This document summarizes maternal health initiatives and statistics in India. It notes that India's maternal mortality ratio has declined significantly from 556 per 100,000 live births in 2000 to 130 in 2015, and neonatal mortality has also dropped. However, more progress is still needed to meet national targets. Key programs discussed include Janani Shishu Suraksha Karyakram, which provides free care for deliveries and complications; LaQshya, which improves quality of labor rooms; and various trainings to strengthen health workforce skills. Anemia and institutional delivery rates vary significantly between states. Moving forward, priorities include delayed cord clamping, revised ANC guidelines, improved referral protocols, and a focus on respectful maternity care.
1) The DAKSHATA program aims to improve the quality of maternal and newborn care during labor and delivery through strengthening the competency of providers.
2) It focuses on training providers, ensuring essential supplies are available, improving monitoring and accountability, and implementing strategies to reinforce learning.
3) The program's goals are to reduce maternal and newborn mortality and morbidity by promoting evidence-based practices through competent providers.
CASE REPORT OF LAQSHYA INITIATIVE PPT.pptxanjalatchi
Every facility achieving 70% score on NQAS will be certified as LaQshya certified facility. Furthermore, branding of LaQshya certified facilities will be done as per the NQAS score. Facilities scoring more than 90%, 80% and 70% will be given Platinum, Gold and Silver badge accordingly
CASE REPORT OF LAQSHYA INITIATIVE PPT.pptxanjalatchi
This document provides an overview of India's LaQshya quality improvement initiative for labor rooms and maternity OTs. It was launched in 2017 to reduce maternal and newborn morbidity and mortality and improve quality of care during delivery. Key features include infrastructure upgrades, ensuring essential equipment and staff, capacity building, and quality improvement cycles. Facilities achieving certain targets can receive certification and incentives. As of late 2019, over 350 labor rooms and 300 maternity OTs had been prioritized for certification under this initiative to help achieve India's maternal and newborn health goals.
Labour Room Quality Improvement Initiative (LaQshya).pptxanjalatchi
The document discusses India's Labour Room Quality Improvement Initiative (LaQshya) which aims to improve quality of care in labour rooms and maternity operating theaters. The key points are:
- LaQshya aims to reduce preventable maternal and newborn mortality, morbidity and stillbirths associated with delivery care.
- Objectives include reducing mortality from various causes, improving quality of delivery care, ensuring timely referrals, and providing respectful maternity care.
- Strategies include aligning labour room layouts and workflows, ensuring obstetric HDUs, and adhering to clinical protocols before referral.
- The program targets government medical colleges, district hospitals, and other high-volume
Labour Room Quality Improvement Initiative (LaQshya).pptxanjalatchi
LaQshya program will benefit every pregnant woman and newborn delivering in public health institutions. Program will improve quality of care for pregnant women in labour room, maternity Operation Theatre and Obstetrics Intensive Care Units (ICUs) & High Dependency Units (HDUs)
HSDPF Dr. Elizabeth Ogaja Presentation, ECM Health, Kisuu County-HRH and UHC ...Emmanuel Mosoti Machani
This document provides an overview of health reform in Kenya, with a focus on human resources for health (HRH) in Kisumu County. It discusses the country's constitution and health policies aimed at achieving universal health coverage. In Kisumu County, key challenges include poor health indicators, inadequate HRH, and low health financing. Opportunities for improving HRH include policies supporting county health sectors and partnerships between government and training institutions. Effective governance structures will be important for counties to optimize HRH as they work to strengthen primary healthcare and achieve health reform goals.
Adolescent sexual and reproductive health (ASRH) in Nepal Public Health
1) The document outlines Nepal's Adolescent Sexual and Reproductive Health (ASRH) strategy, which aims to promote the health of adolescents aged 10-19.
2) Key achievements include expanding ASRH services to 75 of 77 districts, establishing 6 ASRH clinical training sites, and training over 1,700 health workers.
3) Challenges include high rates of early marriage, low contraceptive use among adolescents, and a need for more trained staff and resources for the ASRH program.
1) The DAKSHATA program aims to improve the quality of maternal and newborn care during labor and delivery through strengthening the competency of providers.
2) It focuses on training providers, ensuring essential supplies are available, improving monitoring and accountability, and implementing strategies to reinforce learning.
