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Role of Public Health Institutions and Academia in Increasing the Prescription of ORS and Zinc for Diarrhoea Management Dr. V.K. Srivastava, Professor of Social & Preventive Medicine & Head, Department of Hospital Administration, CSM Medical University, Lucknow 
Govt. of India Policy on use of Zinc in National Programme for Management of Diarrhoea: Zinc (20mg/day for 14 days) is to be used in national programme as an adjunct to ORS in the management of diarrhoea in children older than 3 month to reduce duration and severity of acute diarrhoea (Govt. of India, 2006).
Why involve Public Health Institutions/ faculty members? Because: Their opinion matters Their involvment gives value to the products Their endorsement  is convincing to people.
Public Health Institutions VISION Healthy people in healthy community MISION Development of appropriate health man power for comprehensive health care
Academia/Faculty Members are associated with: Development of Health Manpower (country’s need specific), and Offer solutions to tackle health problems by carrying out research - both basic and applied
Why faculty members should involve themselves? Is it of National significance? Is it of Academic/Clinical interest? Whether any value attached to it? Is it within the purview of MCI ? It is convincing? Not much work done in this field? Scope for further research?
Whether issue is of National Interest?
National Diarrhoea Disease control Programme  Goal  Reduce diarrhoeal associated mortality in children under the age of 5 years by 30% by 1995 and by 70% by 2000 AD. Reducing case fatality rate to less than 1%.
It is convincing? Enough evidence available Recommended by UNICEF/WHO. Govt. of India Policy
WHO: 7-Point Plan for Comprehensive Diarrhoea Control ,[object Object],Fluid replacement to prevent dehydration Zinc treatment ,[object Object],Rotavirus and measles vaccinations Promotion of early and exclusive breastfeeding and vitamin A supplementation Promotion of hand washing with soap Improved water supply quantity and quality, including treatment and safe storage of household water Community-wide sanitation promotion.
Is it within the Purview of MCI ?
THE POSTGRADUATE MEDICAL EDUCATION – MCI-REGULATIONS, 2000 - SALIENT FEATURES      The goal of postgraduate medical education shall be to produce competent specialists and/or Medical teachers who :  Shall recognize the health needs of the community, and carry out professional obligations ethically and in keeping with the objectives of the national health policy  Shall have mastered most of the competencies, pertaining to the speciality, that are required to be practiced at the secondary and the tertiary levels of the health care delivery system;
THE MCI REGULATIONS ON GRADUATE MEDICAL EDUCATION, 1997 - SALIENT FEATURES  	At  the  end of undergraduate program, the medical  students should be able to :     (a)	Recognize “health for all” as a national goal and health right of all    citizens and by undergoing  training for medical profession fulfil his/her social obligations towards realization of this goal.       (b)	Learn  every aspect of National policies on health and devote himself/herself to its practical implementation.       (c)	Appreciate rationale for different therapeutic modalities, be familiar with the administration of the "essential drugs"  and their common side effects. 
Work done by Medical Colleges in UP-UK in use of promoting use of Zinc in Diarrhoea
A PILOT PROJECT ON DEVELOPING A MODEL FOR BUILDING A COMMUNITY LEVEL CAMPAIGN A Pilot project was taken up in six cities across three states (Lucknow, Varanasi, Ranchi, Dehradun, Kanpur & Agra) with the objective to:  ,[object Object],			through: Use available localized media & messengers Use existing community-based voluntary networks
SELECTED CITIES FOR the COMMUNITY MODEL
Approach: Step wise Step 1- Training and detailing of local HCPs about Zinc and diarrhea management Step 2- Spreading awareness about Zinc and diarrhea management amongst consumers
IMPACT ASSESSMENT Correct knowledge about Zinc Therapy  Change or adaptation among providers Reduction in prescription of other medicines
How to accomplish the task by Academia/Faculty? Through  Teaching Training Research Others
1. Teaching/Training: Undergraduates Postgraduates Interns Others- ICDS, NGOs etc.
2. Research Basic Applied ,[object Object]
Operational ResearchGuiding ,[object Object]
Ph.D.
