villages outside of the governments catchment area.
Rationale:
In order to achieve MDG-4 of reducing child mortality immunization plays a key role. To our knowledge, data
on mothers awareness towards vaccination of infants is not available for rural Udaipur. Such information is
urgently needed, since the reasons for noncompliance with or non-delivery of vaccinations to eligible children
on schedule and the factors that may affect immunization rates need to be identified and addressed in order
to prevent these diseases. The data thus collected can be utilized to develop strategies to increase universal
health coverage of infants.
47

Methodology:

Sampling: Convenient sampling

Sample size: 357

Respondents: Mothers coming to Seva Mandir immunization camps

Area covered: Five blocks of Udaipur- Badgaon, Girwa, Jhadol, Kherwara and Kotra.

Technique: Personal Interview

Tool used: Semi structured questionnaire

Data analysis: Univariate and bivariate analysis by using SPSS.

Objectives:
Primary
i. To find the association between education level and vaccination awareness among mothers coming to
the camps conducted by seva mandir in rural Udaipur, rajasthan
ii. To find the association between education level and vaccination frequency among mothers coming to
the camps conducted by seva mandir in rural Udaipur, Rajasthan.
Secondary
i. To find the association between education and number of children born to mothers coming to the camps
conducted by seva mandir in rural Udaipur, Rajasthan.
ii. To know the status of mamta card retention among mothers coming to the camps conducted by seva
mandir in rural Udaipur, Rajasthan.
Findings and Conclusion:
Out of 357 respondents more than two third (263) mothers were Illiterate. (Literate here means women,
who could read, write and understand.)
i).
Education level
(n)

To prevent diseases in
(%)

It is beneficial for
health in (%)

To get non cash incentives


(Lentils) in (%)

Dont know in
(%)

Literate (94)

36

20

Illiterate (263)

64

80

100

91

100

100

100

100

Education level
(n)

Every month in
(%)

Every two months in


(%)

More than two months in


(%)

First time in
(%)

Literate (94)

26.5

19.6

15

31

Illiterate (263)

73.5

80.4

85

69

Total (357)

100

100

100

100

Total (357)
ii).

iii).
Education level
(n)

Number of
children is 1

Number of
children is 2

Number of
children is 3

Number of
childrenis 4

Number of
children is 5

Literate (94)

46.7

27.5

21.5

12.2

3.4

Illiterate (263)

53.3

72.5

78.5

87.8

96.6

Total (357)

100

100

100

100

100

48

Almost fifty percentof mothers who came to immunization camps said they had mamta card with them
while seventeen percentdid not have mamta card because of some reasons.

Twenty percent of mothers forgot to bring their card at the campsites, while 5 %mothers had lost mamta
card.

3 percent had come for first ANC check up so mamta card would be issued in subsequent visits

Code - IP15B22

Futuristic Aspect of Universal Coverage - ward Sabha Model


Prabal Mukherjee and Biswajit Patra, IIHMR University
Rational:
Universal health coverage brings the hope of better health and protection from poverty for hundreds of
millions of people- especially those in most vulnerable situation .Nearly one in every six urban Indian residents
lives in a slum, as per census 2011 data and roughly 1.37 crore households, or 17.4% of urban Indian households
lived in a slum. Therefore, slums are unavoidable part of our society and these areas are pervasively present
in the system. These people live in without inadequate amenities, overpopulated and unhygienic conditions
people do not get government facilities. So here, we would like to propose a model at one side which will
help government to trace out this slum people with the help of NGOs and on the other hand this slum
people will get a platform where they can convey their problems to government level. The model is calling
Ward Sabha.
Objective:
To find out the accessibility of health services in urban slums.
Description:
In this model each person of the ward to participate in decision- making at local level. It provides a forum to
people in the area to meet and discuss their common problems, and consequently, understand the needs
and aspirations of the community. This will mainly focus on the sanitation and health care facilities. It also
provides a forum to meet, discuss, debate and analyse the development and administrative actions of elected
representatives and thereby ensure transparency and accountability. There should be a urban steering
committee from each of the ward and a group who will collect feedback from community level. The members
of this committee are, councillor of that particular ward, NGO, party representatives, government service
providers (ICDS/HHW), SHG, Club members & influential person of that area In Ward -sabha, there will be
two representative(one male & one female) from community level who will represent their needs. The major
focusing area for the meeting

Maternal and Child health services

Cost of healthcare including communicable and non-communicable disease

Managing and allocating funds for health services.

Methodology:
Sampling Technique - Non Probability Sampling (Convenient Sampling)
Data Collection Method - Tool Structured Questionnaire, Technique-Interview
49

Data Analysis - Univariate analysis using MS Excel


Sample Size - 106
Study Area - Kolkata Municipal Corporation Borough VII (ward no- 56, 59, 63 & 67)
Key Findings:
Improve the level of accessibility of different health services provided by the government

Strengthen the capacity building of community

Increase the level of awareness

Conclusion:
This model will ensure for receiving the promotive, preventive, curative health services to those people who
are living in the urban slum. People are addressing their issues or grievances in front of government officials
in ward sabha meeting.

Code - IP15B19

Hospital OPD Pharmacy : Role in Improving Quality of Healthcare


Kush Dua, Eshna Srigyan
Abstract
Outpatient pharmacy in a hospital plays an important role in patient care, as well as improving the quality of
life and health outcome by adequate and timely delivery of prescribed medications, reducing medication
related problems and counselling the patient for preventive care and health promotion by pharmacists.
Pharmacists have expanded their roles in practice settings and now serve as integral members of an
interdisciplinary health care system. The aim of this paper was to identify and propose the major areas for
improvement in outpatient pharmacy especially through capacity building of OPD Pharmacy personnel so
that necessary strategies can be implemented so as to prevent the dilution of hospital brand and also for
strengthening the healthcare system and improve the quality of service provided by them which in turn will
improve the quality of healthcare.
The study revolves around 4 major objectives :

To identify the factors influencing the service delivery of OPD pharmacy

To assess the patient level of satisfaction with OPD pharmacy

To identify the major areas requiring capacity development

To propose capacity development needs of OPD pharmacy.

For this purpose, a secondary research was carried out to identify the factors influencing service delivery in
OPD Pharmacy which were found out to be Availability of drugs, Behavior of pharmacists, Knowledge of
Pharmacists, Interaction with patient (Practice Perspective) and Availability of staff. A questionnaire was
then prepared on above parameters which was administered to patients visiting OPD Pharmacy in Jaipur,
Rajasthan to assess their satisfaction level. A total of 180 patients were surveyed across 6 major hospitals in
Jaipur. The survey revealed that Timeliness, Availability of drugs and Patient counselling are the major areas
of dissatisfaction among patients in Jaipur. Approximately 68% showed their dissatisfaction from timeliness
and 48% each for availability and counseling. It is evident from previous studies that there is a regular basis
50

need for educational intervention to update the knowledge and awareness of the pharmacist to the healthcare
services provided by them.
On the basis of findings, following recommendations were proposed:
For Timeliness, Proper utilization of staff and concept of E-prescription;
For Availability, Efficient use of Hospital Pharmacy Computerized Inventory Program; For Counselling, concept
of Counselling Course;
A concept of Departmental Awards is also proposed to improve the efficiency of the pharmacy department.

Code - B11

Hearing loss in patients attending the Out Patient Clinic in an Industrial Tertiary
Healthcare centre
Dr. Bhudeb Sengupta
Additional Chief Health Director (Administration & Public Health), Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata

Dr. K P Verma
Divisional Medical Officer & Head of Department- ENT, Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata-700043

Mr. Venkat Raman Prusty


Audiologist & Speech Pathologist,Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata-700043

Mr. Mayank Awasthi (Speech Therapist & Audiologist), Ram Manohar Lohiya Institute of Medical Sciences, Lucknow
Rationale: Hearing loss is invisible disability of one of the distant senses, which affects individual in performing
activities, secondary to psychosocial problems, life threat and the basic loss of effective communication. This
may cause serious harm to the individual, to the family and dependents and also the co-workers in an
organization.
Objective:
This study aimed to determine the frequency, causes, types of hearing impairment in patients attending the
out-patient ENT clinic of a tertiary Health care unit of an Industrial Organization.
Methodology:
Purposive sample included Hearing profile of 160 patients, in 6 months duration (January 2014- June 2014),
was grouped into 4 age groups (0-20, 21-40, 41-60, above 60 years). Complete profile of each person were
noted including onset, growth, complaint, Medical & other relevant history, Associated system, Hearing
evaluation report, Other related tests, final Diagnosis and Recommendations. Descriptive statistics and other
statistical test showed age wise significant differences for many features. A detail analysis helped to understand
types of possible causes, therefore indicating preventive measures in many cases.
Key findings:
Total 117 patients were found to have same site of lesion in both ears, constituting 102 sensorineural, 10
Conductive and 5 mixed hearing loss. Patients seen with unilateral or bilateral different lesions were 21, with
other 22 patients not grouped into any. Majority of patients were found have a gradual onset (110) and a
progressive growth of the condition (107). The severity of condition showed a wide difference. Patients with
associated symptoms were high. The complaint & reporting were analyzed and seen to be patient specific
perception of their problem.
51

Conclusion:
Occupation wise analysis indicated the chances of noise induced effects on hearing mechanism to be a
predominant factor. However, detail analysis is warranted in terms of testing all the subjects with similar job
profiles to confirm a noise induced hearing loss.
Key words: Hearing impairment, Tertiary Healthcare Unit, Industrial organization

Code - B12

Hearing loss and Balance disorders causing Mobility Impairment in Elderly


population
Mr. Venkat Raman Prusty
Audiologist & Speech Pathologist, Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata-700043

Dr. K P Verma
Divisional Medical Officer & Head of Department- ENT,Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata-700043

Mr. Mayank Awasthi


Speech Therapist & Audiologist, Ram Manohar Lohiya Institute of Medical Sciences, Lucknow

Dr. Bhudeb Sengupta


Additional Chief Health Director (Administration & Public Health), Central Hospital, South Eastern Railway, Gardenreach, BNR, Kolkata

Rationale:
Balance requires reliable sensory input from the individuals vision, vestibular system (the balance system of
the inner ear) and proprioceptors (sensors of position and movement in the feet and legs), muscle strength
and joint mobility. The elderly are prone to a variety of diseases that affect these systems. Effect extends to
functional incapability or loss of confidence in mobility.
Objective:
This study aimed to determine the extent of mobility impairment in elderly individuals with hearing and
balance disorders. It was also required to find out if a scale or questionnaire should be mandated when
dealing with elderly population.
Methodology:
Hearing profile, Balance assessment and mobility scale score for 177 patients, in 1.5 years duration (January
2014- July 2015) was grouped into 4 age groups (50-60, 60-70, 70- 80, above 80 years). Each age group were
sub divided into four groups, such as- a) with only significant senile hearing loss without observed balance
problems; b) only reported and observed balance problems; c) both with balance problems and hearing loss;
and d) no reported and observed significant balance or hearing problems. Exclusion criteria were specific to
no neurological problems, no musculo-skeletal deformities, no significant vision loss. Complete profile including
hearing assessment, vestibular and balance evaluation was done along with scales for mobility and gait.
Individuals with BPPV, diagnosed by symptomatic progress with maneuvers, were excluded.
Key findings:
It was observed that there was a huge difference within the groups for balance and gait indices. Detail
observation suggested that hearing loss, though may not be directly causing balance problems in many
individuals, it helps retain a healthy mental condition and confidence, which in turn helps in balance and
mobility. In the older groups, the mobility issues were significant, with most of them having some sort of
reported problems related to balance. The aspect of reported growth in problems were noted but not analyzed
52

statistically, as they were subjective reporting. The severity of condition showed a wide difference. The most
elderly group (70-80 and 80 years above) were less numbered in the fourth sub group, as most of them had
either reported, observed and both for some kind of hearing or balance related issues.
Conclusion:
The study is evident to mark a need of a mandatory use of questionnaire for all individuals above 70 years, to
avoid risk of fall, though never reported any problems.
Keywords:
Hearing loss, balance disorders, mobility impairment, and elderly.
Code - B19

Burden of Multiple Disabilities among the Older Population in India: An Assessment


of Differential Factors
Iffat Naseem1, Shibu John2
Abstract
The study focuses on identifying the burden of multiple disabilities among the older population in India. In
the field of health related research the pattern of causes provide a clear and in depth idea about the situation
of the diseases and injuries prevalence in the population under study. Identifying the causes of disability
among sex, place of residence and most importantly among different age groups have a useful contribution
in proper health planning. The main focus of the study is to explore the patterns of causes of disability in
India with special reference to older population. The census 2014 gives disabled peoples data using unilabiate,
bivariate and two way anova analysis.
Results reveal that locomotors disability is the most prevalent type of disability affecting the population of all
ages in India. Mental problems are highest among working age population, and visual and hearing disability
are highest among the aged population. Mental disability is occurring mainly due to serious illness during
childhood, head injury in childhood and pregnancy and birth related causes. Old age, cataract, glaucoma and
other eye disease are the main causes for having visual problems while polio, injury other than burns, other
illness, stroke, arthritis, cerebral palsy are the main causes of locomotors disability. The study also shows
that injury other than burns is a vital cause of having disability in India.
Key word:
Disability, Injury, Health, Locomotor

53

Abstracts for Poster Presentations


Code - IP15A016

Study The Impact of Dots on Accessibility & Affordability of Medical Treatment for
Patients
Pratiksha Pal (MBAHM 19) & Vivek N. Mahodaya (ph06)
Rationale:
India is the country with the highest burden of TB, with World Health Organisation (WHO) statistics for 2013
giving an estimated incidence of 2.1 million cases of TB for India out of a global incidence of 9 million. The
estimated TB prevalence for 2013 is given as 2.6 million.It is estimated that about 40% of the Indian population
is infected with TB bacteria, the vast majority of whom have latent rather than active TB. The emergence of
multi-drug resistant TB (MDR TB) contributed to worsening impact of the disease - the principal reasons for
the WHO declaring TB a global emergency in 1993.RNTCP was launched in India in year 1997 to combat
tuberculosis.
Objective:
1. To determine the impact of DOTS on Tuberculosis in India.
2. To know the needs of innovations in DOTS strategy.
Methodology:
Secondary data collection - Published articles, non-published articles and papers, various web sites.
Discussion:
India accounted for 24% of global TB burden. DOTS (Directly observed treatment, short course) was launched
in 1997 treated, 14.2 million cases, saving additional 2.6 million lives and have achieved success rate of 85%
new smear positive patients. Because it includes unique features like district TB control society, modular
training, patient wise boxes, sub district level supervisory staff & robust reporting & recording system. But
the prevalence of MDR TB is increasing throughout the world both among new tuberculosis case as well as
previously treated ones. The risk of developing MDR TB is more in previously treated patients because of
spontaneous mutation or transmission of resistant strains. To deal with this problem some new innovations
are required like Trials are underway to evaluate the efficacy of a new TB treatment called PaMZ which
contains pretomanid, moxifloxacin and pyrazinamide. If these trials succeed, then TB patients might get new,
shorter treatments within the next 5 years.
To make sure that Indian patients benefit from new drugs, the Government will need to streamline its
regulatory and policy adoption processes, and proactively coordinate the introduction of new drug regimens,
along with companion diagnostics that can detect drug-resistance to new regimens.
While we wait for better and shorter therapies, doctors and programmes can improve the effectiveness of
existing treatments by improving treatment adherence. Drug-sensitive TB requires a full 6-month course of
treatment. If adherence is poor, then drug-resistance can emerge.
There are many methods to ensure adherence, including directly observed therapy (DOT). While it is
challenging for patients to visit health care centres for DOT, we must harness the enormous potential offered
by mobile phones to electronically monitor adherence to medications.
54

Conclusion:
As we can see the DOTS strategy is effective in reducing prevalence of new cases of TB, but by incorporating
some new innovative strategies it can be more effective for MDR and XDR cases.

Code - IP15A017

A Study on Reducing Out of Pocket Health Expenditure in India Through Insurance


Namrata Gupta, Devina Khandelwal
Rationale:
Only 21.62 crore people or 17% of total population were covered by health insurance at the end of March
2014.WHO says that 3.2% Indians would fall below the poverty line because of high medical bills with about
70% of Indians spending their entire income on healthcare and purchasing drugs.
Objectives:
1. To analyse the health insurance market and health finance in India
2. To find ways to reduce out of pocket expenditure
Methodology:
Quantitative analysis. The paper largely depends upon the secondary sources based on the literature reviews,
journals, books, websites, etc.
Key Findings:
An increase in the public procurement of medicines from around 0.1% to 0.5% of GDP would ensure universal
access to essential drugs, greatly reduce the burden on private out-of-pocket expenditures and increase the
financial protection for households.
Indian health insurance market is expected to grow at a CAGR of 43% between 2011 and 2015.The market
penetration will be three fold higher in 2015 as is it is one of the fastest growing segments in nonlife insurance.
Conclusion:
The solution is to seek to reduce reliance on out of pocket payments and increase reliance on some form of
pre-payment. Also, the need of hour is to ensure best utilisation of the pool the funds collected by taxes or
insurance contributions, how best to use them to purchase or provide services and how providers should be
paid.

Code - IP15A019

Emerging trends : Health Insurance in the Medical Tourism Industry


Kasturi Saikia (saikiakasturi3@gmail.com)
Devanshi Ahuja (devanshiahuja@gmail.com), MBA-HM 19th batch- IIHMR University
Rationale:
Medical tourism, according to the international nonprofit organization Medical Tourism Association, is a
practice whereby people who live in one country travel to another country to receive medical, dental and
55

surgical care, which they do because of affordability, better access to care or a higher level of quality of
care. Health Insurance is a type of insurance coverage that pays for medical and surgical expenses that are
incurred by the insured. Health insurance can either reimburse the insured for expenses incurred from illness
or injury or pay the care provider directly.
Health insurance in medical tourism is related in two ways - Travel related &Treatment related. Medical
tourism insurance products are an emerging part of health tourism industry.Companies that provide insurance
products for medical travel services will be seen by potential patients as having an advantage over their
competitors.
Objective:
To study the role of health insurance in the context of the medical tourism industry.
Methodology:
A systematic review of the information gathered from the journals has been done. Secondary data was
collected and studied to understand the current scenario of the medical tourism industry and the importance
of health insurance in promoting the further growth of this industry.
Key findings:
Increase in healthcare expenses in developed countries is the prime motivation behind the growth of
medical tourism. Insurance companies and cost alert employers prefer this trend of travelling to developing
countries to seek healthcare at affordable prices. Hence, insurance companies are now providing insurance
cover to such patients, making medical tourism an option for everyone.

A report published by the Mckinsey and Co. assesses that if insurers started providing travel medical
insurance, then annually around 500,000-700,000 Americans may travel overseas for surgery. This will
allow the developing countries (like India) to further strengthen their hold over the western market.

Conclusion:
By using strategies to promote the importance of health insurance in the medical tourism industry both the
patients (receivers) and the countries which provide medical tourism services (providers) will receive equal
benefits i.e. good quality healthcare at low cost for the receivers and a boost to economy for the providers.