3) The program's goals are to reduce maternal and newborn mortality and morbidity by promoting evidence-based practices through competent providers.
CASE REPORT OF LAQSHYA INITIATIVE PPT.pptxanjalatchi
Every facility achieving 70% score on NQAS will be certified as LaQshya certified facility. Furthermore, branding of LaQshya certified facilities will be done as per the NQAS score. Facilities scoring more than 90%, 80% and 70% will be given Platinum, Gold and Silver badge accordingly
CASE REPORT OF LAQSHYA INITIATIVE PPT.pptxanjalatchi
This document provides an overview of India's LaQshya quality improvement initiative for labor rooms and maternity OTs. It was launched in 2017 to reduce maternal and newborn morbidity and mortality and improve quality of care during delivery. Key features include infrastructure upgrades, ensuring essential equipment and staff, capacity building, and quality improvement cycles. Facilities achieving certain targets can receive certification and incentives. As of late 2019, over 350 labor rooms and 300 maternity OTs had been prioritized for certification under this initiative to help achieve India's maternal and newborn health goals.
Labour Room Quality Improvement Initiative (LaQshya).pptxanjalatchi
The document discusses India's Labour Room Quality Improvement Initiative (LaQshya) which aims to improve quality of care in labour rooms and maternity operating theaters. The key points are:
- LaQshya aims to reduce preventable maternal and newborn mortality, morbidity and stillbirths associated with delivery care.
- Objectives include reducing mortality from various causes, improving quality of delivery care, ensuring timely referrals, and providing respectful maternity care.
- Strategies include aligning labour room layouts and workflows, ensuring obstetric HDUs, and adhering to clinical protocols before referral.
- The program targets government medical colleges, district hospitals, and other high-volume
Labour Room Quality Improvement Initiative (LaQshya).pptxanjalatchi
LaQshya program will benefit every pregnant woman and newborn delivering in public health institutions. Program will improve quality of care for pregnant women in labour room, maternity Operation Theatre and Obstetrics Intensive Care Units (ICUs) & High Dependency Units (HDUs)
HSDPF Dr. Elizabeth Ogaja Presentation, ECM Health, Kisuu County-HRH and UHC ...Emmanuel Mosoti Machani
This document provides an overview of health reform in Kenya, with a focus on human resources for health (HRH) in Kisumu County. It discusses the country's constitution and health policies aimed at achieving universal health coverage. In Kisumu County, key challenges include poor health indicators, inadequate HRH, and low health financing. Opportunities for improving HRH include policies supporting county health sectors and partnerships between government and training institutions. Effective governance structures will be important for counties to optimize HRH as they work to strengthen primary healthcare and achieve health reform goals.
Adolescent sexual and reproductive health (ASRH) in Nepal Public Health
1) The document outlines Nepal's Adolescent Sexual and Reproductive Health (ASRH) strategy, which aims to promote the health of adolescents aged 10-19.
2) Key achievements include expanding ASRH services to 75 of 77 districts, establishing 6 ASRH clinical training sites, and training over 1,700 health workers.
3) Challenges include high rates of early marriage, low contraceptive use among adolescents, and a need for more trained staff and resources for the ASRH program.
Labour room quality initiative ppt for ECHO program.pptxanjalatchi
The document provides an overview of the Labour Room Quality Initiative (LaQshya) guidelines in India. Some key points:
- LaQshya was launched in 2017 to improve quality of care during delivery and postpartum periods to reduce maternal and newborn mortality.
- It aims to benefit all women delivering in public health facilities by improving quality in labor rooms, operation theaters, and intensive care units.
- Implementation will focus on medical college hospitals, district hospitals, and community health centers meeting delivery thresholds.
- The initiative establishes quality assurance committees at national, state, district, and facility levels to support implementation through training and mentoring.
- Facilities will implement six two-month
Operation Eyesight has been working in India for over 50 years to eliminate avoidable blindness. It focuses on two key programs: a Hospital Based Community Eye Health Program and a Hospital Improvement Program. Through these programs and partnerships with over 46 hospitals across India, Operation Eyesight screens over 3 million people annually and provides free or subsidized eye surgeries to over 125,000 people. It has recently expanded its work to the remote and underserved North East region of India through new partnerships and community health worker programs.
