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Press Release – Intelehealth awarded at the HDFC Parivartan SmartUp Grants 2022

Intelehealth awarded at the HDFC Parivartan SmartUp Grants 2022

Intelehealth has been chosen as one of the top 85 grantees of the HDFC Parivartan SmartUp Grants 2022 for its innovative and high-impact solutions to key challenges in Indian healthcare.

Intelehealth, a tech-for-impact organization was recently named the 5th annual HDFC Parivartan SmartUp Grants 2022 winner. Along with Intelehealth, HDFC bank awarded grants to 85 other innovative start-ups from a pool of over 150 applicants from across the country working in various sectors. The grants were awarded following a rigorous screening process that focused on addressing environmental, healthcare, and gender diversity issues.

These grants received will help Intelehealth to expand its reach in rural India, launch new telemedicine projects, and develop and strengthen technology that aims to bridge the gap between rural populations and healthcare providers. 

Neha Verma – CEO & Co-Founder, Intelehealth: “We would like to thank the HDFC Parivartan SmartUp Grants 2022 team for recognizing and believing in our work and awarding us the grant. This grant money will be extremely beneficial in assisting us in meeting our current objectives. With this grant, the organization will expand and scale up the Telemedicine projects in areas where access to healthcare remains a barrier. We look forward to this valuable partnership and are grateful for your belief in the mission that we strive for”.

These grants are intended to support startups that provide one-of-a-kind solutions to bring about long-term change in society and the environment. The grants were made available through Parivartan, the HDFC bank’s flagship CSR program for social initiatives. 

About Inteleheath : Intelehealth is a tech-for-impact organization: A team of engineers, clinicians, management and public health experts. We’ve developed an innovative open source telemedicine platform connecting the last mile population with affordable and quality healthcare services. 

Our mission is to “Deliver quality healthcare where there is no doctor”. 

Our vision is “Health for all”, we believe in the vision of universal health coverage – that you should be able to receive the health services you need, when and where you need them, without facing financial hardship.

 To know more about Intelehealth, log on to www.intelehealth.org 

For more information, kindly contact : 

Nishant Pratap Singh – Director, Partnership (nishant@intelehealth.org)

Rhea Mathews Manager – Marketing & Communications (rhea@intelehealth.org)

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Press Release – Intelehealth partners with ACT to deploy eSanjeevani in Odisha

Intelehealth partners with ACT for the deployment of eSanjeevani in Odisha

Intelehealth receives a grant from ACT which will be used to enhance the eSanjeevani telemedicine program in the state of Odisha in partnership with the National Health Mission.

Intelehealth has collaborated with ACT for the implementation of the eSanjeevani Telemedicine programme across the state of Odisha’s Health & Wellness Centres (HWCs), Primary Health Centres (PHCs), and Urban
Primary Health Centres (UPHCs).

The implementation of the national telemedicine programme in Odisha aims to promote comprehensive primary health care while also strengthening systems by making them more resilient and accessible. This project will benefit 1,600 health care facilities in 30 districts.

Neha Verma – CEO & Co-Founder, Intelehealth: “We would like to thank ACT Grants for recognizing and believing in our work and awarding us the grant. This grant money will be extremely beneficial in assisting us in meeting our current objectives. With your support, the organization will deploy eSanjeevani in the remotest parts of Odisha where access to healthcare remains a barrier. We look forward to this valuable partnership and are grateful for your belief in the mission that we strive for”.

Intelehealth aims to improve capacity building, and skill development for the frontline health workforce and mobilize the community to create and increase awareness of the eSanjeevani telemedicine program in the state of Odisha.

About Inteleheath :
Intelehealth is a tech-for-impact organization: A team of engineers, clinicians, management and public health experts. We’ve developed an innovative open source telemedicine platform connecting the last mile population with affordable and quality healthcare services.


Our mission is to “Deliver quality healthcare where there is no doctor”.

Our vision is “Health for all”, we believe in the vision of universal health coverage – that you should be able to receive the health services you need, when and where you need them, without facing financial hardship.


To know more about Intelehealth, log on to www.intelehealth.org


For more information, kindly contact :


Nishant Pratap Singh – Director, Partnership (nishant@intelehealth.org)


Rhea Mathews – Manager, Marketing & Communications (rhea@intelehealth.org)

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Together we can make telemedicine reach the last mile

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Press Release – Intelehealth joins Digital Public Goods Alliance

PRESS RELEASE

Advancing 'Health for All' through Telemedicine: Intelehealth joins Digital Public Goods Alliance

July 04, 2022: Intelehealth was added to the Digital Public Goods Alliance DPG Registry last week. This underscores Intelehealth’s commitment to developing and championing digital public goods that will help achieve ‘Health for All’ and contribute to the Sustainable Development Goals (SDGs). 

