Health Sector In India

Role of Private Sector in Curbing Malnutrition

                Malnutrition occurs due to multi-dimensional problems of quality, safety, availability and affordability of food. Lack of sanitation facilities, hygiene and vulnerability to diseases further perpetuate or are themselves causes of malnutrition. The private sector in India can play a pivotal role in reducing instances of malnutrition by leveraging:

• Large Scale Production Capacity
• Product and Business Model Innovation
• Marketing Expertise and Sale
• Extensive Distribution networks and Supply chains

They are currently engaged in fortification of foods and production of nutritional supplements that often bridge deficiencies of micro-nutrients like vitamins and minerals (iodine, zinc etc)

Role in Spreading Awareness

• Nudging Customers: Retailers can educate consumers through pro-active display and enhancing awareness to enable them to make effective and balanced dietary choices
• CSR Nutrition: Large corporate firms can increase awareness on balanced diet and provide quality food through their CSR programmes
• Leveraging Technology: Technology and telecom services can play a key role in monitoring diets, identifying deficiencies and suggesting balanced diets and effective health care services
• Workplace Nutrition: Workplaces can be used to educate employees regarding health and nutrition choices to enable them to take good decisions regarding dietary choices. Programmes can also be organized to distribute nutritious food among employees
• Influencing Cooking Practices: Media and food companies can educate consumers regarding cooking practices that are conducive to maintaining requisite and balanced level of nutrition

Substance Abuse

Overuse of any substance that affects human body function, mood which has potential for misuse and is harmful for both individual and society is categorised as Substance Abuse.

TOBACCO – Smoking and Smokeless

Overuse can lead to pulmonary and mouth diseases – lung, mouth cancer and other life-threatening diseases – 50% fatality

Passive smokers just as vulnerable to acquiring diseases -1/10^th of tobacco deaths

Issues

• Tobacco farming is highly profitable and yields highest return per hectare
• Powerful industrial lobby and nexus between industry and politicians: Research and Development, Insurance, Subsidy and Export allowances
• Less focus on smokeless tobacco whose health effects are much more averse compared to smoke tobacco

Government Strategy – ‘mPower’ – WHO’s Tobacco Free Initiative

• Offer help to quit and provide appropriate rehabilitation facilities
• Preventing first use : Focus on kids and adolescents
• Monitoring use and creating preventive policy
• Warning about dangers introduced by Cigarettes Act, 1975
• Increase taxes to discourage consumption
• Ban on advertisements and promotions
• Monitoring and regulating vendors
  • Recently the Rajasthan government made it mandatory for vendors selling tobacco products to procure licenses to sell within urban area limits. Further, those shops selling tobacco products shall not sell kid-friendly products- this is to reduce chances of first usage among children

India has ratified UN Convention on Tobacco Control

Cigarettes and Other Products Act, 2003

• Ban on sale to minors
• Ban on setting up shops near school
• Ban on Public Smoking
• Ban on Promotion

National Tobacco Control Programme – Ministry of Health and Family Welfare

Objectives

1. To generate greater awareness about harmful effects of tobacco through Media campaign (Rahul Dravid)
2. To ensure effective implementation of Cigarettes and other products Act, 2003

Other features

Collaboration with research institutes for alternate cropping mechanisms

Integrated with NRHM

Nicotine testing labs

Challenges for the Program

• Powerful industrial and farmer lobby
• No institutional mechanism to check effectiveness
• Overcoming behavioural problem and aversion to change
• Surrogate advertisements
• Faulty tax policy with different tax levied on bheedis and cigarettes
• Increase in space of warnings not fully implemented

Alcoholism

Issues Associated with Alcoholism

Social:

1. Domestic Violence
2. Drunken Driving
3. Increasing suicidal rates

Economic:

• Health Burden on individual and state
• Reduces productivity

Health Issues:

• Affect individual’s thinking capacity
• Liver capacity affected
• 5^th largest cause of death in the world

Different Approaches in Conquering Alcoholism

Phased Regulation vs Complete Ban

Past experiences from complete ban on intoxicants of any kind indicate that it only pushes trade and consumption underground making it extremely difficult for government to monitor and regulate. Hence original consumers are forced to consume even more harmful intoxicants that can have grave consequences on individual health

Phased regulation however gives government the opportunity to monitor and regulate production and consumption simultaneously generating awareness about harmful effects

FOOD SAFETY

Absence of harmful contaminants in food including:

1. Chemicals and toxins 2. Adulterants 3. Pathogens 4. Genetic Pollution

Consequences of Food Contamination

• Occurrence of diarrhoea
• Allergic Reaction
• Risk to acquiring non-communicable diseases
• Death

FSSAI (Food Safety and Standards Authority of India)

FSSAI lays down science based standards for articles of food and aims to regulate its manufacture, storage, distribution, sale, and import to ensure availability of safe and wholesome food for human consumption.

Functions                                                                                                            

• Nodal Authority: Acts as a single point or nodal authority for all matters concerning food safety
• Standardization for Food Quality: Laying down standards and guidelines
• Accreditation of Certification Bodies: Lays down mechanisms and guidelines for accreditation of certification bodies engaged in certification of food safety management system
• Accreditation of labs: Laying down procedure and guidelines for accreditation of labs
• Threat Evaluation: Data collection and analysis regarding biological risk, presence of contaminants, emerging threats and introduction of rapid alert system
• Generating Awareness: Create an information network across the country so that individuals and administrators are aware of the importance of food safety and a consumer’s role in ensuring the same
• Grievance Redressal Mechanism: Any consumer who has been affected by lower quality of food can air complaints towards FSSAI which can then take appropriate action to ensure quality in future.

Issues with Food Safety

• Lack of testing labs
• Insufficient monitoring and inspection
• Industrial Lobbying
• Lack of expertise for inspectors
• Greater Consumer Awareness required

Consumer Protection Act (COPRA), 1986

• Right to Know
• Right to be Heard
• Right to Choose
• Right to safety
• Right to Consumer Education
• Right to Redressal and Compensation