2635
Views & Citations1635
Likes & Shares
India has taken the major transformation reforms and
initiatives addressing barriers to universal health care, ensuring healthy
lives and well-being for all citizens at all ages (Sustainable Development Goal
‘SDG’-3), post-2015. With the growing investment and development in healthcare
in India, the most important barriers requiring constant attention are (i)
persistence of stigma, discrimination and societal obstacles associated with
the health condition (ii) access to the right information and (iii) timely
standard of care. Thus, emphasis on patient-driven policies and programs
besides systemic interventions, and healthcare ecosystem partnership is a
looked-for social impact. India has adopted patient engagement as one of the
tested and validated strategies to achieve the triple aim for value-based
health care (better health and better patient care at lower costs), a path
towards SDG 3. However, India needs to strengthen the healthcare ecosystem for
effective implementation of the patient engagement strategy aiming survival and
quality of life. Above and beyond, culture and system of transparency and
collaboration need to be improved for ‘buy-in' of citizens.
Keywords: Patient, SDG, Healthcare, India
Abbreviations: AIDS:
Acquired Immuno-Deficiency Syndrome; BMGF: Bill Melinda Gates Foundation; HIV:
Human Immuno-Deficiency Virus; INR: Indian Rupees; SDG: Sustainable Development
Goals; TB: Tuberculosis; USD: United States Dollars
INTRODUCTION
In
2015, for the first time, India issued a guideline on the involvement of
non-for-profit organization at community level interventions under the National
Health Mission, Communicable Diseases, Non-communicable Diseases and other
emerging issues [6]. Fifteen years after the last policy, a new India Health
Policy was introduced in 2017, which is patient-centric, quality driven, and
advocates positive and proactive engagement with private sectors and civil
society organizations [7]. With the intent to translate policy into practice, government
departments are endorsing various initiatives and innovative demonstration
projects and their scale-up to ensure healthy
lives and promote well-being for
Guided by the facts, several philanthropic
organizations in India, have integrated multi-pronged approach in health care
intervention using evidence-based and experience-based interventions. For
instance, Tata Trusts [11] formed National Cancer Grid, a network of cancer
hospitals and research institutions, patient advocacy groups and charitable
institutions across India to ensure greater awareness and accessibility to
cancer screening, diagnosis, and treatment. In addition, for the first time in
2018, the cancer patient advisory group was constituted in India, providing an
engagement platform for patients, care providers, and policymakers. On the
other hand, a ‘Peer-to-peer referrals’ strategy has been tested and found
valuable for increasing testing and detection of infectious diseases (e.g. TB),
where peers may have advantages over healthcare workers in both identifying new
patients and providing them trustworthy information [12].
With the growing investment and development
in healthcare in India, the most important barriers requiring constant
attention are (i) persistence of stigma, discrimination and societal obstacles
associated with the disease or health condition (ii) access to the right
information, and (iii) timely standard of care. The numerous evidence [13,14]
have concluded that patient participation and engagement in healthcare may
significantly address the above-mentioned barriers with two ethics integrated
explicitly in the system. These ethics are (a) responsiveness towards the
patient’s vulnerability and (b) shared decision-making that are vital beyond
other interventions associated with efficiency and effectiveness of the health
care. In the given context, the value of patient engagement with well-defined
pathways is the most likely steps to overcome the aforementioned barriers
ensuring positive health outcomes. Thus, emphasis on patient-driven policies and
programs besides systemic interventions and healthcare ecosystem partnership is
a looked-for social impact in India. Therefore, there is a need to understand
more about, “what” as well as “how” of patient engagement along with
confounding factors that facilitate the process.
It is well evidenced that patient engagement
is important in all fields of treatment, particularly chronic diseases like
cancer, diabetes, hemophilia; and its significance can be defined in two ways
[15]. First, transform self-stigmatized passive patient to active patient,
addressing their challenges from diagnosis to care pathway for improved health
outcomes. Second, empower patients to discover, drive and lead in the
patient-centric policy and program meaningfully. However, patients or patient
organizations require support and resources in transforming their capabilities
to effectively participate in the policy-shaping as patient advocates. The most
essential prerequisite to truly translate patient engagement strategy into
action is ‘education on patient’s rights’ including what are the diagnostic,
and treatment options, what should be expected from government and providers,
privacy and confidentiality of data, and how to protect their rights.