Code - IP15A020

Manual Scavenging : Reasons for continuation of the inhuman act and failure of
act, government policies and programmes.
Shivani Arora, Shivika Chugh (The IIHMR University, Jaipur)
Manual scavenging is the obnoxious and inhuman occupation of manually removing night soil and filth using
hands from insanitary or dry toilets, built without a flush system. The occupation has remained intact with
the Dalit communities dictated and forced upon by the caste-system. The forms of manual scavenging have
changed over the period of time both in rural and urban areas. However, this practice continues under different
forms and manner. It has been nearly a century since Mahatma Gandhi, first called for the abolition of manual
scavenging.But, the degrading practice still continues. As per the annual report of the Ministry of Social
Justice and Empowerment (Government of India, 2009), there were 7, 70,338 manual scavengers and their
dependents in India. According to census 2011, there are more than 20 lakh dry latrines in India where the
56

practice of manual scavenging is still prevalent. This situation persists despite the fact that the Employment
of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act, 1993, is in enforcement, which
provides for the prohibition of the employment of manual scavengers as well as construction of dry latrines
.Further the act regulates construction and maintenance of water-seal latrines for assuring the dignity of the
individual, as enshrined in the Preamble to the Constitution. In rural India as well as in urban slums of many
major cities of India, dry toilets are a sad part of the reality which has led to the practice of manual scavenging.
Many acts, government policies and programmes have come into force but they were unsuccessful in throwing
off the yoke of manual scavenging. Manual scavengers are still living at the threshold in expectation of help
from the government.
This research reveals the reasons for continuation of the manual scavenging practice and failure of the act,
government policies and programmes. It also suggests strategies to wipe off the unhealthy and inhuman
practice. The findings of paper were developed from the reviewed information extracted from the contribution
of different authors, internet research of journals, reports of organizations working in the area of water,
sanitation and hygiene, articles and blogs. The problem of continuation of manual scavenging practice can be
viewed from two angles: The community/society perspective (economic and social pressures, lack of wet
toilets especially in Indian railways which is thus considered the countrys biggest open toilet); and the act/
policy/programme perspective (insufficient financial assistance, more focus on male workers, no monitoring
of their implementation). The strategies to eliminate the practice could be to make the process more
mechanistic, providing alternate employment opportunities, technological innovations to limit manual
handling of human excrement on the railway tracks which include concrete washable aprons, controlled
discharge toilet systems (CDTS), bio-toilets and vacuum toilets. Numerous other reasons for failure and
strategies to overcome them have been traced which are further explored in the paper. It points out a strategic
approach to curb this menace. Implementation of the significant measures would also lead to reduction in
the plight of the communities employed for this practice.
Key words:
Manual Scavenging, Manual Scavengers, Dry Latrines

Code - IP15A022

Neonatal Care By Avoiding Medication Administration Errors


Nupur Kapoor, Ritwik Chawla, MBA - HM (2015-17), IIHMR University, Jaipur
Rationale:
Medication administrative errors (MAE)Electronic health records (EHR) treated in a level four Neonatal
intensive care unit (NICU) in 2011 and 2012 .The rate were evaluated by automated algorithms and were
compared with incident reporting functioning was evaluated by chart review.
Objective:
To evaluate Medication administrative error (MAE) by Electronic health records (EHR) in neonatal care at
Neonatal intensive care units.
Methodology:
The study to identify MAEs within EHR for determining the quality and safety in health care .Various articles
and literature were studied as a source of secondary data from google Scholar, PUBMED and science direct.
57

Results and Key Findings:


In the combined 2011 and 2012 Neonatal NICU data sets, the automated algorithms identified MAEs at the
following parameters, vasoactive medications including: dopamine, epinephrine, and vasopressin. Fluid
administration error were similar: intravenous fluids, parenteral nutrition, and lipid administration. 13 insulin
administration errors were also found. MAE rates were higher for medications that were adjusted frequently
and fluids administered concurrently. The algorithms identified many previously unidentified errors,
demonstrating significantly better sensitivity and precision than incident reporting for error recognition.
Conclusions:
Automated detection of medication administration errors by the EHR is determining the quality as well as
the safety in neonatal care, efficiently and performs better than currently used incident reporting systems.
Automated algorithms may be useful for immediate reporting and keeps a check.

Code - IP15A030

Reducing Cost of Healthcare and Financing Lean Healthcare Management


Dr. Anamika Tripathi, Aastha Mishra (IIHMR University, Jaipur)
Rationale:
Better financing and intelligent methods will reduce cost of healthcare
Objectives:
To determine the ways of reducing cost of healthcare and analyze healthcare financing aiding to cost cutting.
Key Findings:
The financial pressures the healthcare organizations are facing, many hospitals have now contemplated on
bringing in the Lean Techniques that would not only reduce the cost of healthcare but also help organizations
to save money. Lean management methods are all about encouraging everyone to participate in process
improvement, as well as finding creative and interesting ways to save money for a healthcare organization to
avoid those unwanted traditional cost slashing endeavors like layoffs that set foot on the deficit in the long
run. The different ways in which Lean methods prove beneficial are Reducing Never Events, Supply Chain
Improvements, Delay or Cancel Construction and Expansion, Reduce Overtime, Reduce Length of Stay, Reduce
unnecessary testing and diagnostics, Reduce delays and errors in billing.
Across hospital industry many systems that are guided under lean methods are being deployed viz. RFID
system which would provide active real time location that maps resources, monitor activity and measure
performance without impeding any other wireless network across hospital.
Apart from Lean methods, better clinical design that employs clinical and operational experts in order to
develop evidence based toolkits are now surging to substantiate for cost cutting. But these can be better
achieved if unmitigated systems are in place to aid in cost cutting which can be in furtherance with the
Healthcare financing which revolves around mobilization of funds, allocation of funds to the regions and
population groups and for specific types of healthcare and mechanisms for paying healthcare that is not only
done by Public and Private healthcare providers but also by External aid in a number of ways that not only
provides for the rich but also for the poor strata through Tax-based systems, Pay as you use- user fees, Risk
based private insurance, Social health insurance(especially covering health risks of poors), Donor funding or
Community based funding.
58

Conclusion:
The stigma of high cost health services can be covered through concerted effort of Public and Private healthcare
providers which would be achieved if better cost reduction through substantial methods is done that does
not drag with it the deficit and the consequences in the long run thereby contracting the most dreaded word
COST from the brains of the people and also allowing the governmental and non-governmental organizations
to actively serving the purpose in meeting and exceeding the expectations of the people hence easy transition
of the picture of the nation from developing to developed country.
Code - IP15A024

Human Resource In Indian Healthcare: Current trends and the way forward
Ishita Srivastava, Shivani Arora (The IIHMR University, Jaipur)
Rationale:
Healthcare is at an influx of paradigm shifts in terms of changing disease patterns, increasing dual disease
burden for both rural and urban India. Though Indian economy is growing at rapid pace of 7.5%, yet expenditure
on healthcare industry accounts for a mere 1.3%; making itamongst the bottom five across the globe.
Manpower for health services has been described as the heart of the health system in any country. Present
Indian scenario demands attention to challenges which broadly includes scarcity of physicians, nurses and
technicians and uneven distribution of human resources among the rural and urban areas. Presently, doctor
to population ratio is 1:1700 in urban areas and 1:25000 in rural areas, which is much less than the required
ratio of 1:1000 as specified by WHO. The scenario of nurses which is 1.5nurses per 1000 population projects
no good picture either. According to WHO, India requires additional 1.54million doctors and 2.4million nurses
to match the global average.
Objectives:
To study the current status of health workforce.
To identify innovative interventions to overcome the current shortfall and uneven distribution of human
resource.
Methodology:
The paper was developed from the reviewed information extracted from the contribution of different authors,
journals, articles and blogs.
Key Findings:
A deficit of about 2866 (12%) MBBS doctors in the PHCs exists, the requirement being 23 887. With the
latest guidelines which lay down that two doctors should be posted at each PHC, this shortfall is bound to
increase substantially.

The situation is even more serious with respect to specialists at the CHCs. A considerable shortfall of
surgeons, physicians, obstetricians and pediatricians occurs at the CHCs that is 12 301 (64%).

At the PHC/CHC level, there is a 23% shortfall of nurse midwives or staff nurses. The corresponding
figures for pharmacists are 22.5%, laboratory technicians 47.4% and radiographers 53.9%

There is a 37.8% shortfall in the number of health assistants (female) at PHCs, while the number of
health assistants (male) is less by 41.6%. There is a 1.9% deficit in the number of health workers (female)
at the sub centre and PHC. The number of male health workers is short by 64.6% at the sub centre level.
59

Many Innovative interventions have unfolded to combat these challenges which include emergence of
e-health, mobile medical units, providing vocational training, reorienting the education pattern, provision
of tax benefits and better opportunities to help in the shift of skilled manpower to rural areas.

Conclusion:
Though production of health workers has greatly expanded in recent years, this has been at the cost of
increased privatization of medical education in India. The rapid growth in the production of skilled health
workers such as doctors, dentists, nurses and midwives has not helped fill vacant positions in the publichealth system. Moreover, the problems of imbalances in the distribution of these health personnel persist,
with certain states remaining at a disadvantage. Hence, there is an urgent need to adopt sustained and
innovative actions to address Indias current health-workforce crisis.

Code - IP15A025

Primary Prevention in Healthcare: Gateway to Financial Reforms


Shubham Painoli and Sania Loona
Background:
At the turn of this century, health outcomes in India and quality of the underlying health system significantly
lagged those of peer nations. The situation is further complicated by inequity in healthcare; inadequate
government financing; inadequate total health financing in relation to burden of disease; out of pocket
expenditures. There is only about one doctor for every 1700 people in India and it faces more than 60%
shortage of specialists against WHO recommended standard of 1 doctor every 1000 people.
Percentage of patients suffering from Non Communicable Diseases is 29% in 1990 which is expected to
increase to 57% by 2020 leading to increase disease burden on healthcare system.
So the need of the hour is to identify, evaluate and implement those policies at primary level that could
reduce health spending while enhancing population health and the quality of healthcare
Rationale:
Primary care serves as cornerstone in strong healthcare system. Importance of effective primary care serves
in delivering quality healthcare at low cost, improving health outcomes and reducing disparities.
Objectives:
Guidelines by WHO on achieving objectives at Primary level as ultimate goal of primary healthcare is health
for all.

Reducing exclusion and social disparities in health (universal coverage reforms)

Organizing health services around peoples needs and expectations (service delivery reforms)

Integrating health into all sectors(public policy reforms)

Pursuing collaborative models of policy dialogue (leadership reforms) and

Increasing stakeholder participation.

Methodology:
Poster Presentation showing Qualitative study based on review of literature and discussion with our faculty
members. It is a review framework of six building blocks given by WHO in context of present situation in
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India. This is WHOs Health System Framework of Governance, Information, Financing, Service Delivery, Human
Resources, Medicines, Vaccination and Technologies.
On the basis of difference between healthcare espoused and practiced; we tried to give suggestions to improve
healthcare at primary level.
Key Findings:
It is expected that analysis will point towards certain implemental strategies or policy level directives.

Code - A3

What we have and what more should be done toimprove the quality and safety of
healthcare systems through accreditation in India : An analytical study
Dr. Rupinder Kaur*, Dr. Kirti Kataria*
MPH Scholars*, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh.

Abstract / Rationale:
Healthcare quality is the degree to which health services for individuals and populations increase the likelihood
of desired health outcomes and are consistent with current professional knowledge. Healthcare in India has
been undergoing rapid changes. Various parameters of the healthcare services arefocused not only on provision
of safe, effective, efficient, equitable and timely care, but also on quality aspect of the care being provided.
Quality improvement initiatives and tools can prove beneficial for the provision of better & improved health
care services. The Quality council of India has been working for the improvement of safety and quality of
health care in India through the International Organization for Standardization and National Accreditation
Board for Hospitals and healthcare providers, with the ultimate aim of enhancing quality of life.
Objective:
To identify the strengths, weakness, opportunities, and threats of guidelines/standards made to improve
quality of healthcare in India
Methodology:
The guidelines and standards for healthcare organizations by QCI are analyzed.The standardized policies are
analyzed thoroughly and relevant findings are noted and then summarized in key findings. The ultimate aim
of this study is to do SWOT analysis of the guidelines/standards.
Key findings:
The results are made on the basis of SWOT analysis taking into account all the beneficiaries perspective.
Strengths:
1. Benefits to all the stakeholders, major beneficiaries being the patients.
2. Focus on continuous improvement and commitment to quality care.
3. Regular evaluation of patient satisfaction.
Weakness:
Not a mandatory standard for all healthcare providers.
Opportunities:
1. Taking into account the strengths, it should be mandatory for all the healthcare providers ( not only
private sector but the government sector also).
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2. These set of good quality standards can be made as the National Standards for Quality and Safety of
healthcare.
3. Feedback from the patients can be used as a good tool to plan any interventional strategy, to further
improve the quality of services.
4. If standards of quality are implemented properly, it is helpful in increasing the growth of healthcare
market.
Threats:
As the tag of accreditation enable the healthcare organisation to levy more charges for the services, the
possibility of deviation from the main focus of quality maintenance may arise.
Conclusion:
A lots of research is needed in the field of quality and safety of health care systems in India. Patient is solemnly
dependent on the kind of quality service which he/she gets from any healthcare organisation which may lead
to either good faith or lack of faith in the services being provided. Standardization of evidence-based practices;
infection control issues, medication errors etc. were the areas which needed attention and are easily
identifiable through these quality standards. Quality Council of India will be the stimulus to create a
revolutionary change in quality and safety areas. The opportunities are the new way forward to strengthen
the quality of healthcare organisations.

Code - A4

Swachh Bharat Abhiyans Impact in Chandigarh


Navdeep Kaur, Sukhman Preet Kaur, MPH Students, Centre for Public Health Panjab University, Chandigarh
Introduction:
Swachh Bharat Abhiyan is a national campaign by the Government of India which was launched on 2nd October
2014. Its estimated cost is Rs 62,000crores and is expected to reach 4000 towns in next 5 years. Its an
intensive effort to generate awareness and provide health education to create a felt need for personal,
household & environmental sanitation facilities. The mission is to achieve a cleaner India by 2019 coinciding
with the 150th birth anniversary of Mahatma Gandhi.
Aim:
To study the campaigns impact on urban & slum areas in Chandigarh and observe the changes positive or
negative due to it.
Methodology:
A cross-sectional design has been used for the study. The study was conducted in the randomly selected
urban & slum areas of Chandigarh. A set of 500 self-structured questions comprising of 20 questions was
developed. A set of 250 questionnaires were filled from urban areas, 150 from various offices in Chandigarh
and 100 from slum areas all selected by lottery method.
Results:
The preliminary study shows that there has been an increase in awareness about cleanliness among people
but a lot still need to be done to make the mission successful.
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Conclusion:
The mission being in its initial stages has led to an increased awareness about better sanitation & clean
surroundings among people. But a lot needs to be done to make this more than a paper project. Proper
implementation and aggressive spread of awareness is needed at ground levels to achieve the desired goals.

Code - A5

Norms & Reality - The Sanitation and Hygiene practices among students of schools
of Chandigarh
Sumit Kumar*, Manoj Kumar Sharma**
*Student (Masters of Public Health), Centre for Public Health, Panjab University, **Assistant Professor (Centre for Public Health)

Introduction:
It has long been recognised that investments in school sanitationand hygiene education together can create
improved learning environments, thereby facilitating increased attendance and retention of students.This
study was undertaken to assess the sanitation facilities and awareness about the hygiene practices adopted
by selected private and government primary schools in Chandigarh, Punjab.
Objective:
i) To assess the sanitation facilities in Govt. & Private Schools.
ii) To compare it with the national norms setup.
Methodology:
i) A cross-sectional study was conducted in Govt. Model High SchoolSector-25 Chandigarh & Ankur Public
School Sector -14 Chandigarh with randomly selected sample size of 70 students from each school(total
= 140).
ii) A self structured questionnaire comprising of 18 questions was used.
Result & Conclusion:
School-based hygiene education is vital in orderto decrease the rates of transmissible diseases as well as
school drop outs. During Interaction & survey, it was found that students are more receptive to learning and
are very likely to adopt healthy behaviors at a younger age. They can also be agents of change by spreading
what they have learned in school to their family and community members. Hence, it is recommended that
sanitary guidelines should be met before the establishment of schools.

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Code - A7

Changing face of Indian Healthcare Industry: Opportunities and challenges


Mr. Anand K*, Himanshu V**, Dr. Manoj Kumar Gupta***
* II year Student, PGDHM, IIHMR Bangalore
** II year Student, PGDHM, IIHMR Bangalore
*** Associate Professor and Dean Research, IIHMR Bangalore

Abstract:
India has been experiencing the epidemiological transition in the form of addition of non-communicable
diseases. The increase in the lifestyle diseases has provided opportunity for the re-emergence of indigenous
system of medicine in the country. This system of traditional medicine gained popularity across the world
started attracting more number of foreign patients and has strengthened Indias position as a preferred
destination for medical tourism. This global flow of patients across borders changed the patterns of demand
and supply of healthcare services in the country and insisted for reshaping the Indian health care industry.
The growing medical tourism started provoking hospitals to improve the quality of services at par with the
international standards. Besides that, considering the innovations and fast pace growth of technology,
healthcare providers also started focusing on the technological aspect of healthcare delivery to fundamentally
change the way of practicing medicine. These swift changes in the scenario of Indian healthcare industry
market started attracting attention of private players, especially profit making organizations for the
investments. Foreign investors also consider India as a strategic location for conducting profitable international
business and started investing in Indian healthcare industry. Besides investing in usual hospital business,
private players also started exploring the areas of research and development (R & D) in the country.
Government of India grabs this opportunity for further progression of Indian economy and started changing
regulations of clinical trials in the country to make contract research as fast growing segment of healthcare
industry.
Key words:
Epidemiological transition, healthcare industry, medical tourism, technology, FDI

Code - IP15A033

A Study on Drug Inventory Optimization : Statistical Approach


Dr. Nivedita Khanra, Student of MBA in Hospital Management, The IIHMR University, e-mail: niveditakhanra@gmail.com
Dr. Megha Maladhari, Student of MBA in Hospital Management, The IIHMR University, e-mail: megha.maladhari5@gmail.com
Background:
As the cost of Supply Chain constitutes a large portion of Hospitals operating expenses. So, improving Drug
Inventory Management provides a great opportunity to achieve lowest possible total cost and to maximize
service level by balancing demand and supply.
Objective:
This study aimed to analyze the efficiency of Drug Inventory Management, to classify the drugs based on its
value and movements and also to find out possibility for improvement.
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Methodology:
This study presents an analytical model of Drug Inventory control. It was conducted by using Quantitative
research method. Relevant information was collected from primary and secondary sources. The central store
department was observed and staff was interviewed. Data was collected from organization database during
the research. ABC Analysis (Always Better Control analysis) and FSN Analysis (Fast moving, Slow moving and
Non-moving analysis) were used as study tools.
Key Findings:
Various drugs were classified into ABC and FSN categories. The matrix retrieved from combination of these
two classification methods, had proved to be an efficient and effective tool. Nine drug groups were generated
from the coupling of ABC and FSN analysis and each group requires different Inventory methods and types of
management.
Conclusions:
Under ABC analysis, the management must have control on A category than on B and C category of drugs
and under FSN analysis, the company must not go for the Non-moving items as far as possible, because there
will be unnecessary blocking of working capital which will hinder the other activities of the organization.
Thus, the company is required to maintain safety stock for drugs in order to avoid stock-out conditions &
help in Continuous Production Flow.
Key words:
Drug Inventory Management, ABC Analysis, FSN Analysis

