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Prospects bright for preventive medicine in India

Dr C V Achhra
Thursday, January 28, 2021, 08:00 Hrs  [IST]

Preventive medicine means the medical practices that are designed to prevent occurrence of disease and to alleviate human sufferings thereby reducing the burden of medical expenditure on individual as well as on the nation. It also averts resulting complications after the onset of a disease.

Preventive medicine can be practiced by Government healthcare agencies, primary care physicians and the individual himself. For example, screening for hypertension and diabetes may help us to pre-empt the onset of disease; which is good preventive medicine. The main challenge for the use of preventive medicine is to motivate and educate the individual to practice his own prevention of disease occurrence by way of taking precautions by eating balance diet, drinking pure water, doing daily exercise and living healthy life style which requires the participation of the primary care physician.

Preventive medicine is an important tool and the effective way of keeping a person healthier which is practiced by many licensed doctors or doctors of osteopathy, which is a system of complementary or alternate medicine. The main aim of the preventive medicine is to protect and promote health of all humans by prevention of diseases and disabilities and thereby reducing the mortality rate leading to reduction of financial burden as to healthcare cost of the nation.

It is said that “prevention is better than cure”. Preventive medicine has a larger role to play particularly in developing country like India having majority of its population living below poverty line; facing challenges from emergence of life-threatening diseases with rising medical costs due to costly novel drugs, use of new diagnostic procedures and modern medical equipment.

India’s healthcare system is already overstretched and over-burdened with rising population on one hand and on the other hand, the diminishing healthcare budget due to escalating economic difficulties and dwindling revenue. India is already facing with serious issues of patient safety and limited healthcare resources and poor population has limited access to modern medicines and modern healthcare facilities. In such a scenario, a preventive medicine is the only hope to address these serious issues in India. There is a dire need in India to utilize experts in this field of preventive medicine and to direct more public attention and to divert resources toward this important specialty.

Prevention of diseases is of two types i.e., ‘primary prevention’, where measures are applied to prevent the occurrence of a disease, and ‘secondary prevention’, where a disease or its complications are averted or halted after the onset of disease. Primary prevention comprises controlling environmental pollution, providing purified drinking water and air, immunizing population against infectious diseases and addressing the nutritional issues of society etc. and secondary prevention includes therapy and rehabilitation to prevent the spread of disease to non-infected individuals, identifying infected persons in early stage of disease and isolate them in order to curtail spread of infectious diseases.

Aims of preventive medicines

  • To prevent disease and disabilities.
  • To reduce mortality rate.
  • To alleviate human sufferings
  • To reduce the risks of disease
  • To reduce the burden of medical expenses on individual and on the nation.
  • To promote healthy life style as to food, water and physical activity or YOGA.
  • To promote principles of alternate medicines / complementary medicines and natural cure.
  • To achieve absence of disease.
  • To curtail progression of disease.
  • To immunize population against infectious diseases.
  • To anticipate risk of emergence of disease through genomic guided preventive medicines.
  • To generate genomic health risk information.
Healthcare scenario in post- independent India
The majority of population in India is living below poverty line in rural areas and is still deprived from social security support like health insurance system, education, housing etc. According to S. V. Joga Rao, “It is a fact that accessible and affordable health care is still a far dream for people of India. The largest part of health sector providing tertiary care in India is privately owned and is unaffordable. General healthcare setup consists of mainly out-patient care or ambulatory care and is being self-supported and the burden of expenditure in healthcare is born at individual level unaffordable to majority of Indian population already reeling under poverty. Whereas, the public health services supported by Governments are very inadequate and under developed and are overburdened.

Public hospital services are mostly existing in the cities having urban population; whereas the rural areas have unequipped primary healthcare centres which are scantly located although rural population is in majority. Indian healthcare system is also overburdened due to scarcity of medical professionals and due to fast emergence of life-threatening diseases like cancer, HIV /AIDS, Diabetes, Dengue, Leptospirosis and drug resistant T.B., SARS and Covid 19 now.

In the review article entitled “Healthcare in India”, Leena V Gangolli and others stated that “Poverty is the real context of India”. Three fourths of the population live below the poverty line or at the subsistence levels. Rural areas are mostly equipped with preventive care promoting social services like immunization and family planning and are lacking from modern curative services and modern infrastructure required for healthcare setup. Due to rising population, the access to affordable healthcare is further deteriorating. Hence, poor and middle classes get adversely affected. Whereas, the public healthcare sector is inadequately staffed, selectively focused and overburdened due to budgetary constraints.