Others,[object Object]
Advocacy for Promoting ORS/Zinc use: Within professional groups Meeting/Conferences Seminar/symposia Others groups Schools NGOs Communities
Challenges Low ORS use rates Irrational use of antimicrobials & other drugs Very-very low use rate of Zinc in Diarrhoea Inappropriate management of dehydration Inadequate emphasis on feeding

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Dr V K Srivastav

  • 1. Role of Public Health Institutions and Academia in Increasing the Prescription of ORS and Zinc for Diarrhoea Management Dr. V.K. Srivastava, Professor of Social & Preventive Medicine & Head, Department of Hospital Administration, CSM Medical University, Lucknow 
  • 2. Govt. of India Policy on use of Zinc in National Programme for Management of Diarrhoea: Zinc (20mg/day for 14 days) is to be used in national programme as an adjunct to ORS in the management of diarrhoea in children older than 3 month to reduce duration and severity of acute diarrhoea (Govt. of India, 2006).
  • 3. Why involve Public Health Institutions/ faculty members? Because: Their opinion matters Their involvment gives value to the products Their endorsement is convincing to people.
  • 4. Public Health Institutions VISION Healthy people in healthy community MISION Development of appropriate health man power for comprehensive health care
  • 5. Academia/Faculty Members are associated with: Development of Health Manpower (country’s need specific), and Offer solutions to tackle health problems by carrying out research - both basic and applied
  • 6. Why faculty members should involve themselves? Is it of National significance? Is it of Academic/Clinical interest? Whether any value attached to it? Is it within the purview of MCI ? It is convincing? Not much work done in this field? Scope for further research?
  • 7. Whether issue is of National Interest?
  • 8. National Diarrhoea Disease control Programme Goal Reduce diarrhoeal associated mortality in children under the age of 5 years by 30% by 1995 and by 70% by 2000 AD. Reducing case fatality rate to less than 1%.
  • 9. It is convincing? Enough evidence available Recommended by UNICEF/WHO. Govt. of India Policy
  • 10.
  • 11. Is it within the Purview of MCI ?
  • 12. THE POSTGRADUATE MEDICAL EDUCATION – MCI-REGULATIONS, 2000 - SALIENT FEATURES The goal of postgraduate medical education shall be to produce competent specialists and/or Medical teachers who : Shall recognize the health needs of the community, and carry out professional obligations ethically and in keeping with the objectives of the national health policy Shall have mastered most of the competencies, pertaining to the speciality, that are required to be practiced at the secondary and the tertiary levels of the health care delivery system;
  • 13. THE MCI REGULATIONS ON GRADUATE MEDICAL EDUCATION, 1997 - SALIENT FEATURES At the end of undergraduate program, the medical students should be able to :  (a) Recognize “health for all” as a national goal and health right of all citizens and by undergoing training for medical profession fulfil his/her social obligations towards realization of this goal.  (b) Learn every aspect of National policies on health and devote himself/herself to its practical implementation.  (c) Appreciate rationale for different therapeutic modalities, be familiar with the administration of the "essential drugs" and their common side effects. 
  • 14. Work done by Medical Colleges in UP-UK in use of promoting use of Zinc in Diarrhoea
  • 15.
  • 16. SELECTED CITIES FOR the COMMUNITY MODEL
  • 17. Approach: Step wise Step 1- Training and detailing of local HCPs about Zinc and diarrhea management Step 2- Spreading awareness about Zinc and diarrhea management amongst consumers
  • 18. IMPACT ASSESSMENT Correct knowledge about Zinc Therapy Change or adaptation among providers Reduction in prescription of other medicines
  • 19. How to accomplish the task by Academia/Faculty? Through Teaching Training Research Others
  • 20. 1. Teaching/Training: Undergraduates Postgraduates Interns Others- ICDS, NGOs etc.
  • 21.
  • 22.
  • 23. Ph.D.
  • 24.
  • 25. Advocacy for Promoting ORS/Zinc use: Within professional groups Meeting/Conferences Seminar/symposia Others groups Schools NGOs Communities
  • 26. Challenges Low ORS use rates Irrational use of antimicrobials & other drugs Very-very low use rate of Zinc in Diarrhoea Inappropriate management of dehydration Inadequate emphasis on feeding
  • 27. Ultimate Goal The revised recommendations must become routine practice both in the home and health facility