Code - IP15A034

Medication Errors and Patient Safety : Challenges and Strategies to reduce


Medication Errors
Dr. Megha Maladhari, Student of MBA in Hospital Management, The IIHMR University, e-mail: megha.maladhari5@gmail.com
Dr. Nivedita Khanra, Student of MBA in Hospital Management, The IIHMR University, e-mail: niveditakhanra@gmail.com
Background:
Medication Errors are the serious problem in healthcare and can be the source of significant morbidity and
mortality in healthcare sector. By understanding the cost of these errors, the most appropriate interventions
can be designed and implemented to minimize their occurrence. The process of achieving substantial control
over Medication Errors is complex, futuristic and comprised of many challenges and hurdles.
Objectives:
This study aimed to assess the Challenges and Strategies to reduce Medication Errors and improve patient
safety
Studymethod:
Pareto Statistical method is employed for the analysis of Medication Errors. Systemic Literature review was
done on studies based on Medication Errors and Patient Safety with special focus on developing countries
like India. Interviews of healthcare experts were also taken to understand the viability of Medication Errors
in Health System.
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Key Findings:
Medication Errors due to Ordering Errors (41%) and Administration errors (39%) were the most frequent
kind of errors, followed by other reasons such as Legibility of hand writing and Improper Labeling (10%),
Many brands of the same drug (4%), Lack of Communication among health professionals (4%), Lack of Patient/
Relative Participation (2%). The challenges faced during this study were under reporting of errors by nurses
and doctors, Lack of Authenticity and Inadequate use of Technology
Conclusion:
This study has shown that Medication Errors are mainly related to Ordering Errors and Administration Errors.
So, different approaches are recommended to reduce Medication Errors, such as Introduction ofCPOEComputerized Physician Order Entry with Pop-up Alerts and DO NOT DISTURB apron for Medication Nurse,
followed by other approaches such as Set up a Pharmacovigilance System which can collect information on
Adverse Drug Reactions, Use of Patient Identifiers like wrist bands, Encouraging doctors to prescribe the
medicine by the generic/chemical name and not by the brand name.
Key words:
Medication Error, Patient Safety, COPE-Computerized Physician Order Entry

Code - IP15A035

Telemedicine - A Network of Easy Reach for Digital India


Swati Mittal and Shruti Sachdeva
Rationale:
Delivery of universal health coverage requires availability of adequate healthcare infrastructure, skilled health
workforce and access to affordable drugs and technology to ensure quality of care to every citizen. But the
implementation remains grossly inadequate because of consistent scarcity of infrastructure, human resources
and access to quality healthcare. The problem gets further aggravated by unwillingness of healthcare
professionals to work in rural setups. This translates torural communities bearing the greatest burden of
being excluded from quality and specialized healthcare services. Telemedicine intending to bridge this gap,
provides readily available, affordable and accessible solutionsto the most neglected and underserved
categories of the society.
Furthermore, India should capitalize on the rapidly growing Information communication and technology
(ICT) to enhance and strengthen the healthcare delivery system for better impacts.
Objectives:
To describe the role of telemedicine in increasing the reach of rural community to quality healthcare services.
Methodology:
Poster is based on secondary data obtained from following sources are - Role of telehealth in evolving
healthcare environment, Using telehealth technology to improve health of vulnerable and underserved
population by Glassman P, Helgeson M, Kattlove, SEHAT-social Endeavour for health and telemedicinegovernment of Indias new health initiative as a component of digital India campaign in collaboration with
Apollo hospitals, ReMeDi by neurosynaptic communications
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Findings:
It aids in increasing the reach ofrural population to basic, specialty, super-specialty consultations at an
affordable price. It serves as a platform to provide easy and ready access to quality healthcare in geographically
remote and inaccessible regions of the country. It serves as an easy means to treat and closely monitor
immobilized patients whose accessibility to healthcare services is questionable for eg. Elderly patients.It
serves as an effective platform for resolution of healthcare queries and sharing of health related information
with the beneficiaries.It provides easily accessible mobile solutions for the rapidly moving mobile working
population of India.

Code - IP15A036

Patient Safety in India - Issues and Suggestions at a Glance


Khushboo, Nupur Gupta (IIHMR University, Jaipur)
Rationale:
Patient Safety issues in Indian hospitals are least worked upon even today. According to an article in The
Telegraph dated 6th January, 2009; deaths caused by hospital staff carelessness have gone up to 60 percent.
Estimates show that in developed countries, as many as one in 10 patients is harmed while receiving hospital
care. This probability is 20 times higher in developing countries than in industrialized nations. This not only
causes physical as well as mental trauma to the patient, but also increases the patients out-of-pocket
expenditure and shakes their trust on the Indian medical services.
Objectives:
Safety and error are the two arms of an individual. With one arm, one makes the mistake and with the other,
one sets it right. This review attempts to highlight the major issues which will help in reviewing the trends,
improving the process and educating the individuals for designing and implementing policies for increasing
patient safety.
Methodology:
The study will be descriptive, based on secondary data from journals, articles and records.
Key Findings:
Atrocious issues such as lack in efforts in handing over patient information when proceeding for leave, delays
in cross-reference of critical patients, hesitation of doctors to treat critical patients or underreporting of
error in treatment due to threat of litigation, decision making and consent issues due to improper
communication between the healthcare provider and patient about operative and post-operative
complications, insensitive behaviour of hospital staff, understaffed emergencies, high workload and incomplete
information from patients (82% and 71% respectively in a study conducted by questioning hundred healthcare
workers in Delhi, 2012 ), inadequate training and skills of medical staff, unnecessary overcharging for services
apart from incorrect diagnosis , documentation and follow-ups, mixing of blood samples and blood transfusion,
administration of outdated or sub-standard drugs, Adverse Drug Events (ADEs) (8.2% in a study conducted in
the inpatient setting of the general hospitals in Delhi, 2012), over-prescribed or unnecessary medication/
investigation, wrong dietary advice, reuse of needles; along with lack of maintenance of infrastructure, safety
and security issues, delays due to equipment malfunctioning and its timely reporting, cross infections due to
unhygienic conditions and practices, are widely prevalent in public and private sectors of the Indian Healthcare
system.
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Conclusion:
Innovation and technology can save lives and improve the quality of healthcare but may introduce complexities
and risk, if used unsafely. The need of the hour is efficient management of hospital settings which includes
adopting of correctivemeasures like establishment of an Auditory body which can randomly inspect patient
safety and satisfaction determinants, security indicators, sanitation system, state of infrastructure and
equipmentsas well as ensure no violation of patients rights without compromising on the staffs dignity.
Also, transparency in regard to patients awareness about the medical procedure and its complications should
be implemented. Staff should be motivated to admit errors caused by them and government should lay
guidelines to provide compensation to the suffering patient for same.

Code - IP15A037

Delivering Innovative solutions in Maternal and Child Health through Google glass:
..... your Journey Our lens
Anudeep Aggarwal, Surbhit Gupta, MBA-HM (19), The IIHMR University, Jaipur
Introduction:
Healthy mothers and healthy children contribute to a healthy family and a healthy society. India is home to
one fifth of the worlds births while contributing to one fourth of total maternal, infants and child deaths that
occur globally. Significant number of these deaths are preventable.
Although the Government of India is committed to address maternal and child health through its increased
financed and flagship programmes, healthcare indicators show otherwise. It is because it lacks in its capacity
to cater to Indias mammoth population and its growing healthcare demands.
This provides an opportunity to private enterprises to apply all their skills to tackle the problem of women
and child health with innovative solutions, noveltransformationalbusiness models and new mindsets as
well as established methods that are already known to work.
Aims and Objectives:
The study aims at understanding Delivery of maternal and child health though the use of Google Glass in
India, make it a self sustainable healthcare delivery model, increase its penetration in the Indian Healthcare
system through partnership with government for installation of WI-FI towers which are a prime requirement
for the functionality of Google glass, training of healthcare workers for use of Google Glass so that response
times could be reduced and precious lives could be saved in a healthcare system where public spending on
health is amongst the lowest in the world.
Methodology:
Secondary data from various published case studies were analyzed. Data on different healthcare models,
performance indicators,success criteria, challenges faced by different healthcare models were collected from
different health care surveys, health care websites and journals.
Findings:
The findings reflect the key operating principles for self-sustainable healthcare delivery models which are4As (accessibility, affordability, acceptability & awareness), local engagement & skills building, Mobile tools(mobile registration, mobile health saving plan, mobile health cards), Telemedicine-Google Glass technology,
Spoke and Hub, Technology integrationand their scalability. The use of Google glass in healthcare is cost
effective as compared to the heavy investment required in traditional Telemedicine Infrastructure and
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through proper training provided to healthcare workers can work wonders in the realm of maternal and
child health.
Conclusion:
Women and child health is a unique area where compassion, altruism and economics combine in a single
cause. By saving lives, we not only do something morally right but also help build more prosperous, productive
communities.
Women and children represent more than half of the worlds population, so their well-being is a cornerstone
of human development and progress. Women who are health literate and can access the health care they
need to give birth safely and ensure their babies get a healthy start in life create the preconditions for
economic growth and prosperity.
Here is where Google Glass steps in. By various educational programmes aimed at doctors and other ground
level healthcare workers Google glass Promises the beginning of a new Era of technology which could transform
Indias Healthcare delivery system.
Code - IP15A038

Use of Herbal Products and Potential Interaction in Patients with Cardiovascular


Disease
Manali Sahu (Pharmaceutical Management) (II Year), IIHMR, e-mail: sahumanali@gmail.com
Background and Rationale:
Herbal products are marketed without proof of efficacy or safety that the Food and Drug Administration
(FDA) requires of drugs.
Complementary and alternative medical (CAM) therapies are becoming increasingly popular, yet little
information is available about the prevalence and patterns of CAM therapy use by patients with cardiovascular
disease (CVD).
Objective:
The present study was performed to investigate the potential herb drug interations pertaining to cardiovascular
diseases.
Methodology:
The literature survey was conducted by extracting secondary data and relevant information from different
review and research articles related to herb drug interactions.
Results and key findings:
Garlic has been mentioned in medicinal texts since the Ebers papyrus .

It has been used for treatment of infectious conditions because of its presumed antimicrobial and immuneenhancing properties. Garlic is thought to have cholesterol-lowering and other antiatherosclerotic and
antihypertensive effects and is used for prevention of cardiovascular disease

Grapefruit is used as a dietary intervention to lose weight and improve cardiovascular health.

In postmenopausal women taking estrogen, grapefruit juice may increase the risk of breast cancer by
inhibiting estrogen metabolism by CYP3A4 . These potential interactions should be discussed with patients
taking medications metabolized by the CYP3A4 system and they should be advised to avoid grapefruit
consumption.
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Conclusion and Recommendation:


Herbdrug interactions are especially relevant when cardiovascular medications with a narrow therapeutic
index, such as digoxin and warfarin, are co-administered with herbs that can potentiate or reduce
pharmacologic effects. Collecting such information is important, particularly in elderly patients at higher risk
of adverse interactions. Physicians should therefore have a good knowledge base about herbal remedies and
should inquire about their use, discuss adverse effects, and monitor and identify possible herbdrug
interactions. In addition, properly designed clinical trials are needed to assess the safety and efficacy of
herbal remedies, including potential interactions with concurrently used medications.

Code - IP15A039

Statistical Quality Control Chart : A Six Sigma Initiative to measure and controlquality
in healthcare operations
Ishita Srivastava, Shivani Arora (The IIHMR University, Jaipur)
Rationale:
Statistical Process Control is a methodology of statistical analysis used to discover special cause variation in
a process. A statistical quality control chart is a tool that graphically displays the control limits on process
outcomes. Attribute based c-charts are used to count bad occurrences as quality defects, attribute based p
charts are used to monitor the proportion of defects in a process that has binomial distribution as its theoretical
base and mean and range charts are used for variables that are measured continuously.
In a health care setting, quality managers can use the appropriate type of control chart to monitor the outcomes
like infections, accuracy of medications, satisfaction among patients regarding hospital services and various
others issues that hampers the smooth running of a hospital.
Currently, statistical quality control charts are being used in the measuring and controlling stage of Six Sigma.
Objectives
To construct various quality control charts viz.:

Attribute based c- chart to controlthe infection rate in I.C.U.

Attribute based p- chartto monitor the patient satisfaction level regarding delivery of services.

Variable based mean and range chartsto monitor the T.A.T. of initial assessment in Emergency
department as per NABH clause.

To analyzethe Control Chart Patternsfor variations using Run based pattern tests.

Methodology
Study type: Descriptive and Exploratory.

Sampling Method: Random sampling.

The study was conducted in a tertiary care hospital in Gurgaon. Primary data was collected through
semi-structured questionnaire and direct observations.

To create c-chart, data was collected from a sample of 50patients over a period of 12 months.

For creating p-chart, data was collected from 50 patients daily for a period of 10days.

To construct mean and range chart, data was collected from 10patients daily for 10days.
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Key Findings:
Analysis of attribute based and variable based charts revealed that the processes under study were statistically
out of control as per 3sigma limits.Run based pattern test was conducted to further investigate any anomaly
in the control charts.Quality manager of the hospital was requested to take appropriate control measures
and bring the processes under control.
Conclusion:
SPC is both a data analysis method and a process management philosophy, with important implications on
the use of data for improvement in various clinical and administrative processes, thus ensuring improved
standards of healthcare.
Control charts have found their applicability in various areas such as hospital performance infection rates,
rates of patient falls, waiting times of various sorts, rates over time in a medical context, such as mortality
rates, rates of disease, bio-vigilance such as patient identification and non-infectious hazards of transfusion,
surveillance of infectious diseases, lab turnaround, patient satisfaction scores, medication errors, emergency
service response times, post-operative lengths of stay, door-to-needle times, counts of adverse events and
many others. Thus, they act as phenomenal toolin providing an effective method to visualize data over a
specific monitoring period while considering for boundary conditions and helps to check if the corrective
action has resulted in an improved process.

Code - IP15A040

First 500 days of life-maternal malnutrition through equity lens


Kshemaa Garg, Mansi Agarwal, IIHMR University
Rationale:
Maternal malnutrition is a black spot on universal health. Albeit anindispensable part of healthcare, is still a
neglected section. Thus provision of good quality maternal nutrition is a major milestone in the road map of
UHC 2020. First 500 days,a critical time span providing a unique window of opportunity to improve the
overall maternal and child nutritional status. Imparting appropriate nutrition to women of child bearing age
and pregnant women is thebackbone to bring about a paradigm change in child mortality and malnutrition.
Improved nutrition benefits womens issues whereas undernourished mothers,prone tohigh infection result
in high fiscal costs in terms of lost national productivity. Maternal malnutrition affects rich and poor equally.
Objectives:
Quantifying maternalmalnutrition in terms of Anemia, BMI and IUGR.

Rural-urban comparisonof anemia during pregnancy.

Methodology:
Secondary data analysis of the maternal nutritional status available, has been done to obtain the following
results.
Keyfindings:
During 500 days, child is initially dependent on mother for nutrition through placenta, then via exclusive
breast feeding. Maternal nutrition status varies pan India. The 3 major problems discussed are : 1. Anemia, 2.
BMI of pregnant women, 3. IUGR
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Anemiaan easily treatable disease affects 38% pregnant women (aged 15-49 years) and results in 20 40% of
maternal deaths in India (WHO in 2011). India contributes to 50% of global maternal deaths. Anemia follows
a 2-way modality; 1) affects maternal health, causing lethargy, decreased physical capacity, fatigue and
diminished work performance, 2) affects child health by LBW, decreased iron store in newborns.
Mothers who consumed IFA for 90 days or more when they were pregnant with their last child (%) 22.3(totalNFHS 2005-06), 34.5 (in urban), 18.1 (in rural). Anemia among pregnant women(in rural) is 59%, (urban) is
54.6%, totaling to 57.9 % (IIPS NFHS 2006).
BMI-distinguished as thinness (BMI<18.5; 41% in India),short stature (39%) and over weight (BMI=25-29.9).
Under-weight causes lethargy, decreased physical activity, immunosuppression and high morbidity and
mortality, Overweight causes spinabifida infants. Short stature-due to early childhood malnutrition, poses
risks of pregnancy-related complications and decreased immunity.
IUGR- Maternal nutrition has a strong influence on perinatal outcomes including intrauterine growth
retardation as there is scanty supply of nutrients via placenta to the fetus resulting in small for gestational
age babies. IRof IUGRin India 25-30 %( UNICEF 2007). Estimated annual incidence-56% /year by 2020(WHO
2003).
Conclusion:
One of the limitation is thatin-equity has not been quantified for BMI (infeasible to assess in pregnant women),
IUGR(NFHS does not include IUGR in its survey). However since maternal nutrition holds substantial
importance, thus government too has initiated PPPs for generation of fortified nutritional supplements, backing
organizations like Sukarya, programs like national iron + initiatives which work to scale up the iron scores of
mothers, life course approach(WHO),strict following of the RDAs , NNACP.
Key words:
Maternal healthcare, nutrition, Anemia, Health Indicators.

Code - IP15A041

Drug Innovation and Patent Regime


Aditya Delu, Sneha Priya, MBA PM-07 IIHMR University, Jaipur
Background:
Pharmaceutical companies spend billions of dollars on research. It is estimated that, of every thousand drugs
molecule screened, only few of them reach clinical trials and out of which only one is actually approved for
marketing by the FDA. Pharmaceutical companies patent the drugs that they develop and thereby obtain
exclusive marketing rights. Through appropriate pricing mechanisms the shareholders are recovered the
costs of research and the profits from the patients who receive the patented drugs.
Objective:
To study about the patent process in India; to identify the differences between the patent procedure in past
and present era; to identify the need for drug innovation in the future.
Methedology:
The study involve the collection of secondary data. Which was collected from the research article and reviews
from the journals. Data was collected by both online or offline methods.
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Finding:
Internationally, drug patents are awarded for a period of 20 years, during this time, no other pharmaceutical
company is allowed to manufacture or market the same drug which is manufactured by patent holding
company. After the patent expires, other companies are allowed to manufacture and market the drug now
their brands are known as generic versions.
In the early era of 1970s, the Indian Patents Act was passed under the Indira Gandhi government which
granted greater access of medicines at affordable rates to the poor people in the country. This ACT is process
patents but not product patents and it was for 14 years.In 2005 the alteration was made to the act and then
product patent was established. India has to improve its presence in the global market. India is worlds 3rd
largest producer of generic drugs in term of volume. India is a member of the World Trade Organization. So
that it requires a new patent law to fulfil its obligations under the TRIPS.
On 2007, January 26 the Union Ministry of Chemicals and Fertilizers of India announced that it was considering
the formation of a committee which would suggest a about price negotiation system for patented drugs so
that such drugs could be easily available at an affordable price for everyone within the ambit of the National
Pharma Policy. Drugs would not be given marketing rights in India without negotiated pricing policy. The USA
allows gene patents therefore, private organizations can govern the IPR on genes that determine health and
disease. This gene patents will allow the individuals or organizations to permit or deny the permission for
other, to research or even test for these genes or diseases. So that not only the drugs but also some enzymes
and biotechnological products are patented for human welfare its also an innovative idea in the pharmaceutical
world.
Conclusion:
Government gives most of policies for research and development in pharmaceutical so that industries puts
lots of effort in drug innovation and new drugs will be developed and the patent procedure is also made so
simply for the industry.

