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Indian health care khatrti
1. Health Care In India
Lecture for CHBR Students, Karolinska Institutet,
Sweden
Subhash Khatri PT,PhD
physiokhatri@gmail.com
2. Ayurveda (Indigenous medicine) is one of the
oldest system of health care in the World
Mixed & Interlinked
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
4. Humor
• A man goes to a shrink and says, “Doctor, my
wife is unfaithful to me. Every evening, she
goes to Larry's bar and picks up men. In fact,
She sleeps with anybody who asks her! I'm
going crazy. What do you think I should do?”
“Relax”, says the Doctor, “take a deep breath
and calm down. Now, tell me, exactly where
is Larry's bar?”
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
6. Incredible India!
South Asia
Largest Democracy
Second most populous 1.2b
Third largest army
Four world religions originated here Hindu,
Buddhism, Jainism & Sikhism
Seventh largest country by area
Eight military expenditure
28/7 states & territories
11th largest economy
Multilingual PP
(c)Subhash Khatri
9/24/2014 8:36 AM
physiokhatri@gmail.com
8. Country %GDP spent
on health
Private
spending %
of all health
spending
Per capita
spent on
health in $
Per capita
Govt spent
Doctors per
10,000
India 4.1 70.8 132 39 6.49
http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-spending-world-country
21,511/1,236,344,631=57474
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
9. Incredible health?
• Highest no of medical colleges
• Highest no of doctors
• 4th largest export of Medicine
• Limited health care
• 2/3 don’t get essential medicines
• Medical paradox
• Financial accessibility
• Physical accessibility
• Information accessibility
• Self medication
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
10. Who runs hospitals?
Government
Charitable
trusts
Private
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
17. Public health organizational structure
National
• Ministry health & family
State level
• State level: Ministry health & family welfare
District level
• District health officer
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
20. • A business executive injured his leg skiing one weekend.
By the time he got home Saturday, the leg was very
swollen and he was having difficulty walking, so he
called his physician at his home. The doctor told him to
soak it in hot water. He tried soaking it in hot water but
the leg became more swollen and painful. His maid saw
him limping and said, "I don't know, I'm only a maid, but I
always thought it was better to use cold water, not hot,
for swelling." He tried switching to cold water and the
swelling rapidly subsided. On Sunday afternoon he
called his Dr. again to complain. "Say, what kind of a
doctor are you anyway? You told me to soak my leg in
hot water and it got worse. My maid told me to use cold
water and it got better." "Really?" answered the doctor, "I
don't understand it. My maid said to use hot water."
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
21. Who controls
1. MCI
2. AYUSH
3. Health ministry
4. Family welfare
5. No council for PT
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
25. A middle aged woman has a heart attack and is taken to the hospital.
While on the operating table she has a near death experience.
During that experience she sees God and ask if this is it. God says
no and explains that she has another 30 years to live.
Upon her recovery she decides to just stay in the hospital and have a
face lift, liposuction, breast augmentation, tummy tuck, etc. She even
has someone come in and change her hair color. She figures since
she's got another 30 years she might as well make the most of it.
She walks out of the hospital after the last operation and is killed by
an ambulance speeding up to the hospital. She arrives in front of
God and complains: "I thought you said I had another 30 years.
God replies, "I didn't recognize you."
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
26. Health insurance
• Buy
• Poor
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
27. • A man was making love to a village girl over
Christmas when she realized he was not using
a condom.
She asked him, "U 're not using a condom"?
Man answered, "Yes".
She said, "Hope u don't have HIV / AIDS .
Man, "NO".
Girl: "Thank God, I don't want to get that thing
again" !
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
29. Business in Indian way
3 contractors bid to fix a broken fence at the White House in D.C.
One from Bangladesh , another from India and the third, from
China .
They go with a White House office to examine the fence.
The Bangladesh "I figure the job will run about $900. ($400 for
materials, $400 for my team and $100 profit for me)".
The Chinese "I can do this job for $700. ($300 for materials, $300
for my team and $100 profit for me)".
The Indian contractor leans over to the White House official and
whispers, "$2,700."
The official, How did you come up with such a high figure?"
The Indian contractor whispers back, "$1000 for me, $1000 for
you, and we hire the guy from China to fix the fence."
"Done!" replies the government official.
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
31. Concerns
• Severe shortage of bed (bed density
2.1/1000)
• Morbidity = Medical Equipment, Supplies and
Facilities productive capabilities
• Human resources in health
• 63 million diabetics and 2.5 million cancer
sufferers, 20 million blind people
• 2.5 million Indians annually need heart
surgery severe shortage of hospital beds and
medical facilities
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
32. Health issues
1. Malnutrition
2. Infant mortality rate
3. Poor sanitation
4. Safe drinking water
5. Diseases
6. Health priority
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
34. "I told my doctor I broke my leg in two
places. He told me to quit going to
those places." - Henny Youngman
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
36. Secret of happy married life for 25 years
Husband: "We had been to Scotland for honeymoon after
marriage. My wife tried horse riding horse jumped suddenly,
making my wife topple over. Once again she tried to hop on horse
and said "This is your first time". She again climbed the horse
and continued with the ride. After a while, it happened again.
This time she again kept calm and said "This is your second time"
and continued. When the horse dropped her third time, she
silently took out the revolver from the purse and shot the horse
dead!!
I shouted at my wife: "What did you do you psycho. You killed
the poor animal. Are you crazy?”
She gave a silent look and said: "This is your first time!!!"."
Husband:"That’s it. We are happy ever after. "
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
37. Government efforts
• National Rural Health Mission (NRHM)
• Health insurance
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
43. What needs to be done?
1. Increase public expenditure
2. National Health Package
3. National Council for Human Resources in
Health (NCHRH)
4. Rational use of drugs
5. National Drug Regulatory Authority
6. Pay for performance (30%absentism)
9/24/2014 8:36 AM
(c)Subhash Khatri
physiokhatri@gmail.com