This scenario belongs to standard B1 (Information to care seekers about available services). The PHC appropriately provided pre-procedure counseling and referred the patients to a higher center since abortion services were not available at that facility, informing the patients about the services available.
Conclave indrajit - evidence for policy & impact - 22 apr 2016 v2.1Indrajit Chaudhuri
1) CARE India worked in Bihar through its Bihar Technical Support Program (BTSP) to reduce maternal and child health indicators like MMR, NMR, and malnutrition. It tested and implemented innovative solutions in select districts from 2010-2013.
2) Four key solutions showed successful results - sub-center meetings, quality improvement and nurse mentoring in facilities, team-based goals and incentives for frontline workers, and a comprehensive mHealth solution.
3) These solutions were adopted and scaled up by the Bihar government based on the evidence from their measurement and learning efforts. For example, sub-center meetings were scaled up statewide and the mobile nurse mentoring approach was replicated in many other states. This
The document discusses primary healthcare in India and proposes a solution to universalize access. It begins with defining primary healthcare and describing its eight essential components. It then analyzes India's current healthcare system metrics on expenditures, physician/beds ratios, and life expectancy compared to other countries. The National Rural Health Mission aims to address rural problems through community healthcare workers called ASHAs. Case studies from Maharashtra, Gujarat, Punjab, and Haryana demonstrate how IT solutions have improved primary healthcare delivery by streamlining processes, monitoring health outcomes, and reducing costs. The proposed solution would build on these approaches and leverage technology, community participation, and public-private partnerships.
The document outlines India's digital health initiatives and vision. It discusses the establishment of various institutions to support digital health such as the Centre for Health Informatics. Key initiatives described include the Integrated Health Information Platform, Hospital Information System, and telemedicine programs. Challenges in digital health adoption such as fragmented systems and lack of data interoperability are also mentioned. The initiatives aim to create an electronic health record system, deploy telemedicine nationwide, and make optimal use of IT for surveillance, training and governance across India.
Adolescent Pregnancies, Population Growth, and Family Planning (Zaidi)Rotary International
Girls who become pregnant as adolescents can face an increased likelihood of major health risks and dropping out of school, and a reduced lifetime earning potential. This session will explore these issues and more. We will discuss how Rotary can help improve the lives of adolescent girls, reduce the risks of child marriage, provide broader access to family planning resources, and lower population growth.
Andhra Pradesh Priorities: Maternal & Child Health - ShariffCopenhagen_Consensus
The document discusses three potential solutions to improve maternal and child health indicators in Andhra Pradesh:
1) A mass media campaign and counseling to promote exclusive breastfeeding, with estimated annual costs of Rs. 749 Crore and benefits of Rs. 5,757 Crore.
2) Special immunization drives and incentives in districts with immunization rates below the state average, with estimated annual costs of Rs. 10 Crore and benefits of Rs. 385 Crore.
3) A conditional cash transfer program for pregnant women accessing four antenatal care visits, with estimated annual costs of Rs. 163 Crore and benefits of Rs. 950 Crore.
Dr. Tonny Tumwesigye, Executive Director of the Uganda Protestant Medical Bureau describes the organizations composition and mission and explores how faith communities can be engaged in family planning education and promotion.
The Mother and Child Tracking System (MCTS) is an Indian government initiative to track maternal and child health beneficiaries and improve service delivery. It registers pregnant women and children under 5 for antenatal care, delivery care, postnatal care, and immunizations. Frontline health workers use MCTS to generate work plans, ensure all beneficiaries receive scheduled services, and update the system in real time. Over 2.8 crore mothers and 2.06 crore children have been registered in MCTS so far. The government aims for 100% registration and updating of services provided through the system.
The Mother and Child Tracking System (MCTS) is an Indian government initiative to track maternal and child health beneficiaries and improve service delivery. It registers pregnant women and children under 5 for antenatal care, delivery care, postnatal care, and immunizations. Frontline health workers use MCTS to generate work plans, ensure all beneficiaries receive scheduled services, and update the system in real time. Over 2.8 crore mothers and 2.06 crore children have been registered in MCTS so far. The government aims for 100% registration and updating of services provided through the system.