The cost-effective treatment of diseases and affordability of medicines is very important issue in least developed or developing countries across the globe.

Since, right to healthcare is not recognized in Indian statutes, the health status of Indian population and standards of healthcare are unsatisfactory. The public healthcare sector mostly belongs to Central Government, State Governments, Municipal and Panchayat local governments. There are also special public facilities like the Employees State Insurance Scheme (ESIS) and Central Government Health Scheme (CGHS). Since, these government healthcare sector has limitations in terms of infrastructure, equipment, inadequate maintenance and medical staff, the general population are not able to avail expected benefits for health.

State Governments are gradually reducing their responsibilities and hardly have any budgets for providing minimum health care in the context of increasing population. Hence, already difficult scenario of access to affordable healthcare is getting worse day by day and not only the poor but also the middle classes people get adversely affected. In the context of above, it can be concluded that since right to healthcare is yet to be recognized by parliament, the health status of the general Indian public is less than satisfactory and lies below the minimum standards of fairly good healthcare. In India, there is less focus on speciality branch of ‘preventive medicine’ and India has to go all out to promote public health and awareness about preventive medicine to reduce occurrence of diseases and their complication. Hence, future prospects of preventive medicines and its specialists are brighter in India in days to come which becomes necessity for India.

Primary healthcare and primary prevention in India
Primary prevention of diseases can be mainly practiced through community-based health promotion and through traditional prevention. It is the goal of community health to have population to improve their life style through healthy diet, drinking pure water and by doing YOGA and physical exercises in order to prevent occurrence of diseases. Primary healthcare is provided by health professionals, the ones the patients see first. Primary prevention refers to the early avoidance and identification of risk factors that may lead to certain diseases and disabilities. The points of focus for primary prevention of diseases are following:
  • Nutritional education and addressing the nutritional deficiencies.
  • Educating about water borne diseases and need for purification of drinking water
  • Immunization through vaccines
  • Class room teachings
  • Awareness programs regarding health issues.
  • Improving individual’s environment.
  • Awareness about YOGA practices
  • Educating about healthy life style
  • Educating about self-monitoring skills
  • Educating about chronic disease self-management programs to reduce burden on tertiary healthcare hospitals.
  • Screening on mass scale and generating genetic health risk information.
Need and future prospects of preventive medicine in India
As discussed above, the healthcare sector in India is grossly inadequate to cater the needs of large section of its population which is living below poverty line and situation becomes worse in absence of effective free medical insurance system. In this situation, adoption and promotion of concepts of preventive medicine on large scale is required to curtail the emergence of diseases. There is the need to promote community health in India which is the branch of public health which focusses on people’s health and on environmental factors. It focusses on the maintenance, protection and improvement of the health status of population and communities.

India already has a wide net-work of primary healthcare centers and therefore there is great scope for promoting preventive medicine. Primary healthcare programs aim to reduce risk factors in order to prevent causing disease by increasing health promotion. India being developing country having limited infrastructure for secondary and tertiary healthcare and having limited healthcare budget is in dire need of preventive medicine specialty in order to avoid disease occurrence and to reduce heavy expenditure on modern medicines and medical procedures.

India is heavily dependent on network of primary health care spread in rural India which can play effective role for preventive medicine and health promotion by educating population at gross root level in order to prevent disease occurrence. India having a strong base for alternate medicine/complementary and alternate system of medicines (CAM) with a strong network of ‘AYUSH’, Naturopathy and Yoga plays an important role in prevention of diseases by promoting physical as well as mental wellbeing.

Conclusion
India already having a vast net-work of primary health centers in rural India and having ancient knowledge and resources for Yoga  and Naturopathy and having medical professionals trained in ‘AYUSH’ and “Complimentary and Alternate Medicines (CAM)” and specialists in preventive medicines can promote public health and awareness by educating public on a mass scale in order to reduce occurrence of diseases and to minimize complications due to onset of diseases which shall alleviate suffering as well as minimize burden of medical expenditures. Hence, there is a bright future for preventive medicine in India. u

(The author is the Director of CHM College Campus and former principal of K M Kundnani Pharmacy Polytechnic)

 

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