Code - IP15A042

Blue ocean strategy : Healthcare perspective


Dr. Namita Mishra, Dr. Priyanka Shukla (MBA - HM 19th batch, IHMR University Jaipur)
Abstract / Rationale:
Created by Professor W Chan Kim and Chan Kim & Renee Mauborgne, the Blue Ocean Strategy (BOS) is a
process with frameworks & tools, covering both strategy formulation and execution. The aim of BOS is not to
out-perform the competition in your market, but to create new market space or Blue Ocean, thereby making
competition irrelevant.
Objective:
Today the health care industry is facing a cut throat competition. Layton says. Blue Ocean can give health
care the fresh water it needs today. This statement prompted us to undertake a study that provides an
analysis of the applicability and feasibility of BOS in healthcare.
Methodology:
The present research was a cross sectional survey based on a questionnaire, which was sent to the marketing
executives of different hospitals to know their strategic views and awareness regarding BOS.
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Key findings:
It was revealed that marketing executives accept that the competition of health care is ruthless and competing
in existing market space: the so called red ocean is not easy and it needs to be uncontested (BOS).
Conclusion:
Blue Ocean Strategy is an alternative approach to growing an agencys revenue. It requires a complete
commitment; upfront investment and willingness to take a risk, on the other hand it should only be implicated
after a thorough analysis of recent market trends.

Code - IP15A043

Improving Pharmacy Dispensing Performance through Time Management


Akshita Shah, Manipal Hospital, Jaipur (akshita.shah@manipalhospitals.com)
Kajol Shah, The IIHMR University, Jaipur (kajol101292@gmail.com)
Introduction:
Pharmacyisthehealthprofessionthatlinksthehealthscienceswiththechemicalsciencesanditischarged
with ensuring the safe and effective use of pharmaceutical drugs.
Outpatient pharmacy in a hospital plays an important role in patient care, as well as improving the quality of
life and health outcome by adequate and timely delivery of prescribed medications, reducing medication
related problems.
Aim:
The aim of the study is to monitor and assess the waiting time of patients in pharmacy department of hospital.
Objctive:
1. To estimate TAT (turnaround time) for pharmacy in Hospital.
2. To study the satisfaction level of patients in pharmacy.
3. To access the demand/need to improve the services at pharmacy in hospital.
Methodology:
The research approach adopted in the study is descriptive and analytical. It includes collection of information,
opinions and attitudes directly from the subject of the study through structured questionnaire. The
Methodology of study is divided into four different parts, each fulfilling a separate objective.
Findings:
The study was conducted retrospectively. Total sample of 70 OPD patients were collected for the period of 7
days. The analysis revealed that on an average a patient had to wait for 30 minutes at hospital drug store. The
causes of delay were elicited. The delay was majorly caused because of unavoidable circumstances from the
departments view as at times the emergency patients and patients of ICU (Intensive Care Unit) were given
priority over the non emergency patients. The patient load was analyzed day wise and also in different time
slots of the day.
Conclusion:
After a thorough analysis of the collected data, we hereby conclude that long waiting time for pharmacy
patients is annoying and causes inconvenience to both patient and the department. The delay if, minimized
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in the early morning hours, that can significantly reduce waiting time of patients. This will help the department
to function with optimum efficiency and provide quality care to patients.Online indenting of the medicines
can reduce errors as well as improve the efficiency and accountability of the pharmacy personnels.Seperate
counters for credit and payment purchase can reduce the long waiting time in the pharmacy department of
the hospital.

Code - IP15A044

Universal Health Care and Sustainable Healthcare Financing in India: Lessons from
German Healthcare Market
*Dr. Nidhi Nigam, *Dr. Paridhi Mehra, *Institute of Health Management Research University, Jaipur
Introduction:
WHO defines Universal Health Coverage as ensuring that all people can use promotive, preventive, curative,
rehabilitative and palliative health service of sufficient quality to be effective while also ensuring that the use
of services do not expose the user to financial hardships. To achieve UHC countries adopt various funding
models including compulsory insurance, single payer, tax based financing, social health insurance, private
insurance and community based insurance.
The German healthcare system is based on compulsory health insurance which grew out of self help friendly
societies and became a federal system in 1998 with Bismarcks RVO (Imperial Insurance Decree). In 2009 it
became mandatory for all German citizens and long term residents to have health insurance. The country
has two main types of health insurance where the citizens can enroll themselves with either a statutory
health insurance (SHI) provided by the government or private health insurance. The public health insurance
which is provided by Federal Ministry of Health comprising of 150 competing Sickness funds and constitutes
85% of the population covered under SHI. While the remaining 15% percent being covered by private and
special regimes such as scheme for soldiers. German healthcare system is recognized worldwide as providing
good quality healthcare. The total health expenditure is 11.6% of GDP. The country ranks 20th in the world
with the average life expectancy of 80.5 years. The practicing physicians per thousand population are 3.7
while practicing nurse per thousand population are 11.3. Infant mortality rate is 3.4 per thousand live births
and maternal mortality ratio is 8 per one lakh.*
India is embarking on an ambitious target of achieving UHC where every citizen would be entitled for
comprehensive health security in the country. Currently the total expenditure on healthcare is 4.1% of GDP
where only 1.3% is public funded.* The number of people covered under health insurance is abysmally low.
Learning from the successful experience of developed countries like Germany, health insurance industry in
India is growing with more and more private and community based microinsurance scheme penetrating the
Indian healthcare market. The government has started various health insurance schemes including the
Employees State Insurance Scheme (ESIS), Rashtriya Swasthya Bima Yojana (RSBY) scheme and Central
Government Health Scheme (CGHS) at the central level. At the state level, the schemes include the Rajiv
Aarogyasri (Andhra Pradesh), Yeshasvini (Karnataka), Vajpayee Arogyashri (Karnataka), Kalaignar (Tamil Nadu),
RSBY Plus (Himachal Pradesh) and the proposed Apka Swasthya Bima Yojana (Delhi).
In the Indian context, this veritable wave of health insurance represents an alternative form of mobilizing
and allocating government resources for health care. In an environment challenged by low public financing
for health, entrenched accountability issues in the public delivery system and the persistent predominance
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of out-of-pocket spending, particularly by the poor, government health insurance schemes have introduced
a new set of arrangements to govern, allocate and manage the use of public resources for health to reach
universal coverage by first covering the poor. These arrangements are promising foundations for reaching a
positive consensus on reforming Indias health finance and delivery system. Moving close to UHC is not an
unattainable dream. Momentum is building and developing countries like India are on the right path to attain
UHC.
* Healthcare Systems: Germany Based on the 2001 Civitas Report by David Green and Benedict Irvine
* Draft National Health Policy 2015 and World Health Organization Global Health Expenditure database

Code - IP15A045

A Study of Major Operations Management techniques in Healthcare Systems


Dr. Rupal Shrivastava, Dr. Usha Kiran, Batch 20th, MBA, Health & Hospital Management, IIHMR, Jaipur
Rationale:
Operations management is the design, operation, and improvement of the processes and systems that create
and deliver the organizations products and services .The goal of operations management is to more effectively
and efficiently produce and deliver the organizations products and services. Healthcare professionals have
realized that the theories, tools, and techniques of operations management, if properly applied, can enable
their own organizations to become more efficient and effective.
Objectives of the Study:
The objectives of the study are:

To introduce aspiring health care managers to themajor operations management techniques applicable
in healthcare systems.

To elucidate the concept of PERT & CPM in managing healthcare projects.

To explain Quality Management Concepts, techniques and applications for healthcare process
improvement.

To illustrate the Healthcare Supply Chain Management in Operations Management.

To explain the major innovations and contemporary approaches in Healthcare Operations Management,
like JIT, Lean & Six Sigma, NABH 4th Edition.

Methodology:
The study is descriptive and exploratory in nature. It is based on secondary data books, journals, Internet etc.
The study is descriptive as it illustrates the various OM techniques in hospitals and exploratory in natureis
exploratory as it is trying to identify the applicability of OM techniques in healthcare.
Key Findings:
PERT & CPM could be applied in managing and controlling project activities, costs, resources.
Quality Management Concepts; Six Sigma is one of the latest quality goalstrategy for errors occurring in only
3.4 times per million observations.Deployment of six sigma could be done using DMAIC or DMADV.The concept
of quality management is to transform poor health to wellness for patient through Diagnosis, Procedures
and Treatments with quality certification and awards like ISO 9000, NABH and JCI (set of standards of quality
management and quality assurance).Lean management principleconcept helps in reducing waste of money,
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time, supplies, or goodwill (e.g. Japan).JIT is an inventory management strategy aim at reducing or eliminating
inventory (i.e.goods arrive just before they are needed; best applied in expensive implants and medical devices).
Supply Chain Management encompasses the planning and management of all activities involved in sourcing
and procurement conversion, and all logistics management activities.
Conclusion:
Healthcare organizations are facing increasing pressures from consumers, industry, and governments to deliver
efficient and effective services and need to adopt these new philosophies to remain competitive.
Operations management (Scientific Management) methods called for eliminating the old rule-of-thumb by
replacing the varied methods with the best way of performing the work to improve productivity and
efficiency.

Code - IP15A046

Occupational Safety of Nurses


Know safety of nurses, for no injury to patients
Aarushi Dua, Dr. Kingshuk Kar
Rationale:
Nurses are falling ill, incurring workplace injuries, and suffering disabilities from exposure to workplace hazards.
As a result, the industry is losing critical members of the health care team, compounding to the already
existing nursing staff crisis and adversely affecting the well-being of patients. Approximately 3 million health
care workers experience exposure to blood borne viruses resulting in 80,000 Hepatitis and 200 to 5000 HIV
infections annually.Most commonly reported issues were of skin disease and 85.5% suffered musculoskeletal
disorder. 75.8% of the nurses feel occupationally unsafe which influences their decisions about this career. 1
in 17 patients die due to infection caused by nurses which proves failure to protect nurses has implications on
patient care. Nurses are exposed each day to a variety of health and safety hazards, including: Biological
Ergonomic Psycho-social Chemical and Physical. Hence, importance should be given to the people
delivering health care also so that patients will benefit from safe and quality care.
Objectives:
1. To assess nurses present knowledge regarding universal precautions
2. To identify factors affecting their compliance with the universal compliance and its subsequent effect on
quality of health care.
Methodology:
A descriptive cross sectional study was conducted through a self administered survey with a fixed cohort size
of 100 nurses in a private hospital of Jaipur. Nurses were divided according to homogeneous exposure groups
and results were recorded by face-to-face interviews using a semi-structured questionnaire.Safety concerns
were explored in three dimensions : 1. perceived safety environment; 2. workplace hazards occurrence rate
and corrections; and 3. top health and safety concerns. RCA (Root Cause Analysis) Technique was used.
Key findings:
Major reasons for non-compliance were lack of supervision 4.9%, lack of proper guidelines 14.8%, nonavailability of supply material 21.8%, heavy work load or no time 26.8%.30% of nurses in this study reported
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that they felt either somewhat safe or unsafe. Notably, 41% of the survey respondents had experienced a
work-related injury in a year, and 48% had experienced an illness.Top concerns reported by respondents (1)
acute and chronic effects of being overworked; (2) a disabling back injury; and (3) being infected with a
needle stick. 76% reported that unsafe working conditions interfered with the delivery of quality nursing
care.
Conclusion:
India is faced with the double challenge of producing more nurses as well as maintaining their professional
safety to avoid the serious risk of withdrawal of qualified nurses due to their fear of an unhealthy career. This
study proves that nurses arent solely responsible for nurse-sensitive outcomes it is lack of safety
management practices in the hospitals. Potential interventions suggested were 6-Safety Structure Framework
and Health Facility Employer. Health and safety operations that should be integrated into daily workplace
activities.
Code - IP15A047

A Study on Cost Reduction of Cathlab Procedures.


Dr. Varsha Jamakhandi, Dr. Sheeba, Dr. Ritu Chaudhary
Key words:
Catheterization laboratory, Affordability , Utilization of resources, Profitability, Consumables, Costing
Abstract:
A catheterization laboratory or cathlab is an examination room with diagnostic imaging equipment used to
visualize the arteries of the heart and the chambers of the heart and treat any stenosis or abnormality found.
Diagnostics & treatment procedures performed in cardiac catheterization laboratory are Coronary angiogram,
Percutaneous transluminal coronary angioplasty, Trans catheter arterial chemoembolization, Hickman catheter
insertion, Cerebral angiogram, Patent-Ductus-Arteriosus (PDA) closure device, Myocardial Biopsy, Inferior
vena cava filter insertion etc .Heart disease is the most common cause of the death in India.Most of the
heart disease are intervened in Cath lab. The healthcare organisations are facing financial pressure and are
using different methods to reduce the cost of the procedures to increase the affordability and utilisation of
the hospital services.
The objective of the study was to reduce the cost of Cath lab procedures , to increase the affordability and to
increase the utilization of Cath lab.
The study is descriptive by observational method in the Cath lab department of a tertiary care hospital of
Bangalore for a period of three months. In order to reduce the cost of Cath lab procedures, a sample of 75
patients who were admitted to undergo Cardiac Catheterisation were observed from the entry of the hospital
to their discharge. This study includes the costing of consumables and manpower, equipment cost,
replacement cost, maintenance cost and miscellaneous costs depending upon the time consumed for
performing procedures.
It was found that around 30% of cost can be reduced by standardising the usage of consumables and other
resources like human resources,equipment,laboratory facilities etc to different cardiac catheterisation
procedures considering the deviations(severe cases with complications) according to the time consumed to
perform procedures. By reduction in cost their would be increase in the utilisation of the services which in
return will lead to profit for the organisation and also affordable to the customers or patients.
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Code - IP15A048

The Hungry India


Aman Preet Kaur, Rahul Sharma
Introduction:
Despite being the second fastest growing economy in the world, India continues to harbour some of the
worst social sector indicators. India has the highest burden of child malnutrition in the world, with 42.7% of
children under 5 years of age (U5s) classified as underweight (low weight for age). Twenty per cent of children
under five years of age are wasted (low weight for height). The child prevalence of malnutrition in India is
twice that of Sub-Saharan Africa and more than one third of the worlds children who are wasted live in India.
A recent survey by the National Nutrition Monitoring Bureau, 2007 shows that there is a daily deficit of over
500 calories in the intakes of children in the age group of 1-3 years and about 700 calories in children in the
age group 3-6 years.
Rationale:
It is observed that the malnutrition problem in India is a concentrated phenomenon that is, a relatively small
number of states, districts, and villages account for a large share of the malnutrition burden only 5 states
and 50% of villages account for about 80% of the malnutrition burden.
Objective:
To discuss the issues and strategies for strengthening service delivery to under-five malnourished children in
India.
Methodology:
Based on secondary data
Capacity building approaches:
The Indian government has been trying to address this problem through its Integrated Child Development
Services (ICDS) program. Launched in 1975, the ICDS operates a network of daycare centers
calledanganwadisacrossthecountry.
Newer approaches to consider:

Support Small Farmers

Target Infant Nutrition

Roll Out Biotech

Conclusion:
Strengthening public health interventions for malnutrition cases among the vulnerable groups with a focus
on socioeconomic development in the country are the prerequisites required to tackle malnutrition among
under-five children in India.

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C0de - IP15A050

Khushi Baby : M-Health solution to increase immunization


Dr. Aman Preet Kaur, Ms. Doma Sherpa, Dr. Vijendra Banshiwal, Dr. Shirish Dhore
Introduction:
Vaccines have made a major contribution to public health but vaccines-preventable diseases (VPDs) are still
responsible for significant deaths of under-five children. Despite Global efforts, the coverage in two WHO
regions namely Africa and South-East Asia (SEA) still remain short of set targets for 2010. As a result, the SEA
Regional Director has declared 2012 as the Year for Intensifying Routine Immunization (RI) in the Region.
Khushi Baby isthe mHealth and wearable technologywith an NFC (Near Field communication) necklace that
digitizes data at the point of care, developed in April 2014 out of the Yale Center for Engineering and Designs
course on Appropriate Technology, Yale University for the Developing World
Rationale:
In developing nations like India, many parents arent able to keep track of their childs immunizations. Current
solutions such as hard copies of records are easily lost, and there is no centralized location to retrieve this
information. Moreover, in rural India, there is little incentive to get children immunized when it is at the price
of losing valuable hours in the workday during which parents could otherwise be earning money for the
family. These reasons compounded together ultimately mean that there are large hurdles to overcome in
order to achieve effective and systematic immunization, and by extension, overall health in society. At the
same time, the same rural population has a high growth rate of mobile phone usage. Khushi Baby seeks to
leverage this fact to solve the problem of low immunization rates in rural India.
Objective:
To assessthe impact of Novel mobile health solution for Vaccination record keeping in rural Udaipur Rajasthan
Methodology:
Primary data was collected from the 5 Blocks of Udaipur district of Rajasthan (Girwa, Badgaon, Kherwara,
Kotra & Jhadol). The study was carried out for 2 months from 28th March -29th May 2015. Total 357 respondents
of all the blocks who came for immunization camps were interviewed face to face through semi-structure
questionnaire.
Findings:
60 % (213) of the total mothers who came to immunization camps were aware about the importance of
vaccination
Conclusion:
KB system removes the need for connectivity to a central database read and update digital patient data. KB
necklace form factor acts as a visual health symbol and campaign tool for increasing health awareness. With
the use of App we collect more complete data to improve demand forecasting at the ground level.