Country Learnings and opportunities to advance pediatric quality of carekunalkanani5
This document summarizes discussions from a webinar on advancing pediatric quality of care held by the Child Health Task Force Network. Representatives from Kenya and Uganda shared their experiences designing and implementing national programs to improve pediatric quality of care. Key barriers to pediatric quality of care were identified, such as lack of prioritization and coordination, as well as opportunities like leveraging existing quality improvement platforms and expanding measurement of pediatric quality indicators. The webinar aimed to facilitate peer learning between countries on progress and priorities for scaling up pediatric quality of care.
ICDS was launched in 1975 to address malnutrition. It was restructured in 2012 to strengthen operations, improve outcomes, and meet nutritional goals. Key reforms included constructing AWCs, positioning them as early learning centers, supplementary nutrition revisions, and new provisions like Sneha Shivir for moderately malnourished children. The goals were to reduce child malnutrition by 10 percentage points and anemia by one-fifth in women and children to contribute towards lowering mortality rates. Restructuring focused on institutionalizing services, building capacity, inter-sectoral collaboration, and monitoring improvements to the scheme.
Reproductive and child health phase IIManoj Vaidya
RCH Phase-II outlines new initiatives to improve reproductive and child health in India, including making First Referral Units functional, training MBBS doctors in life-saving skills, and establishing blood storage facilities. The Janani Suraksha Yojana cash incentive program aims to increase institutional deliveries. Other initiatives proposed include the Rural Health Care Mission, establishing referral transport, and designating Accredited Social Health Activists. Infection management and environment plans will be implemented, and safe abortion practices like medical and MVA methods will be supported. Quality indicators are used to monitor programs through monthly reporting.
The document summarizes Rwanda's efforts to integrate palliative care into its national health system. Key points include:
- Rwanda established a palliative care program in 2011 with a vision of universal access by 2020. It has trained over 1,000 health care professionals and integrated palliative care services into hospitals, health centers, and communities through a network of home-based care practitioners.
- Palliative care services are part of Rwanda's community-based health insurance and national health information system. A palliative care desk coordinates services at referral and provincial hospitals.
- Lessons from partnerships include the importance of regional collaboration for training and mentorship, decentralizing services to effectively scale up palliative care,
2023JUL_Webinar_Ped QoC (1) (1).pptx by mitikumitiku34
The document summarizes a webinar on advancing pediatric quality of care held by the Child Health Task Force. It includes:
- Agenda items on sharing country efforts to improve pediatric quality from Kenya and Uganda, outcomes of recent discussions, and a roundtable discussion.
- Kenya has made progress developing pediatric quality standards and indicators, piloting a health facility assessment tool, and mapping indicators to their health information system. Challenges include resources for wide implementation and institutionalizing standards.
- Uganda has seen steady reductions in childhood mortality since 1989 through programs addressing leading causes of death. Future focus is strengthening health systems to support quality service delivery across all levels of care.
The document summarizes recent advances in Reproductive, Maternal, Newborn, Child Plus Adolescent Health (RMNCH+A) in India. It discusses programs and policies across various components of RMNCH+A including pregnancy and childbirth, newborn and child health, and reproductive health and family planning. Key initiatives highlighted include Janani Suraksha Yojana, Janani Shishu Suraksha Karyakram, and Rashtriya Bal Swasthya Karyakram.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
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Labour room quality initiative ppt for ECHO program.pptxanjalatchi
The document provides an overview of the Labour Room Quality Initiative (LaQshya) guidelines in India. Some key points:
- LaQshya was launched in 2017 to improve quality of care during delivery and postpartum periods to reduce maternal and newborn mortality.
- It aims to benefit all women delivering in public health facilities by improving quality in labor rooms, operation theaters, and intensive care units.
- Implementation will focus on medical college hospitals, district hospitals, and community health centers meeting delivery thresholds.
- The initiative establishes quality assurance committees at national, state, district, and facility levels to support implementation through training and mentoring.
- Facilities will implement six two-month
Operation Eyesight has been working in India for over 50 years to eliminate avoidable blindness. It focuses on two key programs: a Hospital Based Community Eye Health Program and a Hospital Improvement Program. Through these programs and partnerships with over 46 hospitals across India, Operation Eyesight screens over 3 million people annually and provides free or subsidized eye surgeries to over 125,000 people. It has recently expanded its work to the remote and underserved North East region of India through new partnerships and community health worker programs.
This scenario belongs to standard B1 (Information to care seekers about available services). The PHC appropriately provided pre-procedure counseling and referred the patients to a higher center since abortion services were not available at that facility, informing the patients about the services available.