Intelehealth is a non-profit delivering high-quality healthcare for the last -mile population where there is no doctor through telemedicine. Using our open-source technology platform that’s driven by an innovative digital health assistant, we connect patients and frontline health workers at the last mile with qualified doctors, diagnostics & medications. Intelehealth is on track to provide healthcare for 10 million women over the next three years in partnership with Ministries of Health in India & Kyrgyzstan. Intelehealth has been recognized by the World Economic Forum, UNICEF, and NITI Aayog as an impactful Digital Public Good. 

Our mission is to “Deliver quality healthcare where there is no doctor through Telemedicine” 

Our vision is “Health for all” we believe in the vision of universal health coverage – that you should be able to receive the health services you need, when and where you need them, without facing financial hardship. 

For us, being recognized as a digital public good – defined as open source software, available data, open AI models, open standards and content that adhere to privacy and other applicable laws and best practices- does no harm and help attain the SDGs. 

“Intelehealth’s addition to the DGP registry recognizes its commitment to providing high-quality healthcare for last-mile populations where there is no doctor through Telemedicine and for closing the digital divide between urban and rural populations by providing affordable access to healthcare using our digital public good platform”, said Intelehealth CEO & Co-founder, Dr. Neha Verma. 

The Digital Public Goods Alliance is a multi-stakeholder initiative endorsed by the United Nations Secretary-General, working to accelerate the attainment of the Sustainable Development Goals in low- and middle-income countries by facilitating the discovery, development, use of, and investment in digital public goods. 

To know more about Intelehealth, log on to www.intelehealth.org For more information, kindly contact : 

Nishant Pratap Singh – Director, Partnerships (nishant@intelehealth.org)

Rhea Mathews – Manager, Marketing & Communications (rhea@intelehealth.org)

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India is home to 77 million diabetics, second highest in the world : Is Telemedicine a solution?

Diabetes is one of this century’s most significant global health emergencies, ranking among the ten leading causes of mortality and cardiovascular disease (CVD), respiratory disease, and cancer. According to the World Health Organization (WHO), non-communicable diseases (NCDs) accounted for 74% of deaths globally in 2019, of which Diabetes resulted in 1.6 million deaths, thus becoming the ninth leading cause of death globally.

[Data source WHO   https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/ncd-mortality]

According to ICMR’s guidelines, India is home to the world’s second-largest adult diabetes population, and every sixth person with Diabetes in the world is an Indian. The past three decades witnessed a 150 percent increase in the number of people with Diabetes in the country. The progressive lowering of the age at which type 2 diabetes is being diagnosed, with the disease prevalence becoming apparent in the age group of 25-34 years in both urban and rural areas.

[Data Source ICMR https://main.icmr.nic.in/sites/default/files/upload_documents/ICMR_Guidelines_for_Management_of_Type_1_Diabetes.pdf]

Causes of Diabetes

  • Multifactorial pathogenesis in which metabolic, behavioral, lifestyle and environmental factors precipitate disease in genetically predisposed persons
  • The combination of insulin resistance increased hepatic gluconeogenesis, and relative defects in insulin secretion promote metabolic dysfunction.
  • Overweight or obese body habitus is a significant factor contributing to insulin resistance, which is a precursor to glucose intolerance and diabetes development.
  • A hypercaloric diet and sedentary lifestyle also worsen insulin resistance
  • Hyperglycemia develops when progressive impairments in insulin secretion render pancreatic β-cells unable to maintain euglycemia
  • Vital hereditary component contributes to the manifestation of the disease, with complex polygenic inheritance pattern underlying most cases