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Code - IP15A051

Quality : Utilization of Operation Theaters


Prateek Sharma and Dr. Shaleen Vashishtha, IIHMR University
Abstract
A study was carried out at a tertiary care hospital with objective of assessment of Operation Room Time
Utilization analysis and identification of bottlenecks, if any for optimum utilization. It is essential to assess
the existing workload as well as to optimize facility functioning and patient scheduling for surgical operations.
The operation time utilization varies in different healthcare settings. Optimum utilization of the OT time has
always been a priority area for hospital administrators. It also aids in allocating reserve time for emergency
operations, asepsis measures and procedures, and provides decision making information for augmentation
or downsizing of the facility. The study revealed that the utilization though satisfactory could be further
maximized by increasing the operational timing of OT, reducing the Opportunity Cost in each OT and also
minimizing the reasons for the delay. The study identified the main bottlenecks as the non- adherence to OT
timings which is leading to opportunity lost that is resulting in cases to go prolong from the scheduled timings.
Objective:
Delay caused from patient wheel in time to incision time.
Methodology:
Study type : Observational, Duration : 30 days, Sampling type : Non-probability, Sample size : 686
Results:
Total working time of each OT-12 hrs. (21600 mins.)
OT1 Total utilization time-12769 mins, OT2 Total utilization time-3188 mins, OT3 Total utilization time11625 mins, OT4 Total utilization time- 12495 mins, OT5 Total utilization time-13536 mins, OT6 Total
utilization time-12449 mins, Vascular OT Total utilization time-9447 mins, PR-OT Total utilization time6108 mins, ESWL Room Total utilization time-185 mins, Trauma OT Total utilization time-5140 mins.
Actual Time Wasted
Total time of OT The time utilized in each OT are in OT1 = 8831, OT2 = 18412, OT3 = 9975, OT4 = 9105, OT5
= 8064, OT6 = 9151, Vascular OT = 12153, PR-OT = 15492, ESWL Room = 21415, Trauma OT = 16460
Total Cases Delayed
(wheel in time-to-incision time), As the standard time set by FOS is 30 mins. So any case which starts after 30
mins. is considered to be as a delayed case Total delayed cases calculated in the month of April 2015 are: 369
and Total no. of cases = 686. Total no. of cases delayed in % = 369/686*100 = 53.79%

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Code - IP15A052

Harnessing the Demographic Dividend The Future of Healthcare in India


Sheeba, Varidhi (IIHMR University, Jaipur, India)
Abstract:
The global healthcare sector is on the cusp of a tipping point and it is more evident in developing countries
like India, as these countries grapple within key issues such as rapidly aging population, Non-Communicable
Disease epidemics, and steady rise in healthcare cost due to raise in out of pocket expenditure
Also with 356 million 10-24 year olds, India has worlds largest Youth Bridget, despite having the smaller
population than China. India hence, would be able to see its economic soar, provided it invests healthily in
the youths education, health and protect their rights. Young people are the innovators, creators, builders
and leaders of the future. They can transform the future only if they have skills, health, decision making and
other choices in life. Thus for India to make any remarkable and sustainable progress, capacity building of the
youth i.e. the 10-24 year olds holds utmost importance.
This poster apart from highlighting the current situation of healthcare and disease burden in India, will also
explain key issues such as youth education, health promotion (in relation to Non-Communicable diseases)
and youth empowerment as sustainable measures in overall development of the country.
For addressing these, Peer Education, Health Information Centers and collaboration with CSR wings of various
educational and technical institutions have been found out to be effective approaches in the capacity building
of young people.
A cross sectional design was chosen for conducting the study in Mangolpuri Resettlement colony and Holambi
Kalan area of North-West Delhi where 214 young people of age group 10-24 years were interviewed using a
semi-structured questionnaire. Thereafter Peer education was undertaken which was seen to effect a change
at the group or societal level by modifying norms and stimulating collective action.

Code - IP15A053

Working Towards Equity; The Inclusion of Persons with Disabilities (PWDs) in HIV/
AIDS Program Interventions in India
Dr. Neha Garg, Narendra Patel
Introduction:
India has the third largest number of people living with HIV in the world. The UNAIDS has identified twelve
risk groups that are especially vulnerable and have been left behind from the national AIDS response. Of
these twelve, one is persons with disabilities. Low awareness, sexual abuse, and lack of access to health
services are the major reasons for people with disabilities being vulnerable. The National AIDS Control
Organization has completely ignored this vulnerable risk group .Disability is both a public health issue and a
human rights issue. According to Census (2011) 21.9 million population are differently abled including 10
million visually impaired people. The situation regarding the disabled and HIV and AIDS needs more attention
because they are more susceptible to contracting HIV and AIDS compared to their non-disabled peers. Disability
cannot be looked in isolation.
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Rationale / Need For The Study:


The poster seeks to address the plight of the visually impaired persons in accessing and utilizing HIV and AIDS
services in India.
Objectives:
To describe the current state of knowledge about the impact of HIV/AIDS on people living with disability
with reference to visually impaired disability.

To identify models and gaps of good HIV AIDS interventions currently in place or policy making where
people with disability are excluded from HIV/AIDS outreach efforts and service delivery.

Methodology:
Data reviewed on the basis of secondary data available on Sexually Reproductive health for persons with
disability, disability inclusive HIV/AIDS programs in India & Africa.
Findings:
Many programmes and campaigns have been set up to create awareness on how to prevent, manage and
live positively with HIV and AIDS but these programmes and campaigns however are rarely made accessible
to the visually impaired persons for instance, information is not provided in accessible formats like Braille
and large print, and they have limited or no knowledge of how to live with HIV and AIDS or how to care for
others with the disease. There are cases of illiteracy among visually impaired persons particularly in rural
settings. Lack of skills is also an impediment to health practitioners in providing HIV and AIDS services to the
visually impaired. As a result, support services are not modified to suit the needs of the visually impaired.
Additionally, the infected persons receive little support from the community due to social stigmatization
thus accelerating their immunity deficiency. In some circumstances, the vulnerability of the visually impaired
persons to HIV is exacerbated by traditional beliefs and myths which presume visually impaired persons to be
at no risk of contracting HIV and as a result they are excluded from voluntary counselling, testing and treatment
facilities.
Conclusion:
To efficiently close the gap, an integrated and disability-inclusive HIV response is needed so that people with
different types of disabilities, their caretakers, healthcare professionals and society are empowered to fight
the collective battle against HIV/AIDS.
Code - IP15A055

Quality Improvement in Healthcare Delivery Using Efficient Cold Chain Management


Praveen Batra and Sakshi Jalali (The IIHMR University, Jaipur, Rajasthan, India)
Background and Rationale:
India is a fast developing country, for it to attain the status of a developed country,the Millennium Development
Goals are required to deal with. Health care industry is growing at a tremendous pace owing to its strengthening
coverage, services and increasing expenditure by public as well private players. During 2008-20, the market
is expected to record a CAGR of 17 per cent. The total industry size is expected to touch USD160 billion by
2017 and USD280 billion by 2020.Although India is trying its best to achieve what is desired, yet there are
certain lacunae pulsating within the Health System that need to be resolved. Most prominent of which is
gaps prevailing in the current immunization programmes and addressing through effective COLD CHAIN
management.
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Key words:
Cold Chain Management, Healthcare delivery
Objective:
To find out the existing gaps prevailing in the vaccine management. To reduce the cost of health care by
channelizing cold chain management.
Methodology:
The literature survey was conducted by extracting data and relevant information from different review and
research articles related to cost on healthcare which were carried out in different hospital settings. The
databases which were searched include PUBMED, GOOGLE SCHOLAR and SCIENCEDIRECT.
Results and key findings:
One of the cross sectional study which was conducted in the UHCs reported some of the reasons for improper
cold chain management which are as follows: Absence of separate stabilizer for deep freezers and ILRs (icelined refrigerators), ill-maintained temperature-record register, lack of criss-cross pattern of ice packs in deep
freezer, presence of things other than ice packs in deep freezer and things other than vaccines in ILR .All
these factors indicate poor cold chain maintenance. In one more study which was conducted for temperature
monitoring and observing the Frequent exposure to suboptimal temperatures in vaccine cold-chain system,
it was concluded that exposure to temperatures above 8 C occurred at every level of vaccine storage, exposure
to subzero temperatures was only frequent during vaccine storage at peripheral facilities and vaccine
transportation.
Conclusion and Recommendation:
Efforts should be made in order to train the technical staff about the importance of temperature in cold
chain management so that the issue where vaccines are losing its potency could be resolved. It would ultimately
aid in reducing the health care cost. Systematic efforts are needed to improve temperature monitoring in the
cold-chain system in India.

Code - IP15A056

Quality and Safety in Healthcare


Ahana Chaudhary, Priyanka Kundrai
Rationale:
The word Healthcare incorporates the moral values of caring as well as improving the primary wealth of life
which is health. Sustenance and maintenance of health is therefore, the central point of departure in every
society, leading only towards assurance of improvement in quality and safety in the same.
Improvement in quality or more specifically improved measures of safety in the healthcare domain is the
combined efforts of healthcare professionals as well as the associated partners like, scholars in the research
fields, patients and their families and the education system in the society working towards the overall
development towards improvement.
The idea of quality assurance in healthcare and improved safety measures would unfold the need for change
in every aspect of the system in which healthcare is actually delivered. Health the most fundamental issue
in human life is to be sustained and improved. Consequently, substantial knowledge of human biology or the
scientific knowledge of the same is to be incorporated in order to spread awareness.
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Our discussion therefore focuses the drives towards the improvement of quality as well as safety in healthcare.
Objective:
The objective of the discussion is two-fold:
i)

To realize the different dimensions of healthcare and how such diverse phenomena can actually work in
the untiring attempts towards sustenance of the patients.

ii) To study and analyze the changes that would help in achieving improved health outcomes for patients,
better performance of the system of healthcare and also improved professional developments.
Methodology:
Discussion on the quality and safety in healthcare involves a two-way approach
i)

The theoretical approach towards the spreading of awareness for safety and improved quality through
education initiating the efforts towards better performance.

ii) The other is delving into the practical steps of the united efforts of each and every individual involved in
healthcare industrywhich range from the professionals to the people to whom such care is actually
catered to i.e. the patients.
Healthcare providers have increasingly looked at methods of Six Sigma because variety of factors have propelled
this movement, including the need for a more rigorous approach to ensuring quality; one that extends beyond
the quality department.
Key Findings:
Our discussion on the improvement measures in healthcare explicates the following issues:
i)

The doctor-patient or the teacher-learner relationship lies at the centre of the much wanted attempts
towards betterment.

ii) Patients can only be benefitted if the safety and quality improvement culture is embraced in education
as well as the practice of the professional healthcare units.
Conclusion:
Finally, I would like to point out that the concept of healthcare implies morality therein.The boon of life can
only be sustained through good care of health. For the purpose, medical education for healthcare professionals
ought to take care of sustenance, maintenance as well as the scope for improvement. Until and unless the
quality is assured and the scope for safety measures are taken care of, the healthcare industry can never
succeed in its noble mission of safeguarding the health of human beings.

Code - IP15A058

Application of Failure Mode and Effects Analysis (FMEA) and Root Cause Analysis
(RCA) in reducing the Patient Identification errors in a tertiary care hospital
Rachana Kashyap and Jasmeen Bawa1
Rationale:
Failure Mode and Effects Analysis (FMEA) is a prospective assessment that identifies and improves steps in a
process thereby reasonably ensuring a safe and clinically desirable outcomes. It is an operations management
technique to identify and prevent problems or errors in product or processes. Successful implementation of
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FMEA helps in improving the quality, reliability and safety in the processes of a hospital. Root Cause Analysis
(RCA)isamethodofproblemsolvingthattriestoidentifytherootcausesoffaultsorproblems.Accurate
patient identification is an important step in reducing mortality and morbidity rate in hospitals. Historically,
Accident prevention has not been a primary focus of hospital medicine. Previously, hospital systems were
not designed to prevent or absorb errors; they just reactively changed and were not proactive.
Globally it has been estimated that approximately 1.42 lakh people died in 2013 because of adverse effects
of medical treatments. Hence there is strong need to prevent medication errors and accurate patient
identification.
Objectives:
The objectives of the study are:

To apply Failure Mode Effects Analysis and Root Cause Analysis in order to reduce patient identification
errors in hospital.

To recommend strategies to reduce errors in the patient identification process.

Methodology:
The current study has been carried out in a super speciality tertiary care hospital in Patna, Bihar. The study is
descriptive, exploratory and cross sectional in nature. The data was collected from the duty doctors, nurses,
customer care staff, staff of the wards, and from the staff of radiology department. The data collection
technique was personal interview and discussions. The secondary data was collected from hospital records.
The sampling technique was judgemental and convenience method, however care was taken in selecting the
respondents. Process mapping was done during data collection. Templates of FMEA and RCA from Sigma XL
were used in the study. The data was analysed through SPSS, Excel, and Sigma XL.
Key Findings:
During FMEA analysis fifteen failure modes were identified in patient identification. In these failure modes
the maximum risk priority number (RPN) was of bed number used for the identification of patient. The
criticality i.e. severity x occurrence was also very high in the same failure mode. The second failure mode
having high RPN was the wrong X-ray film due to several potential causes. Both failure modes were considered
as vital few. RCA was carried out in identification of the causes of the failure modes.
Conclusion:
Failure Mode and Effects Analysis and Root Cause Analysis could be applied in hospitals in order to reduce
patient identification errors for improving quality of service. The process steps having high RPN should be
focussed for redesigning. In case of Root Cause Analysis, after identifying the main causes that leads to
errors, actions should be taken. The process having high criticality should be considered for intervention.

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Code - IP15A059

Are children safe on Indian roads? The Haddon matrix approach for prevention of
road traffic accidents and injuries in India
Shivika Chugh, Suchismita Mishra (The IIHMR University, Jaipur)
Abstract
Road traffic injuries have been recognized as a major global public health problem both by the World Health
Organization (WHO) and United Nations (UN) as one of the leading causes of death, disability and
hospitalization with severe loss of socio-economic costs, across the world. Road Traffic accidents are the 9th
leading cause of deaths accounting for 2.2% of the deaths globally (nearly 1.3 million people dying each
year). It is projected to be the fifth leading cause of deaths worldwide by 2030 as per the Global Status
Report on Road safety, 2013.Developing countries bear a large share of the burden, accounting for 85 percent
of annual deaths and 90 percent of the disability-adjusted life years (DALYs) lost because of road traffic injury.
India accounts for around 1.4 lakh deaths due to road crashes each year (Ministry of Road Transport and
Highways, GOI, 2013). The estimated GDP lost due to road traffic crashes in India is 3 % (2009, 10th Five year
plan).It is found to be the leading cause of death among young people, aged 1529 years. Children, pedestrians,
cyclists and older people are among the most vulnerable road users constituting half of those dying on the
worlds roads. India has one of the worst road accident records in the world, that too taking more of young
lives, particularly of school children. According to the National Crime Records Bureau, 20 children under the
age of 14 years die daily in road accidents in India. Thus, there is a pressing need to address the issue of road
safety and particularly child safety as there are no child safety laws in India. Preventive measures require a
multidisciplinary approach.The approach is based on The Haddon Matrix (1978, William Haddon Jr.) which is
a conceptual framework for understanding the origin of injury problems and for identifying multiple
countermeasures to address them. It is a 3x3 matrix in which a set of risk factors that increases a childs
susceptibility in road traffic is considered and wherein each cell offers opportunity for interventions. Our
study suggests some interventions such as use of child restraints (age appropriate child or booster seats),
standardized helmets specially designed for children, and putting school buses in a special class of vehicles
such as an ambulance. There should be enforcement of stringent child restraint law in India which already
has an evidence of effectiveness in reducing deaths by a huge number amongst children in high-income
countries.
Key words:
Road traffic injuries and deaths, Haddon matrix, Child safety, Child restraints

Code - IP15A063

Blue Ocean Strategy for Corporate Hospitals - Mobile Healthcare Services


Dr. Sonalika Singh, Vaibhav Shanker (MBA-HM-19, IIHMR University, Jaipur)
Rationale:
In India, the 21st century has marked the onset of customer centric business solutions providing hassle free,
organized and systematic delivery of products in utmost convenient manner to the consumers. Healthcare
scenario has also evolved substantially yet it has failed to include consumers residing in distant places and in
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providing a minimum basic level of healthcare. A large chunk of population is still not able to access the latest
technological advancements made in healthcare industry.
In India, particularly private sector plays an important role in the countrys healthcare segment with its share
of 68% in spending. But running a fully fledged hospital requires an enormous investment thus its viability
considerably reduces in lesser dense populated areas. The cities where running such hospitals is viable, there
is a cutthroat competition among the existing hospitals. This makes it imperative for any corporate hospital
to come out of the red ocean and include new or untouched population with minimal costing possible.
Objective:
Create and capture new demand by focusing on unaddressed groups of customers (non-customers),
with a strategic offering that creates a leap in value for both the buyers and the company.

Increase awareness among the population about the possible treatments available.

Providing services with quality and precision, addressing the need of the consumer.

Methodology:
Secondary data was extensively referred to in finding the important new age factors affecting their choice of
individuals while selecting amongst the hospitals or healthcare options. A blue ocean strategy was formed
for a new generation hospital which provides customer friendly services and achieve maximum market share.
The idea floated is to develop a network of specially designed vehicles able to provide telemedicine facilities,
blood work and immunization. Each Vehicle would be deployed in a particular Locality with a team consisting
of Medical officer, Paramedic and a driver/helper within the allocated radius from the hospital. An affiliation
will be required with local hospitals which are able to conduct lab tests which would help in reducing the
transportation costs.
Key Findings:
The Model is convenient as the elite patients get the services at their doorstep thus non value adding processes
to the patient are reduced greatly.
It provides a comprehensive platform in reaching out to the untouched population, marketing of the hospital
as well as its doctors, opportunity of creating new referral points, conduct corporate social responsibility and
building rapport & trust among its patients. .
The model would cut the competition and provides a hedge from overdependence on hospitals physical
facility. A first well executed model by a corporate will be hard to replicate, and would provide great future
opportunities and revenue.
Conclusion:
The model is sustainable and efficient in delivering both acute and preventive care. The model is beneficial to
the patients as well as the organization.

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Code - A9

Pharmacogenomics The new trend for personalized medicine


Debolina Majumdar, Biotechnology Scholar, Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur (Debolina
Majumdar, e-mail: debolina1908@gmail.com)

Dr. Vikram Kumar Yadav, Asst Professor-Pharmacology, Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur
Pharmacogenetics and pharmacogenomics are two major emerging trends in medical sciences, which influence
the success of drug development and therapeutics. In current times, though pharmacogenetic studies are
being done extensively for research, its application for drug development needs to get started on a large
scale. The major determinants of success of a new drug compound, viz safety and efficacy, have become
more predictable, with the advent of pharmacogenetic studies. There is a need felt for pharmacogenomic
studies, where the effects of multiple genes are assessed with the study of entire genome.
Pharmacogenetic studies can be used at various stages of drug development. The effect of drug target
polymorphisms on drug response can be assessed and identified. In clinical studies, pharmacogenetic tests
can be used for stratification of patients based on their genotype, which corresponds to their metabolizing
capacity. This prevents the occurrence of severe adverse drug reactions and helps in better outcome of
clinical trials. This can also reduce attrition of drug compounds. Further, the variations in drug response can
be better studied with the wider application of pharmacogenomic methods like genome wide scans, haplotype
analysis and candidate gene approaches. The cost of pharmacogenetic testing has become very low, with the
advent of newer high throughput genotyping systems. However, the cost of pharmacogenomic methods
continues to be very high. As the treatment with several drugs is being more and more pharmacogenetically
guided (e.g. warfarin and irinotecan), the FDA has laid down guidelines for pharmaceutical firms regarding
submission of pharmacogenetic data for their drug products in labelling.