Conclave indrajit - evidence for policy & impact - 22 apr 2016 v2.1Indrajit Chaudhuri
1) CARE India worked in Bihar through its Bihar Technical Support Program (BTSP) to reduce maternal and child health indicators like MMR, NMR, and malnutrition. It tested and implemented innovative solutions in select districts from 2010-2013.
2) Four key solutions showed successful results - sub-center meetings, quality improvement and nurse mentoring in facilities, team-based goals and incentives for frontline workers, and a comprehensive mHealth solution.
3) These solutions were adopted and scaled up by the Bihar government based on the evidence from their measurement and learning efforts. For example, sub-center meetings were scaled up statewide and the mobile nurse mentoring approach was replicated in many other states. This
The document discusses primary healthcare in India and proposes a solution to universalize access. It begins with defining primary healthcare and describing its eight essential components. It then analyzes India's current healthcare system metrics on expenditures, physician/beds ratios, and life expectancy compared to other countries. The National Rural Health Mission aims to address rural problems through community healthcare workers called ASHAs. Case studies from Maharashtra, Gujarat, Punjab, and Haryana demonstrate how IT solutions have improved primary healthcare delivery by streamlining processes, monitoring health outcomes, and reducing costs. The proposed solution would build on these approaches and leverage technology, community participation, and public-private partnerships.
The document outlines India's digital health initiatives and vision. It discusses the establishment of various institutions to support digital health such as the Centre for Health Informatics. Key initiatives described include the Integrated Health Information Platform, Hospital Information System, and telemedicine programs. Challenges in digital health adoption such as fragmented systems and lack of data interoperability are also mentioned. The initiatives aim to create an electronic health record system, deploy telemedicine nationwide, and make optimal use of IT for surveillance, training and governance across India.
Adolescent Pregnancies, Population Growth, and Family Planning (Zaidi)Rotary International
Girls who become pregnant as adolescents can face an increased likelihood of major health risks and dropping out of school, and a reduced lifetime earning potential. This session will explore these issues and more. We will discuss how Rotary can help improve the lives of adolescent girls, reduce the risks of child marriage, provide broader access to family planning resources, and lower population growth.
Andhra Pradesh Priorities: Maternal & Child Health - ShariffCopenhagen_Consensus
The document discusses three potential solutions to improve maternal and child health indicators in Andhra Pradesh:
1) A mass media campaign and counseling to promote exclusive breastfeeding, with estimated annual costs of Rs. 749 Crore and benefits of Rs. 5,757 Crore.
2) Special immunization drives and incentives in districts with immunization rates below the state average, with estimated annual costs of Rs. 10 Crore and benefits of Rs. 385 Crore.
3) A conditional cash transfer program for pregnant women accessing four antenatal care visits, with estimated annual costs of Rs. 163 Crore and benefits of Rs. 950 Crore.
Dr. Tonny Tumwesigye, Executive Director of the Uganda Protestant Medical Bureau describes the organizations composition and mission and explores how faith communities can be engaged in family planning education and promotion.
The Mother and Child Tracking System (MCTS) is an Indian government initiative to track maternal and child health beneficiaries and improve service delivery. It registers pregnant women and children under 5 for antenatal care, delivery care, postnatal care, and immunizations. Frontline health workers use MCTS to generate work plans, ensure all beneficiaries receive scheduled services, and update the system in real time. Over 2.8 crore mothers and 2.06 crore children have been registered in MCTS so far. The government aims for 100% registration and updating of services provided through the system.
The Mother and Child Tracking System (MCTS) is an Indian government initiative to track maternal and child health beneficiaries and improve service delivery. It registers pregnant women and children under 5 for antenatal care, delivery care, postnatal care, and immunizations. Frontline health workers use MCTS to generate work plans, ensure all beneficiaries receive scheduled services, and update the system in real time. Over 2.8 crore mothers and 2.06 crore children have been registered in MCTS so far. The government aims for 100% registration and updating of services provided through the system.
Country Learnings and opportunities to advance pediatric quality of carekunalkanani5
This document summarizes discussions from a webinar on advancing pediatric quality of care held by the Child Health Task Force Network. Representatives from Kenya and Uganda shared their experiences designing and implementing national programs to improve pediatric quality of care. Key barriers to pediatric quality of care were identified, such as lack of prioritization and coordination, as well as opportunities like leveraging existing quality improvement platforms and expanding measurement of pediatric quality indicators. The webinar aimed to facilitate peer learning between countries on progress and priorities for scaling up pediatric quality of care.