Risk factors of Diabetes

Age
  • Incidence increases with age, owing in part to age-related reduced glucose tolerance but also reduced physical activity and increased adiposity
Gender: Women with a history of the following are at greater risk for diabetes:
  • Polycystic ovary syndrome (PCOS)
  • Delivery of an infant weighing more than 4 kg
  • Previous diagnosis of gestational diabetes (Diabetes during pregnancy)
Genetics
  • Most cases of type 2 diabetes have a complex multifactorial polygenic basis, with over 100 loci identified as contributing to a higher risk.
  • Genetic risk for type 2 diabetes is primarily expressed in environmental factors such as obesity and a sedentary lifestyle.
Ethnicity/race
  • Increased prevalence in African American, Latino, Native American, Pacific Islander, and Asian American populations
 Other risk factors/associations
  • Prediabetes (hemoglobin A1C level (HbA1C) 7%-6.4%; 5-fold elevated risk)
    • Overweight or obesity (2-fold elevated risk if overweight; risk rises proportionately with a higher class of obesity)
    • Sedentary lifestyle
    • Medications that worsen glucose tolerance or exacerbate hyperglycemia, such as:
      •  GlucocorticoidsThiazide diuretics
      • Atypical antipsychotics
      • Sleep disorders (eg, obstructive sleep apnea, chronic sleep deprivation, night shift work schedule) in conjunction with glucose intolerance

    What is Type 1 Diabetes?

    Type 1 diabetes (previously known as insulin-dependent, juvenile, or childhood-onset) is characterized by low insulin production and requires daily administration of insulin. In 2017 there were 9 million people with type 1 diabetes; most of them live in high-income countries. Neither its cause nor the means to prevent it are known. Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.

    What is type 2 Diabetes?

    Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body’s ineffective use of insulin. More than 95% of people with Diabetes have type 2 diabetes. This type of Diabetes is primarily the result of excess body weight and physical inactivity. Symptoms may be similar to type 1 diabetes but are often less marked. As a result, the disease may be diagnosed several years after onset, after complications have already arisen. Until recently, this type of Diabetes was seen only in adults, but it is now also occurring increasingly frequently in children.

    Prevention

    Simple lifestyle measures are effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:
    • Achieve and maintain healthy body weight;
    • Be physically active – doing at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control;
    • Eat a healthy diet, avoid sugar and saturated fats; and
    • Avoid tobacco use – smoking increases the risk of Diabetes and cardiovascular disease.

    Diagnosis and treatment

    • Early diagnosis can be accomplished through relatively inexpensive testing of blood sugar.
    • Treatment of Diabetes involves diet and physical activity along with lowering blood glucose and the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications.
    • Interventions that are both cost-saving and feasible in low- and middle-income countries include blood glucose control, particularly in type 1 diabetes. People with type 1 diabetes require insulin. People with type 2 diabetes can be treated with oral medication but may also require insulin, blood pressure control, and foot care (patient self-care by maintaining foot hygiene; wearing appropriate footwear; seeking professional care for ulcer management; and regular examination of feet by health professionals).
    Other cost-saving interventions include screening and treatment for retinopathy (which causes blindness), blood lipid control (to regulate cholesterol levels), and screening for early signs of diabetes-related kidney disease and treatment. [Data source – WHO https://www.who.int/news-room/fact-sheets/detail/diabetes)

    Intelehealth and MSF India Response

    Diabetes is rising in India, with the second-highest diabetics due to increased sedentary lifestyles, unhealthy diets, tobacco use, and obesity. Nearly 50% of the population are unaware that they have Diabetes. Intimidated by the stats showing India has the second highest number of diabetics in the world, MSF India launched the telemedicine Diabetic Management Helpline, powered by Intelehealth, to provide primary-level diabetes care and manage the disease and encourage healthy living. A pan-India toll-free helpline would improve access to standardized and uniform helpful information about diabetes care which would be customized to their needs. This would significantly help the underprivileged, who would otherwise postpone or even forgo needed healthcare due to non-affordability. Such digital technology platforms motivate the patients for diabetes self-management through constant follow-ups, counseling and access to a diet plan. The helpline would allow the patients to seek consultations at their convenience. By providing appropriate counseling on healthy meal plans and lifestyle modifications by an accredited dietician, increasing awareness, and promoting self-monitoring of health and routine follow-ups, the helpline could minimize the risks of future complications.  Additionally, the helpline would also support the patients in seeking psychological healthcare, which is crucial to the overall management of Diabetes, without the fear of stigmatization. If you have Diabetes and need medical assistance, contact the Diabetic Management Helpline. Call 1800 309 4144 and connect with a team of nurses, doctors & nutritionists and learn how to manage your diabetes effectively.