Code - A1

Investigating the Patterns of Creating an Edge Over Competitors in Healthcare


Markets: A Systematic Review
Yadav Prateek, Mehta Mayuri (IIHMR Delhi)
Introduction:
Innovation distinguishes between a leader and a follower. India; a vast South Asian nation is home to a
population of close to 1.25 billion. Rural Population with an annual increase of 1% accounts for 68% of the
total population. The outreach of health facilities to such a large population is still inadequate and often
earmarked by issues of underperformance. A high performance healthcare systems with innovations to tap
the uncontested market space is needed for bridging this gap and reduce the disparities. Market leaders have
been focusing on the need to create an innovative enterprise for themselves to beat out their competitors
and increase their market share.
Purpose:
The aim of this review was to determine the common strategies used by leading market players who carved
a niche for themselves and to suggest any recommendations in healthcare industry if any.
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Methodology:
A systematic review of articles was done by using databases from websites like Pubmed, Medline, Lancet etc
in context of the purpose stated. The article also discusses diverse examples from healthcare, airlines, package
delivery and jet engines.
Findings:
Of the many potentially relevant studies identified, only few met all criteria and were included in this review.
The authors inferred that the healthcare environment is highly competitive and hospitals continue to fight
for market shares and profits. Using examples from other industries; the authors illustrated how new ideas
can provide differentiated value for customers at a low cost to companies
Conclusion:
An innovative framework is needed by healthcare managers that enables them to think out of the box and
maintain a competitive advantage and strong profitability.
Key words:
# Innovative Strategies in Health # Unique Business Ideas # Niche Markets # Blue Ocean in Healthcare

Code - A2

Exploring Blue Ocean Strategies for Health Promotion in Low and Middle Income
Countries: Learning from the Malaysian example
Kirti Kataria*, Poonam Yadav*, Rupinder Kaur*
*MPH Scholars, Post Graduate Institute of Medical Education and Research, Chandigarh

Rationale:
The concept of Blue Ocean Strategy has been proved as a successful model in distinct fields. However, its
application in the health sector is yet to be explored to optimum level. The study tries to explain the possibilities
that various blue ocean strategies may have for health promotion activities in low and middle income countries.
Objectives:
1. To study the concept and methodology of Blue Ocean Strategy.
2. To study the Malaysian Governments National Blue Ocean Strategy(NBOS) initiatives in health sector
and their impact
3. To explore the possibilities of implementing blue ocean strategies for health promotion in India on the
analogy of Malaysias NBOS
Methodology:
We studied the concept of Blue Ocean Strategy, the National Blue Ocean Strategy Initiatives by the Malaysian
government and the current gaps in health promotion in India which can be addressed by implementing such
strategies.
Key Findings:
The Malaysian Government had introduced the National Blue Ocean Strategy in various sectors. Their initiative
in healthcare, the 1 Malaysia Family Care, has delivered quality services to the elderly, persons with disabilities
and single mothers in the country. Its inter-sectoral approach uses cost effective measures to provide screening,
consultation and referral (if required) along with quality treatment services. The programme functions by
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tying up with NGOs and roping in volunteers to facilitate the implementation. Apart from health benefits, the
strategy aims to provide them financial and emotional support in a family like environment.
Conclusion:
The scope for blue ocean strategies to be adopted in health sector is enormous. Drawing example from the
analogy of Malaysia, Indian health sector can tap this unexplored potential. There are several sections of the
society like elderly and persons with disabilities in India which such blue ocean strategies can target. The
study provides the evidence to policymakers of low and middle income countries that such strategies if
implemented well can reduce the burden of the health sector in a cost effective way.

Code - B5

Universal Health Coverage for India


Dr. Mrinalini Dixit, Dr. Isha Porwal, Dr. Karishma Tanwar (Student of PGDHM IInd year IIHMR Delhi)
Introduction:
Healthcare in India is in a state of enormous transition: increased income and health consciousness among
the majority of the classes, price liberalization, reduction in bureaucracy, and the introduction of private
healthcare financing drive the change.
India has Health expenditure is largely out of pocket (67%) and Public expenditure on Health 1.2%
Only about one fourth of the population is covered by some form of health insurance Lack of an efficient and
accountable public health sector has led to the burgeoning of a highly variable private sector
Universal coverage (UC), or universal health coverage (UHC), is defined as ensuring that all people have
access to needed promotive, preventive, curative and rehabilitative health services, of sufficient quality to
be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
(WHO)
Rationale:
India is vast country of having 2.4% of world geographical area with 16% of worlds population to carry.
Assuring a Health to its populates is prime importance of the country as its also said in constitution of free
India raising the level of nutrition and the standard of living of its people and the improvement of public
health as among its primary duties. Health can be insured to the countrymen by the security that they are
covered at the time of need of services for health. Health insurance, which remains highly underdeveloped
and less significant segment of the product portfolios, is now emerging as a tool to manage financial needs of
people to seek health services. 75% of population is without any health insurance.
Objective:
1. To increase the coverage of health insurance
2. To reduce OOP of the country that is a major hindrance in economic development and social growth
Methodology:
Emphasis on preventive and promotive actions for health by regular counselling with collaboration of private
hospitals. Recognize and promote community health insurance which cater to different community and
understand their needs. Direct CSR activity toward insurance coverage of the marginalised population.
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Key Finding:
Prevent individual member inform bearing the financial burden of hospitalization

Encouraging the participation by the community in their own health care

Improvement in access to health care.

Conclusion:
Through the universal health insurance coverage will help India for prevention of diseases and promotion of
good health through cross sectorial action, Developing human resources for social and economic development,
Encouraging medical pluralism, Building the knowledge base required for better health and Financial protection
strategies.

Code - IP15A032

Pharmaceutical multinational corporations diversification towardsGeneric: Indian


scenario
Naresh Mali, Neha Bala (The IIHMR University, Jaipur)
Background:
The world pharmaceutical market has undergone fast, unprecedented, tremendous and complex changes in
the last several years. The pharmaceutical industry is today still one of the most inventive, innovative and
lucrative industry. Pharmaceutical industry has been changing profoundly in the last decade. Intensive
globalization, increased competitiveness and the fight for global market shares create new challenges for
pharmaceutical companies. From last few decades Multinational corporations (MNCs) like Pfizer,AstraZeneca
etc. their primary focus was on drug innovation and research and development sector.
Objective:
The objective of present study was to describe the pharmaceutical MNCs diversification towards generic
medicines that leads to reduction in healthcare cost.
Discussion:
The Multinational corporations (MNCs) in the global pharmaceutical industry have been reporting sluggish
growth over the last few years, being held back by several factors including implementation of cost containment
measures in developed countries, lack of strong product pipelines, expiry of patents on existing products (by
2020 around $200 bn), and increased investments into R&D. On the whole, all these factors are expected to
restrict the annualized growth rate of the pharma MNCs, This situation has led to pharma MNCs shifting from
the traditional model of focusing on patented products to Branded Generics. The growing use of generic and
branded generics drugs has led to pharm companies reorganizing their strategies by focusing on the generic
and branded generics business in developed as well as developing countries for higher growth. The emerging
markets are expected to reach a size of US$ 400 billion by 2020. India has become one of the strategic
markets for the pharma MNCs. As result Pharma MNCs are currently launching branded generics in the
Indian market via product localization, a strategies including: better quality, innovation, differentiation,
diversification, cost cutting measures, strategic alliances, joint venture, mergers and acquisitions.With the
special significance increasing on new product launches and geographical expansion, the pharma MNCs
operating in India have been scaling up their field force to attain their strategic goals. Few of the pharma
MNCs have also outsourced their sales and marketing functions in remote rural areas to third parties, given
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that it is not cost effective for them to have their own field force in such locations. The expenses made by
pharma MNCs on promotional& marketing strategy have also increased, with the result that the operating
margins of the pharma MNCs operating in India have shrunk, although they are still largely within the range
of comfort.
Conclusion:
Enforcement of Drug Price Control Order is the biggest steps taken by the government to ensure availability
and affordability of quality drugs for the masses.With the pressure of increasing healthcare costs serving to
drive up volumes in the generics business across markets, this segment is becoming increasingly relevant for
all players in the industry, including the large innovator companies. In this context, markets like India are
especially attractive, given their potential for higher growth.

Code - IP15A027

Portable E Health Record Systems : An initiative to Increase Access and Availability


of Healthcare in rural India
Lovina Mulchandani, Pritam Singh (The IIHMR University, Jaipur)
Introduction:
Portable E-Health record systems are user-friendly, mobile health-data collection system using wireless devices
(Tablet-PC and Smart phones) that interface with an Android application.These android-based applications
can be used to support minimally trained, non-clinical health workers (ASHAS and ANMs) to record all the
information regarding child and maternal health.
Rationale:
Health data collection poses unique challenges in rural areas of India. Traditionally in India, Child and Maternal
health records have been paper based and are manually maintained by ASHA & ANMs .The quality of child
and maternal health depends on many factors, including error free and timely availability of a childs medical
information and with traditional system it is difficult.
Technological innovation could be one of the options to improve the equitable quality of services by addressing
multiple bottlenecks faced by the frontline functionaries. By the use of Portable E-Health record systems
execution of policies for child and maternal health become easier and affordable.
According to TRAI the total numbers of mobile phone subscribers have reached 980.81 million as of June
2015 of which 417.85 are rural users, this shows opportunity for portable systems as this system send
information via SMS and also need mobile network to store information to a centralized system.
Objectives:
To enable ANM and Frontline functionaries to deliver lifesaving services with quality and improve
Effectiveness.

To provide improved Interactive Client Centric Communication to facilitate actions at the community
and Family Level.

Methodology:
This model is proposed based on Janswasthya which is an android-based application developed for National
Health Mission Rajasthan, by an innovation hub set up at State Institute of Health and Family Welfare (SIHFW)
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with the technical support of UNICEF, Rajasthan, which has transformed the functioning as well as thoughts
of the ANMs from number to quality.
This was initiated with 15 ASHAs in one of the most deprived district called Barmer and then advocated with
the partners and district administration of various districts. This pilot intervention is running successfully in
Dungarpur, Pali, Jhalawar and now nearly 400 ANMs are using it across Rajasthan.
Conclusion:
This innovation will take the public health care delivery at a different level of quality and access as it has the
power to the reach the unreached area. This will certainly contribute in bending the curve of Neonatal, Child
and Maternal mortality and morbidity and lead to development.

Code - IP15A028

Health Challenges Faced By Urban Poor In Indian Cities


Dr. Sowjanya VD, Dr. Priyanka Baghel
Introduction:
One of the prime concerns of the 21st century is the burgeoning rural to urban migration in the metropolitan
cities of developing countries. High wages and labour demand attract rural populations towards cities and
they end up living in low cost, disease-ridden areas. The health of urban poor is significantly worse compared
to the rest of urban population.
This paper analyzes the intricacies of the health of urban poor in India. It also outlines the challenges in
improving health outcomes of urban poor and provides operational solutions to address such challenges.
All cities having low Standard of Living Index (SLI) has been considered as URBAN POOR. The planning
commission has setup the bracket for urban poor as Rs. 4824 per month.
Rationale:
Urban population of India has increased from 286 million to 377 million from 2001 to 2011. As of 2011, 76.6
million are estimated to be living in slums of urban areas. If urbanisation continues at present rate, 46% of
population would be living in urban area by 2030.
Objectives:
1. To study the reasons behind the lack of accessibility of health services.
2. To discuss on ways to improve health and health care services for urban poor.
Methodology:
The study is done through review of literatures published in the last ten years relating to urban cities in India.
Keywords like (health of urban poor) AND India were searched in online databases like PubMed and Google
Scholar. The articles having contemporary issues related to health of urban poor were filtered and suggestions
for the same are developed.
Key Findings:
The access to health services are unsatisfactory for the urban poor and the reasons may be rapid growth of
population which render the health infrastructure inadequate, ineffective outreach, social exclusion, lack of
information and assistance, weak referral system and lack of economic resources.
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Since slums are usually illegal areas, local government tend not to acknowledge their existence except when
they are demolishing them and no money is invested in country on MAPPING. For instance in Agra only 215
slums are officially declared and there is no account of 718 unlisted slums.
Suggestions:
After literature suggestions review, the article has come with likeCommunity based institutions like MAHILA
AAROGYA SAMITI and ROGI KALYAN SAMITIS should be encouraged. Public Private Partnership should be
increased. Relationship with NGOs can rapidly expand health services to underdeveloped slums.Innovation
of urban health programmes, Policy advocacy, focus on policy implementation should be developed.
Conclusion:
By this we can conclude that the inhabitants of slums are unable to get subsidised health care. Women
health is especially neglected. 1 million Indian children are born in slums every year with little or no medical
assistance. So, we should achieve the goal of universal health services to all urban population that should
ensure free, high quality geographically and socially accessible, respectful and comprehensive health care to
the target population.

Code - IP15A001

S4 (Sab ka Saath, Sab ka Swasthya) - A model on delivering of primary healthcare


services for BPL category in India
Vikash Kumar (IIHMR University, Jaipur) e-mail : vikashnav104@gmail.com
Kumari Swati Sinha (IIHMR, Delhi) e-mail : swatibank14@gmail.com
Introduction:
Internationally an income of less than $1.25 per day per head of purchasing power parity is in extreme poor.
In India there are 269.8 million total population are of poor families which government have considered
them under Below Poverty Line .According to Tendulkar committee for 2011-2012 the poverty line was
Rs.816 in rural areas and Rs.1000 in urban areas as their per capital expenditure. Indias economic growth is
bringing with it an expected health transition, in terms of shifting demographics, socio-economic
transformations and changes in disease patterns- with increasing degenerative and lifestyle diseases and
altered health care behaviour .The public health care system is big deal for the poor section of the society.
Even the essential primary health services which is based on scientifically sound and socially accepted methods
and technology is very far behind for the poor section of the society unless they not rush for private health
care.
Rationale:
More than 80% of health expenditure is done by individual household and only 3% of population mainly
benefited from several health insurance. India spent just more than 1% of GDP on public health care. The
weaker section makes compromises depending on the situation either with cost, quality or dignity. There
huge burden on public tertiary care hospitals in our country because there is lack at Primary health care
service facility. At the tertiary level people face both burden of disability as well economically.
Objectives
To cater the maximum poorer population for primary health care.
To reduce the cost of healthcare and financial burden on BPL families in India.
To minimize the gap between primary healthcare services provider and service delivery.
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Methodology:
Data was developed from the reviewed information extracted from the contribution of different articles and
then it was analysed and synthesized into the current article.
Action Plan:
Initially this is for primary healthcare services which consist of preventive services which will launch in tier3
cities of India. Under this model seven scopes of speciality health services through preventive and curative
care will be given. Firstly one time amount of rupees 500 for each person for six month coverage and copayments structure of rupees 10 for each and every individual visit. Through the private partnership the
health infrastructure and services will be given by private local or particular renowned clinical doctors of
those cities. For sustainable business this model has three channels of revenue generation as well dispersion.
First one each doctor will paid per patient consultation charge, secondly we have our own generic medicine
shop or outlet in the city lastly the partnership with diagnostic and screening centre which will provide
affordable subsidized rate rather than market value. The model has its own call centre by which patient can
give details and ask about their health problems .Then after according the patient need, the patient get their
prior appointment. The whole concept of this health services is to reach maximum number of selected people
groups. At time of launching this model, the masses will sensitize by various channels of communication and
from future prospect the model having expansion plan to increase in services and financing partners.
Key words:
Primary Heath Care, BPL, Health Coverage, Affordability, Availability.

Code - IP15A002

Need of Public Private Partnership in Universal Health Coverage


Verma Mohit*, Mahanta Banoj, Khan Md Ataullah (IIHMR University, Jaipur, Rajasthan)
Introduction:
India is embarking on an ambitious target of achieving Universal HealthCoverage for all during 12th five year
plan. Everybody will be entitled for comprehensivehealth security in the country. It will be obligatory on the
part of the State to provide adequatefood, appropriate medical care, safe drinking water, proper sanitation,
education and healthrelated information for good health. Universal Health Coverage (UHC) was constituted
by the Planning Commission of India in October 2010, with the mandate of developing aframework for
providing easily accessible and affordable health care to all Indians. Whilefinancial protection was the principal
objective of this initiative, it was recognised that thedelivery of UHC also requires the availability of adequate
healthcare infrastructure, skilledhealth workforce and access to affordable drugs and technologies.
Rationale:
Indias Public health system is patchy with underfunded and overcrowdedhospitals and inadequate rural
coverage. Reduce funding by the government has beenattributed failure on the part of MOHFW to spend its
allocate budget fully. Lack ofinfrastructure, innovations can also be attributed to the failure of public health
system. It iswell known that the government is not able to cope up with demand of the healthcareservices.
Given respective strengths and weaknesses, neither the public sector nor privatesector alone is in the best
interest of the health system. 80% of expenses from Out-of-Pocket,Debilitating Effects on the Poor. Concern
towards unbridled commercial behaviour of theprivate sector. There is a big need of the private sector which
is doing really well incomparison to the public sector to fill the gap.
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Methodology:
Secondary Data review from different articles and Papers.Benefits -Contracting Management of Super
speciality hospitals, Community Health Centres,Primary Health Centres. Free services like diagnosis, treatment,
drugs, 40% beds for poorpatients and free OPD services to poor. Except selected surgeries all the surgeries
are free forpoor. Institutional deliveries through private obstetricians, primarily for women from poorfamily.
Strengthens Yeshashwini co-operative farmers healthcare scheme. Contractingmanagement of CT Scan/ MRI
Diagnostics which is free for all poor and subsidized rate forothers. Clinical and Radio diagnostics through
health camps, Lab tests free to all BelowPoverty Line cardholders. Mobile health care units.
Conclusion:
By implementing UHC with its unique reach and scope of healthcare delivery,India stands to gain the political
goodwill and support of 1.2 billion potential beneficiaries.The provision of free healthcare and medicines for
both in-patient as well as out-patient carethrough financial protection, can be expected to significantly reduce
or reverse the highprivate out of pocket spending. A healthy population in turn can contribute to
economicgrowth through increased productivity and higher earnings. There are other benefits as
well.Promoting health equity also contributes to increased social cohesion and empowerment andby joining
the global movement towards UHC India now has both the capacity andopportunity to emerge as leading
force for equitable healthcare of all.
Key words:
UHC (Universal Health Coverage), Yeshashwini co-operative farmers

Code - IP15A003

Hospital Acquired Infection : Measuring its impact on Increase Average Length of


Stay and Cost of Care
Shiva Agrawal (MBA HM, The IIHMR University, Jaipur), e-mail: drshivaagrawal@gmail.com
Introduction:
Healthcare-acquired infections (HAIs) are social and economic burden to both the patients and the healthcare
industry. Patients in health care institutions across the country as well as globally acquire healthcare associated
infection that results in increase average length of stays as well as economic burden. Such infection can cause
patients great discomfort and adversely impact the overall quality and cost of health care.
Objective:
To analysis the impact of HAI incidence rate and the increase economic burden to the hospital and the
patients.
Study Method:
It is a retrospective study based on secondary data analysis. Systemic Literature review was done on studies
based on HAI in healthcare with special focus on developing countries like India.
Data Analysis:
Urinary tract infection occurred in 3%, wound infection in 1.7% and multiple infections in 0.6% of all patients.
Urinary tract infection prolonged the average hospital stay by an average of 5.1 days, wound infection by
12.9 days, post-operative fever by 8.0 days and multiple infections by l8.0 days as compared to the uninfected
patients. During their stay in hospital, 13% of patients with a hospital acquired infection died, compared with
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2% who did not acquire infection in hospital. Surgical site infections are most frequent in developing countries,
with incidence rates from 1.2 to 23.6 per 100 surgeries. The cost was higher for the hospital as well as for
patients due to HAIs. Antimicrobial drugs formed a major part of the extra cost due to HAIs which is five time
higher as compare to non infected patient. Ventricular Associated Pneumonia ranked first with respect to the
economic burden.
Conclusion:
HAI lead to functional disability and emotional stress to the patient that reduce the quality of life. Prolong
stay not only increase the direct cost to the patient as well as the indirect cost due to loss of work. HAI add to
the imbalance the recourse allocation between primary and secondary health care by diverting scarce fund
to the management of potentially preventable condition.
Key word:
Hospital acquire infection (HAI), Average Length of Stay (ALOS), Cost

Code - IP15A004

Replacing Out of order Medical Equipment? Mobile Mechanics : A cost-effective


and feasible option
Diwanshu Sharma and Dr. Sushma R. Pathak (IIHMR University, Jaipur)
Emergence of Idea:
The secretary general of the United Nations stated that70% of essential medical equipment is non-functioning
in the developing world1. The data also suggested that 40% of all medical equipment is out of service in low
and middle income countries including India1. The health impact of this vast sea of dilapidated equipment is
unknown.
Rationale:
The major concern arises from the fact that with 14.4 million hospital beds in India, 8.6 million beds
(approximately 60%) are in public health sector attracting a fair degree of basic biomedical equipment
intensity2. A non-functional status of these equipments can actually make the bed strength redundant and
affects the health statistics.
Objectives:
To estimate the cost of idle equipments at various SCs/PHCs/CHCs of Jaipur District.