ICDS was launched in 1975 to address malnutrition. It was restructured in 2012 to strengthen operations, improve outcomes, and meet nutritional goals. Key reforms included constructing AWCs, positioning them as early learning centers, supplementary nutrition revisions, and new provisions like Sneha Shivir for moderately malnourished children. The goals were to reduce child malnutrition by 10 percentage points and anemia by one-fifth in women and children to contribute towards lowering mortality rates. Restructuring focused on institutionalizing services, building capacity, inter-sectoral collaboration, and monitoring improvements to the scheme.
Reproductive and child health phase IIManoj Vaidya
RCH Phase-II outlines new initiatives to improve reproductive and child health in India, including making First Referral Units functional, training MBBS doctors in life-saving skills, and establishing blood storage facilities. The Janani Suraksha Yojana cash incentive program aims to increase institutional deliveries. Other initiatives proposed include the Rural Health Care Mission, establishing referral transport, and designating Accredited Social Health Activists. Infection management and environment plans will be implemented, and safe abortion practices like medical and MVA methods will be supported. Quality indicators are used to monitor programs through monthly reporting.
The document summarizes Rwanda's efforts to integrate palliative care into its national health system. Key points include:
- Rwanda established a palliative care program in 2011 with a vision of universal access by 2020. It has trained over 1,000 health care professionals and integrated palliative care services into hospitals, health centers, and communities through a network of home-based care practitioners.
- Palliative care services are part of Rwanda's community-based health insurance and national health information system. A palliative care desk coordinates services at referral and provincial hospitals.
- Lessons from partnerships include the importance of regional collaboration for training and mentorship, decentralizing services to effectively scale up palliative care,
2023JUL_Webinar_Ped QoC (1) (1).pptx by mitikumitiku34
The document summarizes a webinar on advancing pediatric quality of care held by the Child Health Task Force. It includes:
- Agenda items on sharing country efforts to improve pediatric quality from Kenya and Uganda, outcomes of recent discussions, and a roundtable discussion.
- Kenya has made progress developing pediatric quality standards and indicators, piloting a health facility assessment tool, and mapping indicators to their health information system. Challenges include resources for wide implementation and institutionalizing standards.
- Uganda has seen steady reductions in childhood mortality since 1989 through programs addressing leading causes of death. Future focus is strengthening health systems to support quality service delivery across all levels of care.
The document summarizes recent advances in Reproductive, Maternal, Newborn, Child Plus Adolescent Health (RMNCH+A) in India. It discusses programs and policies across various components of RMNCH+A including pregnancy and childbirth, newborn and child health, and reproductive health and family planning. Key initiatives highlighted include Janani Suraksha Yojana, Janani Shishu Suraksha Karyakram, and Rashtriya Bal Swasthya Karyakram.
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Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. Background
• Over the past few years, India has achieved substantial gain in health for
mothers and newborns.
• India's Maternal Mortality Ratio declined by 77% from 556 per 1 lakh live
births in 2000 to 130 per 1 lakh live births in 2015.
• During the same period, India's newborn mortality dropped by 44% from 1.2
million newborn deaths to under 7 lakh annually.
• Still we have a long way to go in terms of ‘Ensuring healthy lives and promote
well being for all at all ages'.
India is committed to reduce
• Maternal mortality ratio to less than 70 per 1,00,000 live births and to reduce
neonatal mortality to at least as low as 12 per thousand live births by 2030
under Goal-3 of Sustainable Development Goals.
• Positive birthing experience through respectful maternity care.