CONCLUSION
India has adopted patient engagement as one
of the tested, and validated strategies to achieve the triple aim [16] for
value-based health care (better health and better patient care at lower costs),
a path towards SDG 3.0. However, India needs to strengthen the healthcare
ecosystem for effective implementation of the patient engagement strategy
aiming survival and quality of life. Above and beyond, culture and system of
transparency and collaboration need to be improved for ‘buy-in’ of citizens.
1.
India State-Level Disease Burden
Initiative Collaborators. (2017) Nations within a nation: variations in
epidemiological transition across the states of India, 1990-2016 in the Global
Burden of Disease Study. Lancet 390.
2.
India State-Level Disease
Burden Initiative Cancer Collaborators. (2018) The increasing burden of
diabetes and variations among the states of India: The Global Burden of Disease
Study 1990-2016. Lancet Glob Health 6: e1352-1362.
3.
India State-Level Disease
Burden Initiative Cancer Collaborators. (2018) The burden of cancers and their
variations across the states of India: The Global Burden of Disease Study
1990-2016. Lancet Oncol 19: 1289-1306.
4.
The UN Sustainable Development
Goals for the period of 2015-2030. https://sustainabledevelopment.un.org/?menu=1300
(accessed on May 15, 2019).
5.
The UN system SDGs action
database. https://sustainabledevelopment.un.org/unsystem
(accessed on June 16, 2019).
6.
Government of India. Ministry
of Health and Family Welfare. Guideline for NGO Involvement under National
Health Mission in the Twelfth Five Year Plan. Available at: http://nhsrcindia.org/sites/default/files/Guidelines%20for%20NGO%20Involvement%20under%20NHM.pdf
(accessed on June 19, 2019).
7.
Government of India. (2017)
Ministry of Health and Family Welfare, National Health Policy. https://mohfw.gov.in/documents/policy
(accessed on May 31, 2019).
8.
United Nations High-Level
Political Forum (2017). On implementation of Sustainable Development Goals.
Voluntary national review report. Available at: https://sustainabledevelopment.un.org/content/documents/16693India.pdf
(accessed on May 31, 2019)
9.
Government of India (2018)
Ministry of Health and Family Welfare, Ayushman Bharat Mission. https://www.pmjay.gov.in/about-nha
(accessed on June 2, 2019).
10.
Government of India (2019) Ministry
of Health and Family Welfare. A brief report on Major Events and Achievement. Available
at: https://mohfw.gov.in/sites/default/files/Major-Events-Achievement-Month-of-March-2019_en.pdf
(accessed on May 6, 2019).
11.
Tata Trusts. Available at: https://www.tatatrusts.org/section/inside/Cancer-Care
(accessed on April 19, 2019).
12.
Goldberg J, Macis M,
Chintagunta P (2018) Leveraging patients' social networks to overcome
tuberculosis under detection: A field experiment in India. NBER Working Paper
No. 25279. Available at: https://www.nber.org/papers/w25279
(accessed on April 19, 2019).
13.
Vahdat S (2014) patient
involvement in health care decision making: A review. Iran Red Cress Med J 16:
e12454.
14.
Legare J (2011) Patient and
public involvement in clinical practice guidelines: A knowledge synthesis of
existing programs. Med Decis Making 31: E45-74.34.
15.
(2018) Population-based cancer
screening programmes in low-income and middle-income countries: Regional consultation
of the International Cancer Screening Network in India. Lancet Oncol 19: e113-e122.
16. Berwick DM, Nolan TW, Whittington J (2008) The triple aim: Care,
health and cost. health affairs. Health Reform 27.
QUICK LINKS
- SUBMIT MANUSCRIPT
- RECOMMEND THE JOURNAL
-
SUBSCRIBE FOR ALERTS
RELATED JOURNALS
- Journal of Blood Transfusions and Diseases (ISSN:2641-4023)
- Journal of Psychiatry and Psychology Research (ISSN:2640-6136)
- BioMed Research Journal (ISSN:2578-8892)
- Chemotherapy Research Journal (ISSN:2642-0236)
- International Journal of Medical and Clinical Imaging (ISSN:2573-1084)
- Journal of Nursing and Occupational Health (ISSN: 2640-0845)
- Journal of Carcinogenesis and Mutagenesis Research (ISSN: 2643-0541)