To compare the cost effectiveness of replacing old with new equipments.

To determine the operational feasibility of deploying Medical Mobile Mechanics at grass root level.

Methodology:
The study involved research approach with both primary and secondary data to find out the possibilities of
improving the conditions of basic medical equipments with the help of Medical Mobile Mechanics. For this,
a pilot study had been conducted at 15 SCs/PHCs/CHCs of Jaipur District. A multi-stage sample design was
adopted with simple random technique. A questionnaire was prepared and dependent and independent
variables were selected. From this, comparison of costs of idle equipments was estimated with the audit
results and operational feasibility of Mobile Mechanic was determined.

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Key Findings:
In non-functional infrastructure, 4 criteria were selected i.e. Basic Equipments of CHCs/PHCs, Labour
room/OT Equipments, Laboratory & Diagnostics Equipments and I.T and additional areas.

The estimate of idle equipments was calculated. The equipments worth Rupees 20 Lacs were found idle
in pilot study.

Repairing of these equipments would cost 60% less than the cost of replacing them with the newer ones.

Deployment of Mobile Mechanics in accordance with Hub and Spoke Model- - would be a feasible
solution.

Conclusion:
In rural India, due to shortage of skilled mechanics, delay in treatment occurs even for even minor procedures
like B.P. measurement, Blood sugar etc. For this, we can create Medical Mobile Mechanics for the
maintenance and repair of such medical equipments. This grass root level solution will save both time and
money. It will strengthen internal capacity, infrastructure, avoid brain drain and provide job opportunities.
Key words:
Medical Mobile Mechanics, Grass root level, Hub and Spoke Model, Cost-effectiveness, Operational feasibility.
Code - IP15A005

Is Rashtriya Swasthya Bima Yojana Indias plausible approach of financing


healthcare for BPL families
Banoj Kumar Mahanta, Mohit Verma (IIHMR University, Jaipur)
Introduction:
In 2008, Indias Labour Ministry launched a hospital insurance scheme called Rashtriya Swasthya Bima Yojana
(RSBY) covering Below Poverty Line (BPL) households having five members, now it has been transferred to
Ministry of Health and Family welfare (MOHFW). RSBY is implemented through insurance companies;
premiums are subsidized by Union and States governments (75: 25%).
Rationale:
For people living below poverty line, an illness not only represents a permanent threat to theirincome earning
capacity, in many cases it could result in the family falling into a debt trap. When the need to get the treatment
arises for poor families they often ignore it because of lack of resources, fearing wage loss, or wait till the last
moment when its too late. Even if they do decide to get the desired health care it consumes their savings,
forces them to sell their assets and property or cut other important spending like childrens education.
Alternatively they have to take on huge debts. Ignoring the treatment may lead to unnecessary suffering and
death while selling property or taking debts may end a familys hope of ever escaping poverty. These tragic
outcomes can be avoided through a health insurance which shares the risk of a major health shock across
many households by pooling them together. A well designed and implemented health insurance may both
increase access to healthcare and may even improve its quality over time. As the enrolment for RSBY increases,
the amount of insurance premium to be paid for the BPL families will also be increasing for the government.
Therefore it is needed to ensure proper funding for the RSBY program by the GOI (Government of India).
Objective:
The aim of the study is to get the current status of RSBY enrolment and to assess whether thecurrent funding
for RSBY program by GOI is suitable to pay all the insurance premium of enrolled families.
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Methodology:
Secondary Data review from different articles and data from RSBY of GOI. Numbers of BPL are obtained from
data of Planning Commission of India. District-specific premiums are weighted to obtain national average
premiums. Using the BPL estimates and national premiums, we calculated overall expected costs of full rollout of the RSBY per annum, and compared it to Union government budget allocations.
Results:
By March 31, 2015, RSBY enrolled about 50 per cent of the number of BPL households. Theaverage national
weighted premium was 530 per household per year in 2015. The expected cost of premium to the union
government of enrolling the entire BPL population in financial year (FY) 2015-16 would be approximately 19
billion representing about 0.08 per cent of the total unionhealth budget. The RSBY budget allocation for FY
2015-16 is only about 0.005 per cent of thetotal union budget, sufficient to pay premiums of only 7 per cent
of the BPL households enrolled by March 31, 2015.
Interpretation & Conclusions:
RSBY could be the platform for universal health insurance when the budget allocation will match the required
funds for maintenance and expansion of the scheme and the scheme would ensure that beneficiaries rights
are legally anchored.
Key words:
Below-poverty-line, Health insurance, Healthcare, India, RSBY, GOI (Government of India), MOHFW.

Code - IP15A006

Home Care : Patient care model of the future


Gunjan Gulia and Harsheen Sethi, IIHMR University
Background:
The concept of delivery of medical care is changing, and the paradigm is now shifting to provide the needed
care in a better way in non-hospitalized settings. This includes providing Healthcare in the comfort of patients
home.
In the coming years we will see an exponential increase in the number of people with disabling chronic
health problems; a concomitant decrease in number of available caregivers; diminishment in the resources
in hand that support health care, especially under commercial and government health insurance and an
inevitable increase in stress on caregivers in the family. This can be ascertained to the pool of young population
(demographic dividend) today, which will contribute to the old aged population (around 18 percent) in 2050.
As per a recent publication of population reference bureau, the aging of Indias population will lead to increases
inthepreva-lenceofchronicconditionssuchasdiabetesandhyperten-sion.Byonemeasure,nearlyonehalf (45 percent) of Indias disease burden is projected to be borne by older adults in 2030, when the population
age groups with high levels of chronic conditions will represent a much greater share of the total population.
Early results from the pilot phase of the Longitudinal Aging Study in India illustrate the health risks faced by
older Indians. Thirteen percent of older Indians sampled had some type of disability that affects at least one
activity of daily living.

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Rationale:
The upcoming trend in healthcare points to the the provision of home based health care especially catering
the elderly population in India, which very soon would form a major chunk of population(18% by 2050).
Therefore, to identify the need and advantages of home care to hospital care lays the core foundation of
carrying out this study. Since not much has been dealt with this issue, there is a need to assess the pros and
cons of applying this strategy on national level.
Objectives:
1. To identify the need for home care in india for old age patients.
2. To identify the advantages of home care to hospital care.
Methodology:
The findings of the paper are based on literature review and internet research of journal reports and relevant
organizations working in the area of elderly care.
Discussion:
Hospital at Home allows patients to opt the option of receiving hospital care at home. Patients, particularly
older ones, are more vulnerable to infections and complications like bed sores in the hospital, and are actually
safer at home, as per experts. Moreover studies have reported that treatment of acutely ill older adult patients
diagnosed with chronic conditions such as coronary heart disease, cancer, chronic respiratory diseases and
diabetes has many benefits at home rather than in a hospital. Next important fact to be considered is the
reduced costs, shorter duration of hospital-equivalent treatment, fewer procedures, reduced geriatric
complications, improved activities of daily living, and better patient and caregiver satisfaction.

Code - IP15A007

Health Care : Reducing Cost Burden not Quality


Apurva Kashyap, Garima Kalra (The IIHMR University, Jaipur)
Rationale:
Rising health care cost is a curse for any nation. Especially in current scenario where evident epidemiological
and demographic transition is seen. The increase in health care spending is narrowing other priorities of a
common man like savings for childrens education, or savings for their own retirement. The health care
providers are under the burden of financing health care needs of growing and ageing population mostly
suffering from chronic diseases which require long term treatment for increasing life sustainability. Some of
the biggest reasons for this ever increasing cost of health care over the last few decades are advancements in
medical technology, invention of new drugs, unnecessary interventions for common diseases, people receiving
more medical care than required, and also the administrative costs of running a multi-speciality hospital. In
the battle of reducing cost for health care, quality of health care cannot be compromised. Indeed, the need
of the hour is to decrease the cost of medical care and side by side putting in more efforts to increase the
quality of healthcare.
Methodology:
Various methods are being suggested to attain the objectives of reducing cost burden and increasing the
quality of health care like reduction of never events, supply chain improvements, delay in expansion of hospital,
reducing length of stay in a hospital, reducing unnecessary testing, palliative hospital care, increased use of
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inexpensive services, greater attention to prevention and wellness, staff replacement, decrease avoidable
hospital readmission.
Conclusion:
One thing is very obvious and certain that more spending can never translate into better functioning health
care system. Increasing health care expense is now an important issue and a lot of activities are already being
undertaken in public and private sectors to obtain better value for money.
Key words:
Epidemiological transition, demographic transition, never events.
Code - IP15A009

Integrated m-Health strategies to achieve UHC


Meenakshi Agrawal, Kalpana Bindal (IIHMR University, Jaipur)
Background:
The goals of universal health coverage (UHC) are shaping the global health agenda (1&2), emphasizing that
all people, irrespective of socioeconomic status, should have access to health services they need, without
incurring financial hardship. Mobile health (mHealth) describes the use of portable electronic devices with
software applications to provide health services and manage patient information. The ability of even simple
phones to connect to complex digital systems is proving transformative and provides opportunities for mobile
technologies to play a formal role in health services. As health program implementers struggle to scale up
and integrate public health interventions of known efficacy (such as vaccines, micronutrients, and skilled
birth attendance), strategies leveraging mobile wireless technologiesm-Healthare increasingly part of a
systems-thinking approach to resolving these challenges. M-Health can also support the performance of
health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly
in underserved rural locations in low- and middle-income countries.
Rationale:
In 1978, Tanahashi proposed a cascading model to illustrate how health systems lose performance because
of bottlenecks at successive levels, each dependent on the previous layer. Mainly because of gaps in
information, training, quality, and equitable distribution contribute to accumulated losses of potential, leading
to diminished health system performance. Previously m-health was viewed not a direct way of providing
health services but a strategy to overcome the obstinate barrier in health care delivery process, But modified
Tanashahi approach illustrate how integrated m-Health systems solutions can be leveraged to improve existing
implementation plans and reduce health service bottlenecks, to realize improvements in the quality, cost,
and coverage drivers necessary for UHC.
Methodology:
Systematic review of m-Health initiatives were examined using information from peer-reviewed journals,
websites, and key reports. We examined how m- healthstrategies could be used to close UHC determinant
performance gaps also for education and awareness, data access, and strengthening health information
systemsin context of developing countries like India. Type of data reviewed is qualitative data.
Key Findings:
To reduce barriers to accessing services, m-Health strategies use behaviour change communication content
for client health engagement and mechanisms for remote diagnosis and management of illness. Tools include
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phone apps for client self-management; hotline and interactive voice response (IVR) based approaches
that facilitate client-initiated, structured information content retrieval; and access to counselling, diagnostics,
and referral mechanisms.
Conclusion:
For m-Health strategies to be recognized as integral to the achievement of UHC, the field needs to invest
intellectual and financial resources to move beyond vertical solutions addressing single problems. Horizontal
solutions are seldom easy to develop or adopt, especially in the public sector, but guiding frameworks such
as this one can help governments set realistic expectations and prioritize investments across critical health
system layers. Modified Tanahashi model facilitates a systematic approach toward constructing integrated
m-Health strategies that together address multiple gaps in the pathway to UHC, improving performance in
the quality, cost, and coverage necessary to provide care to all in need.

Code - IP15A010

Telemedicine : A Revolutionary Approach for Effective Diabetes Management in Rural


Setup
Dr. Bhavana Methwani, The IIHMR University, Jaipur, e-mail: bhavanamethwani24@gmail.com
Background and Rationale:
According to the recent Indian Council of Medical Researchs India Diabetes study, an estimated 62.4 million
people in India have diabetes. With increasing urbanization and industrialization, we can only expect this
number to grow. Moreover, all diabetes efforts in India are currently focused in urban areas, while 68% of
Indias population lives in rural locations. Diabetes care is not presently available, accessible, or affordable to
people living in rural areas in developing countries, such as India. Patients have to travel hundreds of miles to
meet a specialist and wait for an appointment.
Objective:
The objective of the present study was to investigate and suggest a model with the use of telemedicine in
addressing the problem of diabetes in the rural setup and how telemedicine can provide accessibility at low
cost to the rural population.
Methodology:
The literature survey was conducted by extracting secondary data and relevant information from different
review and research articles related to the use of telemedicine in diabetes care in rural India
Results and Key Findings:
The present study shows that how using telemedicine as a technology it has made a great impact terms of
mass screening for diabetes, increased awareness of diabetes, prevention at various levels, improved HbA1c
levels, and provision of health care for various complications of diabetes.The model uses a combination of
innovative tools such as telemedicine in addition to using locally available talent and personnel, thus providing
employment to local people
Conclusion and Recommendation:
This paper concludes that if the existing facilities which are available in the rural setup are effectively
amalgamated with this model then they can deliver effective prevention and control of the silent killer
diabetes.
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Code - IP15A012

A Descriptive Study on Consumer Protection Act (CPA) & Medical Negligence In


Hospitals
Parul V Gargi, Roopali Raghav
Introduction:
The missing ingredient in the development of new therapies is the voice of patients. - Anonymous.
The noblest of all relationship is the relationship of a doctor and a patient, which is based on trust and
confidence. Today in this era of commercialization and globalization in all spheres of life the medical profession
has been left to no exception. In India healthcare industry is growing at the rate of 14% and delivering care
having both positive and negative impacts. As a result, it was increasingly felt that medical treatment should
be made answerable; therefore, doctors were covered by various laws (ViswanathanVN, 2008). In India the
CPA, 1986 was enacted for better protection of the interests of consumer grievances. It was on 13th November,
1985 that the honorable Supreme Court of India delivered judgement on application of CPA, 1986 to the
medical/ dental profession, hospitals, dispensaries, nursing homes and other related services. The law is not
made to punish all health professionals that cause injury to patients; it is concerned only with negligence
acts. Medical negligence arises from an act or omission by a medical/dental practitioner, which no reasonablycompetent an careful practitioner would have committed. What is expected of medical/dental practitioner is
a reasonably skillful behavior adopting the ordinary skills and practices of the professions with ordinary care
(Mrityunjay K, 2003).
Objectives
To study the Knowledge, Attitude and Practices of medical practitioners with respect to Consumer Protection
Act.
Methodology
1. A descriptive study was carried out to review the literature and analyze the secondary data.
2. SWOT Analysis of CPA was done to understand it better
Key Findings
1. It was observed by reviewing the literature that :
Gender : Males are more aware about CPA than females,

Level of education : Undergraduates are more aware than post graduates and

Practice : Private practitioners are more aware than combined practitioners.

2. It was also observed that due to unawareness about CPA many suits are filed to harass doctors or are
filled to evade the payment of bills. This generates the need for understanding the proper definition of
gross negligence.
Conclusion:
CPA has filled in the void for consumers and has provided a transparent legal system with many positive
aspects which have added to the social well-being for which it was enacted. The growing awareness among
consumers is evident with the increasing number of complaints and grievances the Hospital Managements
are receiving. This act has been able to safeguard the interests of both the parties involved. Therefore both
the hospital and the consumers need to update their understanding on CPA and its amendments to be on a
legally safer side.
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Code - IP15A013

Queuing & Capacity Planning in Central Registration Counter for a large tertiary
care hospital - An Operations Improvement Initiative
Harshul Atul Gautam, Madhukara Majji, Jasmeen Bawa2, MBA-HM (BATCH-19), IIHMR University, Jaipur
Rationale:
Generally central registration counter/front desk services in majority of hospitals have queuing and waiting
time problem. Hence it is important to reduce the waiting time. Queuing theory is a mathematical approach
to the analysis of waiting lines. The goal of queuing is to minimize total costs. The two basic costs i.e. Waiting
Cost and Capacity Cost are those associated with patients or customers having to wait for service and those
associated with capacity. Capacity costs are the costs of maintaining the ability to provide service.
Objectives:
The objectives of the study were :

To analyze the waiting time at the central registration counter by applying queuing theory.

To estimate the service capacity for minimum queuing cost of the registration process.

To identify the reasons for high waiting time at the registration counter through a fish bone diagram.

Methodology:
Study Design and Approach: Prospective study and approach is direct observational study.Sample Size(n)
and Type n = 160, Purposive sampling. Tool and Technique -Direct observation of the patient from entry to
exit at the registration counter.
Data collected was analyzed using Microsoft excel and QM for windows software. 5 parameters were
considered while evaluating service system:
1. Average number of patients waiting (in queue or in the system)
2. Average time the patients wait (in queue or in the system)
3. Capacity utilization
4. Costs of a given level of capacity
5. Probability that an arriving patient will have to wait for service
Key Findings:
The Waiting time for the patients was found to be 10 minutes and the study shows that 39% (62 out of 160)
patients wait for more than 10 minutes at the registration counter and it was observed that longest queue
was observed in the morning. During morning (peak hours 10:30am to 11:30am), the waiting time increased
to even 20 minutes. Amongst these 62 patients, maximum were those who visited the hospital on Mondays
(16) and Saturdays (18) as compared to other weekdays. Capacity analysis results showed that the optimum
utilisation was when 3 servers were used. There were many reasons for the increased waiting time but the
main reason was that the process was not streamlined.
Conclusion:
As society is becoming more and more time-pressed, patients are less willing to spend time waiting in lines.
Queue waits/ Pre-service delays have a negative, forwardcarry-over effect on the evaluation of the service
that follows the wait, unless the wait is well managed.
Application of queuing theory analysis can improve movement and reduce the waiting time of patients. It
also helps to examine the trade-off between capacity and service delaysand helps in providing decision for
an appropriate balance between the cost of service and the amount of waiting.
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Code - IP15A015

Prevention of Medical Negligence and Risk Management in Hospitals


Dr. Sneha Gupta, Dr. Neha Raisane
Introduction:
Patient safety is a critical component of the quality of health care and is often described as a prerequisite for
high-quality care. Harm from medical care poses a substantial burden in terms of mortality and morbidity in
people all over the world. Although estimates of the magnitude of the problem are not precise, it is likely
that millions of people suffer disabling injuries or death directly attributable to medical care. Injuries can
occur in association with many medical interventions ranging from tainted blood supplies to health careassociated infections to substandard drugs. Many of these injuries can be prevented. Risk management refers
to strategies that reduce and minimize the possibility of an adverse outcome, harm, or a loss. The systematic
gathering and utilization of data are essential to harm prevention. Good risk management techniques improve
patient safety and quality of patient.
Objectives:
To study the pattern of medical negligence and malpractices in healthcare system.