3. Our Targets
National Health Policy Targets more ambitious than SDGs
Indicator Current status National Health
Policy
SDG 2030
Maternal Mortality Ratio 130 100 by 2020 <70
Neonatal Mortality rate 24 16 by 2025 <12
Infant Mortality Rate 34 28 by 2019 -
Under 5 Mortality Rate 39 23 by 2025 ≤25
Total Fertility Rate 2.2
Replacement level
fertility
-
National Health Policy Targets more ambitious than SDGs
4. Institutional Deliveries & OOPE on Child-birth
Public,
2004-05,
1162
Public,
2014, 872
Private,
2004-05,
4137
Private,
2014,
8128
Public Private
Reduction in Average OOPE in Child Birth in Rural
areas
Increase in Institutional Deliveries
Institutio
nal
Delivery ,
2005-06,
38.7
Institu…
Institutio
nal
Deliverie
s in
Public
Health…
Institutio
nal
Deliverie
s in
Public
Health…
Institutional Delivery
Institutional Deliveries in Public Health Facilities
Source: NFHS 3 & 4
Source: NSSO
5. Maternal Health
Janani Shishu Suraksha
Karyakram
11.6 million
beneficiaries per year
Janani Surksha Yojana
10.6 million beneficiaries per year
Pradhan Mantri Surakshit Matritva Abhiyan &
comprehensive ANC services
16 million checkups
Strengthening FRUs, Delivery Points
FRUs 3157, DPs 20,000
Capacity Building of HR:
Dakshata/LSAS etc
Universal screening for
HIV and Syphilis
Comprehensive
Abortion Care Services
LaQshya
2235 facilities including 179 Medical
College facilities
Obs HDU & ICU:
Approx 162 Obs HDU &
ICU
MCH Wings
More than 600 MCH
Wings
8. LaQshya| लक्ष्य
(Labour Room & Maternity OT Quality Improvement Initiative)
• Organization and standardization of
Labour rooms, OTs and Obstetric
HDUs/ ICUs as per national
guidelines and standards
• Structured Quality Improvement
efforts/processes to improve
adherence to critical practices
around childbirth
• Improved client satisfaction -
“Respectful Maternity Care” (RMC).
Key Components
Labour Room
Certification
Expected Outputs
75% achievement of
targets for quality
80% satisfaction of
beneficiaries
LaQshya
Badges –
Platinum/
Gold/
Silver
Facility
level
Incentives
9.
10. LaQshya Status
1 Total LaQshya facilities 2235 (including
179 Medical
Colleges)
2 State Certification LR 115
3 State Certification OT 97
4 National Certification LR 54
5 National Certification OT 38
11. Obstetric HDU and ICU
• Need for critical Care Units - More than one third
of all maternal deaths are recorded either at
medical college hospitals or district hospitals (MDR
Software)
• National Guidelines for Obstetric ICU/HDU were
developed and released in 2016
• Operational guidelines to complement the already
existing guidelines in terms of:
– Human resource details
– Capacity Building Plan
– Equipment details
– Recording and Reporting formats etc
12. Janani Shishu Suraksha Karyakram
• Free and Zero Expense delivery including C-
section, free care in case of ante-natal & post-
natal complications
• Free drugs, diagnostics, blood and consumables
• Free diet during stay in facilities
• Free transport home to health institution,
between health institutions in case of referral
and drop back home
• Exemption from all kinds of user charges
• Similar entitlements for sick Infants (upto 1 year
of age)
• Extended to all antenatal & post natal
complications of pregnancy
Launched in June 2011 to ensure service guarantees and eliminate Out of Pocket expenses
Nearly 1.3 crores women availing benefits for free entitlements every year
64 70 45 34 3
% OF WOMEN DELIVERING IN PUBLIC
HEALTH FACILITIES RECEIVING JSSK
BENEFITS
13. •Over 16 million
quality antenatal
checkups
conducted & over
9 lakh HRPs
identified – 25%
checkups in HPDs
•13200 facilities
provide PMSMA
services
•Over 5500
volunteer doctors
from private/ NGO
sector
13
14. Till date 4907 participants trained in National and State Skills Lab
National Institute of
Health and Family
Welfare (NIHFW)
Daksh Training
14
1
2
4
5
3
Five
National
Skills Lab
.
..
Trained Nurses
Association of
India(TNAI)
Jamia Hamdard
University
Safdarjung
Hospital
Lady
Hardinge
Medical
College
A Lab comprising of skill stations where the
trainees learn through practicing skills on
mannequins, simulation exercises,
demonstration videos and presentations
104 stand alone skill labs in
States
15. DAKSHATA - A strategic initiative to strengthen quality of intra and
immediate postpartum care
.
.
