Mapping Malayali's health

THIRUVANANTHAPURAM: With the LDF Government giving top priority to the E Health project, the health records of the state’s entire population will be just a click away within a year. At the moment, the pilot project is on at three primary health centres and two community health centres in Thiruvananthapuram district. Apart from Thiruvananthapuram, six more districts will be covered during the first phase including Kannur, Kasargod, Malappuram, Ernakulam and Alappuzha. “We expect to complete the entire health mapping of the 3.5 crore population in one year,” said project in charge Dr N Sreedhar.

About 8,000 field staffers who have been trained in Health Management Information System (HMIS) and Mother Child Tracking System (MCTS) will be collecting the demographic data on the ground. They have been equipped with tablets. Doctors, nursing staff, paramedics are also being trained for the effective implementation of the E health project. Health data will be computerized and entered in the State Data Centre through the Kerala State Wide Area Network.  It would be registered on the basis of the adhaar number.

Once the system comes into being, the health record of each person seeking treatment at the primary health centre, community health centre and hospitals, will be available for reference by the doctors. This will provide the entire health profile of each patient including family history, ailments, medicines taken and lifestyle parameters which will help doctors plan proper treatment protocol. It will also help people to know their medical parameters like sugar level and BP regularly.

Through the programme, the Government intends to put in place effective measures for controlling lifestyle diseases, monitor infectious diseases, mother-child health care, ensure standards and facilities in health centres and to plan better health programmes in future. OP counters, examination rooms, laboratories, pharmacy, administrative department will all be connected through the local area network in over 1,200 hospitals and health centers coming under the health services department. Once the patient reaches the OP counter, through his adhaar card, all medical records would be downloaded by the hospital after entering the unique identification number.

During the second phase, the E project will be extended to the institutions under the Directorate of Medical Education and subsequently the private health care institutions will also be taken on board. “We are committed to implement the E heath project as part of people’s health policy. Information on health status, blood group, drug reaction if any, vulnerability to infectious disease will all be a click away. Once the entire population is mapped, Kerala will become the first state to have electronic health card system,” said health minister K K Shailaja.

Dr B Ekbal, former member of Planning Board said diagnosis should be based on a standard protocol so that there is uniformity in data. For instance if it is diabetes, then it should be made clear whether it is Type 1 or Type 2. There should be proper guideline on classification of diseases. “Those entrusted with collection of data should be well trained and a strict monitoring mechanism has to be put in place to ensure that these workers are keying in proper data,” he said and suggested that government hospitals should also focus on keeping medical records.

“It is high time we had an electronic health system, Unique registration or unique health card through which heath of citizens can be accessed. Data collection will help in disease mapping, plan better prevention and control strategies, utilise resources effectively,” said Sreejinth N Kumar of IMA. He said to make the programme universal, the private sector which caters to 60 per cent of health care in the state, should also be roped in. Since the government health staff is already burdened with a huge workload, separate manpower deployment is required for the scheme.

Life style diseases pose big threat

With 180 out of every 1,000 people in the state being sick due to one or the other chronic illnesses according to health experts, Kerala clearly needs a long term strategy to deal with the emerging challenges in the health sector. In urban areas, the prevalence of heart diseases is as high as 12 per cent. In rural areas the prevalence is 7.5 per cent. Among lifestyle diseases, problematic heart continues to be a big challenge. As many as 20 per cent of all deaths occurring in the state are due to heart attacks with the mortality rate among 1 lakh persons at 380 for men and 128 for women.

These figures are very high compared to several countries. Approximately 60 per cent of cardiac deaths in men and 40 per cent in women occur before 65 years. Diabetes continues to be an alarming health problem with it affecting nearly 20 per cent of the state’s population. The projections for various health problems for 2020 are alarming. The risk burden for 2020 in the age group 20-59 (in millions)  for the following problems: smoking in males  4.5; hypertension 3.52; diabetes 2.26; high cholesterol 4.5; low HDL 5.4 besides ECG changes of coronary heart disease  at 36 /1,000 and angina at  48/1,000 respectively.

Cancer care is another big challenge faced by the health sector. According to estimates, nearly 40,000 new cancer cases are reported in the state annually. Among males, the 50 per cent cases are related to mouth, throat and lungs caused mainly because of tobacco and alcohol. Consumption of red meat has also contributed significantly to the rise of bowel cancer. Among women, breast cancers are the highest at 30 to 35 per cent. More than 1200 new breast cancers are registered in RCC Thiruvananthapuram annually.