To propose a risk management system for hospitals.

Rationale:
Health care errors are the 8th leading cause of death in the world. One in 10 patients is harmed while receiving
hospital care. Over 7 million people across the globe suffer from preventable surgical injuries every year
(WHO). The focus in this study is to find the influencing factors of medical negligence practices.
Methodology:
The data was collected from secondary sources such as research papers and reports from renowned health
organisations like World Health Organisation. Tool- FMEA Failure modes and effects analysis.
Proposed Findings:
The malpractices followed in hospitals range from reuse of syringes or needles without sterilisation in 70%
cases, wrong drug dose in 40% cases, wrong choice of drug in 20% cases, avoidable delay in treatment in 14%
cases, physician practicing out of area of expertise in 5% cases, etc. A proper risk management system should
be followed in the hospitals wherein a risk management committee should be formed. It should be headed
by a Risk Management Officer who should identify the risks and decide upon objective steps to minimize
their impact on the patient and the hospital. If such a system is developed in India, it can reduce mortality
and morbidity and average length of stay in hospitals, thereby reducing the wastage of healthcare resources.
Conclusion:
Health-care system not only cures disease and alleviates pain but also often causes harm and suffering. This
is not an acceptable cost of providing health care. Our study suggests that much of this harm can be prevented.
Reducing harm will require greater understanding of its causes and risk management. Risk management can
surely reduce the financial burden and prove to be a boon to patient safety and quality in healthcare. With a
continuous and sincere effort, we can ensure that health care is a balm to human suffering and less often a
cause.

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Code - IP15A066

Emerging Opportunity in Healthcare Sector


Dr. Vikram Chopra (The IIHMR University, Jaipur)
The Indian healthcare industry comprising various sub industry such as hospitals, medical devices & equipment,
clinical trials, medical tourism, health insurance, telemedicine etc is growing at a tremendous pace owing to
its strengthening coverage, services and increasing expenditure by public as well private players. A huge
population with unmet healthcare needs and the rising awareness as well as capacity to spend on quality
healthcare is are leading to the growth of the sector.
Indias healthcare sector is expanding rapidly, contributing to 6% of GDP. According to Fitch, a rating agency,
the Indian healthcare industry is estimated to touch $100 billion in 2015, growing by 20% every year. By
2020, it is expected to reach $280 billion. The ever increasing in the demand for professional and expert
healthcare facilities will further boost Indian health sector. During the last four years, the healthcare sector
has experienced significant growth of 12% annually
Using the reasons and data mentioned above, this poster tries to highlight the emerging trends and
opportunities in healthcare industry. It will also throw some light on new emerging industry related to
healthcare like medical textile.
A systematic analysis of Data and information collected from various resources like internet health magazine,
annual reports from various consultancy firms with particular emphasis on healthcare industry was used for
secondary research. In India, the need for healthcare services is rising quite rapidly, and it is extremely
challenging to deliver affordable treatment facilities to the vast Indian population. This also signifies enormous
scope and investment opportunities in the Indian healthcare sector. The Indian healthcare sector offers a
wonderful investment opportunity due to a continuous increase in population and number of diseases.

Code - IP15A067

Innovation in Health and Hospital Sector : M-Health


Dr. Vikram Chopra (The IIHMR University, Jaipur)
Many countries aspire to deliver effective, safe, and affordable healthcare to their citizens. Healthcare systems
consisting of providers, payers, and input suppliers, exist to realize this aspiration and command large and
growing budgets. By 2014, it is expected that global annual spend on healthcare will reach about USD 9
trillion McKinsey & Company research indicates that under current trends, the highly developed nations
could end up spending around 15 percent of their GDP on healthcare within the next twenty years Unless
something changes, and significantly, this figure could double in the US by 2040 and across OECD countries
by 2070
Many emerging markets like India Brazil finding it difficult to provide broad access to healthcare and guarantee
minimum standards of quality and safety. To overcome these obstacles of cost, access, and standards,
healthcare systems must be highly innovative and inventive in their approach of delivering services. One way
is to use the experience of other sectors that have used technology to improve their processes. For example,
financial services and telecommunications have been using technology intensively and investing significantly
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in IT development and IT-enabled innovations. An area of innovation with the high potential to make a huge
difference is M-Health the use of mobile phone communication technologies to deliver healthcare
services.Examples of existing M-Health innovations are: SMS to remind patients to take their prescribed
drugs at the right time, Remote diagnosis and treatment for patients who do not have access to a doctor or
physician, Remote health monitoring (RHM) devices that track and report patients conditions and progress.
This Poster briefly describes the state of the global healthcare sector, illustrates the methodology used in our
recent Health-related research, identifies ways in which mobile technology might play a role in innovating
healthcare delivery systems and healthcare system cost management, and lays out the requirements for
implementing RHM one of the applications with the highest impact potential in a scalable manner.

Code - IP15A069

Role of Public Private Partnerships in Capacity Building of Healthcare


Dr. Vikram Chopra (The IIHMR University, Jaipur)
Deficiencies in the public sector health system in providing health services to the population are well
documented. The inability of the public health sector has forced poor and deprived sections of the population
to seek health services from the private sector leading huge economic burden on them. Today, the healthcare
system in India faces a challenge in raising the service quality and ensuring equitable access to people while
simultaneously gearing up its capabilities to tackle the changing disease incidence profiles
To address the inefficiency and inequity in the health system, many state governments have undertaken
health sector reforms. One of these reforms has been to impetus on capacity building of existing healthcare
system by collaborating with the private sector through Public Private Partnership. In this context, this poster
is the outcome of extensive and exhaustive research done using secondary data to study the avenues and
roles of the public and private partner that would foster Public Private Partners for capacity building of
existing healthcare system and simultaneously stimulate investment in healthcare sector to shape the bright
future of Indian Healthcare Industry. The observations from the study indicate major thrust areas where a
Public Private Partnership could be evolved as a synergistic role model to combine the objectives of capacity
building of healthcare for universal healthcare access as well as the business objective of running a profitable
healthcare facility. The areas where private sector contribution can prove very beneficial in capacity building
of healthcare system are Infrastructure Development, Management and Operations of Health facilities
including Materials and Supply Chain Management, Healthcare Research and Skill Enhancement of Healthcare
Professionals, Financing Mechanism, IT Infrastructure and Telemedicine, Health Insurance.
In each of the major thrust areas, there are different capabilities and drivers for the public and private sectors
in a Public Private Partnership arrangement. In order to make Public Private Partnership financially sustainable
and successful in achieving its main objective of improving the healthcare system, it is essential to have
clarity of the public and private sector positions and develop obvious criteria for assessing Public Private
Partnership models. An evaluation framework is also proposed in this poster to brings out four key principles
on which Public Private Partnership model must be assessed which are Effectiveness,Efficiency, Equity and
Financial Sustainability.
As a recommendation, the Public Private Partnership model proposed primarily assumes a facilitator role for
the public sector by way of offering support and aiding the private sectors role of managing the service
delivery and quality of care. Specific initiatives are also recommended in key thrust areas for increasing
private sector interest and participation.
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Code - IP15A070

Crisis in Public Health : Non-communicable Diseases


Dr. Vikram Chopra, Dr. Risho Singh (The IIHMR University, Jaipur)
Introduction:
A non-communicable disease (NCD) is a medical condition or disease which by definition is non-infectious
and non-transmissible among people. NCDs may be defined as chronic diseases of long duration and slow
progression. They are also known as lifestyle or choice diseases. NCDs include Cardio vascular diseases, Cancers,
Chronic respiratory diseases, Diabetes, Mental health, etc.
Rationale:
According to WHO Global status report on non-communicable diseases (NCDs) are leading cause of death in
the world, outof 57 million global deaths in 2008, 36 million or 63% were due to non communicable diseases.
The four main leading causes of NCD deaths were cardiovascular diseases (17 million deaths, or 48% of all
NCD deaths), cancers (7.6 million, or 21% of all NCD deaths), and respiratory diseases (4.2 million) and Diabetes
caused another 1.3 million deaths. And in India it is responsible for 53 percent deaths which include CVD
(24%), chronic respiratory diseases (11%), Cancers (6%), Diabetes (2%), other NCDs (10%). The burden of
these diseases is rising disproportionately among lower income countries and populations.
Objective:
Using the reasons and data mentioned above, this poster tries to highlight the core issues. It will also throw
some light on WHOs strategic action plan for prevention and control of NCDs.
Methodology:
A systematic analysis of documents related to the non communicable diseases, WHO global status reports
with particular emphasis on the developing world.
Findings:
WHOs strategic action plan for prevention and control of NCDs (2008-2013) were focuses on to raise priority
strengthen national policy, promote interventions, research, implementation of programmes and monitoring
the management of NCDs.
Conclusion:
As population urbanization grows, tobacco and alcohol use, poor diet and inactive lives will drive up deaths
globally by 17 percent in next 10 years. For low income countries the challenges of NCDs compounds the
difficulties of addressing infectious diseases creating a double burden that causes poverty and slows
development and leading to an added increase of mortality and morbidity ratios.
Key words:
Non-communicable disease, lifestyle diseases, Cardio vascular diseases, Cancer, Chronic respiratory diseases,
Diabetes, Mental health, WHO Global status report, Developing world, Strategic action plan.

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Code - IP15A062

Innovating Indian Healthcare Industry : Lessons from Non-Healthcare Industry


Harshul, Madhukara Majji
Introduction:
Business universe consists of two different kinds of market space i.e. Red ocean and Blue ocean. Blue oceans
denote all the industry not in market space today or the unknown market space untainted by competition. It
includes creation of demand and ample opportunity for growth and profitability. Blue ocean strategy in
healthcare industry can redefine and optimize healthcare delivery since healthcare industry has identified
certain areas of underperformance like overutilization, avoidable readmissions, poor communication, service
fragmentation etc. The healthcare industry has witnessed mushrooming of innovations aimed at increasing
life expectancy, quality of life, treatment options, as well as the efficiency and cost effectiveness of the
healthcare system. Organisations in the healthcare industry are busy engaging in new thinking about their
customers. This new thinking is inspired from other industries, health reforms, competition, consumer
demands, healthcare organisations are changing the way they interact with their customers and embracing
them. Healthcare consumers experiences and expectations are now being shaped up with the help of several
service industries outside healthcare. Technologically savvy consumers are now doing their own research
while selecting a doctor, looking for treatment options and taking major healthcare decisions. Tailored
communications at each stage of costumers relationship is possible with targeted marketing. In this poster
we will try to understand other industries efforts which have contributed to their marketing strategies successes
as well as to determine its relevance for incorporation into healthcare industry.
Rationale:
Healthcare industry has reached to a point where current strategies are yielding stagnant results thus the
industry demands newer strategies and innovations which could create a blue ocean in the healthcare industry.
Objectives:
To understand efforts of industries other than healthcare which have contributed in marketing strategies
successes.

To relate these strategies with healthcare industry.

Methodology:
Methodology includes review of literature from various articles and journals focusing on blue ocean strategies
in non-healthcare industries and their possible incorporation into healthcare industry.
Key Findings:
There are ample of strategies adopted by other industries which have led to their success and their
incorporation into healthcare industry is possible in India. Adoption of such successful strategies into healthcare
industries will not only create a new dimension but also a new market space. Use of technology in
implementation of such strategies plays a vital role and thus provides a picture of the future of healthcare
industry.
Conclusion:
Blue ocean strategies could be a game changer in healthcare industry as far as providing affordable and
accessible care is concerned. Learning from other industries enables you to take decisions confidently as
those strategies have been implemented successfully in their respective market space.
Key words:
Blue ocean, Innovation, Healthcare, Strategies.
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Code - IP15A057

Successful Cost Reduction Strategies : Lessons from Established Giants


Dr. Paridhi Mehra*, Dr. Sakshi Kushwaha* (*The IIHMR University, Jaipur)
Introduction:
India with a population of 1.2 billion is the second most populous country and has one of the biggest healthcare
markets in the world. The overall Indian health care market today is US$ 65 billion. However, despite being
one of the worlds fastest growing major economies, it ranks lowest amongst the countries in terms of public
health spending with 1.3% of GDP spent on healthcare. In addition to its high disease burden, substantial
infrastructural and manpower gap, a large part of the population has little or no access to basic healthcare.
Eighty percent of healthcare expenses are paid out-of-pocket due to extremely limited insurance coverage
exacerbating the need for affordable healthcare for all. Addressing the nations pressing demand and need
for affordable quality healthcare some innovative Indian private healthcare providers and entrepreneurs
have devised ways of providing quality healthcare services at affordable prices.
Rationale:
Cost cutting in healthcare is difficult than in any other industry because it is often perceived as a compromise
with quality creating a high level of dissatisfaction among patients and care providers. As countries struggle
to address increasing costs, poor quality and accessibility, healthcare consumers search for affordable costs
and optimal value for money. Some healthcare providers, especially those operating within the private sector
in developing countries, are looking to deliver healthcare at prices that are affordable to the majority of the
population, who often times fall within the mid to lower income brackets
Objective:
The study aims to contribute to an understanding of how the delivery model of Indian healthcare providers
have achieved the provision of quality healthcare at affordable costs to lower income groups, and explores
how the these models can be replicated by other private for-profit sector healthcare providers.
Methodology:
The study was developed by systematic review of literature and information extracted from relevant sources.
Results and Conclusions:
Pioneers like like Narayana Hrudayalaya (Bengaluru), Arvind Eye Care (Madurai), Lifespring Hospitals
(Hyderabad) etc. are serving both lower and higher strata of health consumers. They have devised innovative
ways to dramatically lower their costs yet maintaining high standards of quality care. Such businesses have
been able to scale because of their low costs which attract large volumes of patients, allowing the venture to
be profitable and sustainable without depending on grants, donations or government subsidies.

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Code - IP15B04

Will Personalised Medicine Transform the Future Outlook of Healthcare?


Dr. Jasleen Kaur, Dr. Dikshita Bhuyan (The IIHMR University)
Introduction:
Todays healthcare is in crisis as it is expensive, reactive, inefficient, and focused largely on one size fits all
treatment of diseases leading to many inefficiencies such as trial-and-error dosing, adverse drug responses,
late diagnosis and poor adherence to treatment regimens. One of the alternatives to manage these issues is
use of Personalized Medicine. It is an emerging practice of medicine that uses an individuals genetic profile
to guide decisions made in regard to the prevention, diagnosis, and treatment of disease. Knowledge of a
patients genetic profile can help doctors select the proper medication or therapy and administer it using the
proper dose or regimen. (Definition from: Talking Glossary of Genetic Terms)
Objectives:
To explore the future impact of personalised medicine to exquisite precision in disease diagnosis and treatment.
Methodology:
An exploratory study based on systematic literature review, opinion of leading medical practitioners from
various disciplines and pharmaceutical industry is taken using a structured questionnaire to understand the
future scope of personalised medicine in healthcare industry.
Discussions and Conclusion:
Personalised medicine aims at streamlining clinical decision-making by allowing patients to be monitored
and treated more effectively and precisely in ways that better meet their individual needs thereby offers
significant short and long term benefits however there are multiple challenges to its adoption from many
healthcare stakeholders. Personalized medicine is our chance to revolutionize health care, but it will require
a team effort by the policymakers, entrepreneurs, regulators, innovators and payers.
Key words:
Personalised medicine, genetic profile, Trail and Error, Early Diagnosis

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THE PINK CITY


JAIPUR
Fantasy in pink, city of victory, originally Sawai Jaipur, and now Jaipur epitomizes the dreams of the visionary
Kachhwaha rulers, who wanted to build a new and planned capital city, and the creative ideas of their talented
designer builder, Vidyadhar. The principal monuments of the Pink City are concentrated in the centrally
situated palace sector in and around the Albert Hall City Palace or the royal residence. City Palace, apart from
the beautiful Chandra Mahal, Mubarak Mahal and Diwan Khana, also houses the world famous Maharaja
Sawai Man Singh II Museum. The giant silver Gangajalis displayed in the palace find mention in the Guinness
Book of World Records as largest silver objects in the world. Maharaja Jai Singhs observatory, Jantar Mantar,
exemplifying the marvellous precision which could be achieved in concrete, reminds of the past which sought
knowledge beyond mans world.
Located in the spacious Ram Niwas Garden, the eye-capturing Indo-Saracenic structure of the Central
Museum or Albert Hall, famous for embossed, hammered and chiselled brass ware collection, also displays a
vast array of ivory carvings, jewellery, sculptures and painting which provides a panoramic view of the
Rajasthani culture and traditions.
Hawa Mahal or Place of Winds, little more than an elaborate frontage, once served as the window to the outer
world for ladies of the Rajput Palace, processions and the din of the festive occasions, from dozens of
casements in the place.
Still retaining its pristine beauty, the Amer Fort, rises from the placid waters of the Maota Lake, and spans a
large area of the hilly outer Jaipur. The elegant temple of Shila Mata, the Mother Goddess worshipped with
reverence by thousands of devotees and the spectacular palace complex, combining the finest elements of
Mughal and Rajput architecture, add the radiance of the Monument.

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The western skyline is dominated by extensive parkotas (walls),watch towers and gateways and Jaigarh, the
fort which is widely known for the giant mounted cannon-the Jai-Ban, one of the largest cannons in the
country. Beyond the hills of Jaigarh stands the fort of Nahargarh, providing the most rapturous view of the city
below. In the vicinity lie the cenotaphs of the rulers of Amer, still preserving the traces of paintings that once
embellished their inner and outer walls.
It is not only the static architecture, but the dynamic festive move of the energetic people of Jaipur, that
reflects in the traditional fairs and festivals, and gives the city its vigour.
October-November is marked by the sparkling ceremony of Dusshera and Diwali. The ceremonial burning of
giant effigies of Ravan, the mythical villainous character, on the day of Dusshera, is followed a few days after
the festive occasion of Diwali which is celebrated with colourful fireworks.
The cool breeze makes the pink city a shoppers paradise in the winter season. Jaipur is recognized all over the
world for precious and semi-precious stones, gold and lac ornaments and jewellery, and bluepottery. Bandhej
(tie and dye) and block printing textiles are unique to this part of the country. Rajasthani paintings, a dinstinct
art style in themselves, glorify the rich past of the place.
Jaipur, in all its aspects is an attractive creation worthy of universal admiration.

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We express our gratitude to all our supporters


who have generously contributed to the
grand venture of the International Conference
Global Alliance for Improved Nutrition (Gain)
United Nations International Children'S Fund (UNICEF)
Narayana Hrudayalaya
Bhandari Hospitals
Texon Digital Color Lab
Archana Hospital
Ortho Clinical Diagnostics
Healthcare Executive
Brain Buxa
Pharma Tutor
Express Pharma
eHealth
Abott India Pvt. Ltd
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Mahesh Kumar
Chandra Prakash

Years in

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International Conference on

Universal Health Coverage:


Road Map for 2020
Conference Secretariat
IIHMR University
1, Prabhu Dayal Marg, Sanganer,
Jaipur, Rajasthan - 302029
Phone: 91-141-3924700,
91-141-2791431/32
www.pradanya.iihmr.edu.in
conference@iihmr.edu.in

www.iihmr.edu.in