Skills & Competency
•16,419 providers trained till date
•3119 participants sensitized in
95 DLSM meetings
•928 trainers prepared in 55 ToTs
•1018 training batches conducted
•1548 health institutions covered
•743 health institutions saturated
(80% provider trained).
• 4859 MSVs conducted in
738 Health facilities
• Structured visit package
completed in 394
facilities.
55 ToTs batches has been
done in Rajasthan, Andhra
Pradesh, Jharkhand,
Maharashtra, Odisha, Madhya
Pradesh, Kerala, Assam,
Meghalaya, Nagaland and
Jammu &Kashmir;.
16. Other MH Trainings
EmOC 2412 participants trained till date
2683 participants trained till date
More than 3 lac participants
trained
LSAS
BEmoC
SBA
17320 participants trained till date
17. On the Anvil – Guidelines on Midwifery Services & Cadre
• Cadre of Midwives skilled as per
competencies prescribed by
International Confederation of
Midwives
• Revision of current one year NPM
Training curriculum to 18 months
• Midwifery Led Units in Public health
facilities
• Career Progression for Midwives
• Certification and Regulation by Indian
Nursing Council
To provide access to quality
maternal and newborn health
services:
• Promote natural birthing by
promoting positive child
birthing experience
• Ensure respectful care
• Reduce over medicalization
Lancet Series on Midwifery (2014):
Safe and effective midwifery care can
avert 83% of all maternal deaths,
stillbirths and newborn deaths.
19. Nutrition
Promotion
Enriching foods with micronutrients by
fortification - to address micronutrient
deficiencies - New fortification standards for rice,
wheat, oil, milk and salt has been recently
released by FSSAI, MoHFW
POSHAN Abhiyaan – India’s flagship programme to
improve nutritional outcome of children, adolescent,
pregnant and lactating mothers by leveraging
technology, targeted approach and convergence
Facility based management of sick SAM children by
Nutrition Rehabilitation Centres - 1151 NRCs are
operational for medical management of sick SAM
children – around 0.18 Million sick SAM children were
admitted in FY 2017-18
34.7 million adolescents covered under WIFS
programme - 62% increase in WIFS supplementation
coverage during 2013-2017
19
20. IT INITIATIVES
• RCH portal and ANMOL- 15.54 Crore &
13.32 crore children
• MWMIS- Maternity Wing Management
Information System
• Kilkari- 72 audio messages delivered
weekly
• Mother and Child Tracking and
Facilitation Centre
• LaQshya Portal- Digitalization of all
LaQshya related data.
• All states/ UTs requested to login and
Upload all LaQshya related data in
portal.
• 4 Login Ministry, state , district and
facility
PMSMA
Online
portal
Safe Delivery
App- job aid
&
certification
20
Mera
Aspataal-
beneficiary
feedback
and
satisfaction
25. Areas of concern
Indicator National
Average
NFHS-4
State /UT performing worse than National average
Mothers who had
at least 4 antenatal
care visits (%)
51.2 % Arunachal Pradesh (26.8), Assam( 46.5),Bihar (14.4),
Haryana (45.1), Jharkhand(30.3), Madhya
Pradesh(35.7), Nagaland(15), Rajasthan(38.5), Uttar
Pradesh(26.4), Uttarakhand(30.9)
Institutional
Birth
78.9% Nagaland (32.8), Meghalaya (51.4),Arunachal
Pradesh(52.3), Jharkhand(61.9),Bihar(63.8)
Uttar Pradesh(67.8),Uttarakhand(68.6), Manipur(69.1),
Chhattisgarh(70.2),Assam(70.6)West
Bengal(75.2),Himachal Pradesh(76.4)
Pregnant
women age 15-
49 years who
are anaemic
(<11.0 g/dl) (%)
50.3 Andhra Pradesh(52.9),Meghalaya(53.1),West
Bengal(53.6),Tripura(54.4),Madhya Pradesh(54.6)
Haryana (55),Bihar (58.3),Andaman and
Nicobar(61.4),Jharkhand(62.6)
26. Way forward
1. Delayed cord clamping- Delayed cord clamping
has shown improvement in Oxygen saturation in
new born
2. ANC Guideline- Revision in ANC guideline is
under process In terms of no. of ANC visits,
various services provided during ANC etc.
3. Referral guideline- when , how and where to
refer is the most critical during emergency
situation and Protocol for referral is under
process
4. Focus on Respectful Maternity care