References:
1. Dluhy RG et al: Intensive glycemic control in the ACCORD and ADVANCE trials. N Engl J Med. 358(24):2630-3, 2008

2. Tancredi M et al: Excess mortality among persons with type 2 diabetes. N Engl J Med. 373(18):1720-32, 2015

3. Skyler JS et al: Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. J Am Coll Cardiol. 53(3):298-304, 2009

4. Riddle MC et al: Consensus report: definition and interpretation of remission in type 2 diabetes. Diabetes Care. ePub, 2021

5. Nathan DM: Diabetes: advances in diagnosis and treatment. JAMA. 314(10):1052-62, 2015

6. Bonnefond A et al: Rare and common genetic events in type 2 diabetes: what should biologists know? Cell Metab. 21(3):357-68, 2015

7. American Diabetes Association Professional Practice Committee et al: 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 45(Supplement_1):S17-38, 2022

8. Selvin E et al: Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med. 362(9):800-11, 2010

9. Nguyen NT et al: Relationship between obesity and diabetes in a US adult population: findings from the National Health and Nutrition Examination Survey, 1999-2006. Obes Surg. 21(3):351-5, 2011

10. Telemedicine Cost–Effectiveness for Diabetes Management: A Systematic Review:Jun Yang Lee and Shaun Wen Huey Lee

11. Telemedicine Application in the Care of Diabetes Patients: Systematic Review and Meta-Analysis : Milena Soriano Marcolino, Junia Xavier Maia, Maria Beatriz Moreira Alkmim, Eric Boersma, Antonio Luiz Ribeiro

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Proposed guidelines for Registered Medical Practitioners (2022) by the National Medical Council

Author – Dr Nalanda Singh (Medical Consultant, Intelehealth)

The draft document has been released in the public domain recently by National Medical Commission (NMC) regarding Professional Conduct Regulations (2022) which includes Telemedicine Practice Guidelines for Registered Medical Practitioners (RMP). This will serve as a set of self-regulatory guidelines for the RMP to practice medicine both physical and remote teleconsultations, and commitment to patients, society, and professional colleagues.

Highlights:

Prefix, Suffix, and Modern Medicine:

  • Only those RMPs who are registered under NMC Act, 2019, can use Medical

Doctor (Med Dr.) as a prefix before their names

  • Only NMC recognized medical degree/ diploma as a suffix

  • All RMPs, employed or self-employed should display the unique registration number below the RMPs’ signatures

  • RMPs are allowed to practice only one system of medicine.

  • RMPs need to be involved in public education & awareness activities without involving advertisement.

 

Prescribing Generic Medicine:

  • Every RMP is expected to prescribe drugs using “generic”/“non-proprietary”/“pharmacological” names only.

  • Encourage patients to purchase drugs from Jan Aushadhi Kendras.

  • To avoid misinterpretation prescriptions should preferably be written in capital/ typed and printed.

 

Continuing Professional Development (CPD):

  • 30 credit hours required every 5 years, to be updated online regularly by

receiving training from recognized medical colleges, health institutions or medical societies.

 

Ethics:

 

  • Guidelines reflect relevant professional as well as social expectations from

RMP.

  • Must not refuse to treat a patient in case of a medical emergency, nor

discriminate based on gender, religion, caste, or economic grounds.

  • In case of abusive, unruly violent patients or relatives, the RMP can document, report, and refer the patient.

  • When an epidemic occurs, an RMP with all necessary medical protection and his own health permitting should not abandon his/her duty for the fear of contracting the disease him/herself.

  • Should not engage in endorsement or promotion of any drug, or medical product.

  • RMP & their families must not receive any gifts/travel facilities/ hospitality /cash/ monetary grants.

  • Inclusion of Declaration of Geneva 2017 called ‘The Physician’s Pledge’.

 

Penalties:

 

  • Strict and detailed penalties have been enumerated for uniformity across the country in the assessment of liabilities and award of disciplinary actions in case of professional misconduct.

  • The disciplinary actions mentioned are – Reformation, Temporary suspension of license to practice, which can range from 1 month to 3 years.
    Debarring the RMP will depend on the level (severity) of misconduct proved.

Digitization of Medical Records:

 

  • Every self-employed RMP shall maintain medical records of all patients for 3 years from the date of the last contact with the patient. This should be done within 3 years of publication of the official gazette.

 Consent:

  • Before performing any clinical procedure, or operation, the RMP should obtain the documented informed consent of the patient. In case the patient is unable to give consent, the consent of the legal guardian or family member must be taken.

  • In an operation that may result in sterility, the consent of both husband and wife is required.

  • In-vitro fertilization or artificial insemination shall be undertaken only after informed written consent from the female patient, spouse, and the donor.

  • A RMP shall not publish photographs or case reports of patients without their permission in a manner by which their identity could be revealed.

  • For the use of patient data in academic teaching or clinical case discussions, patient consent is required. Under no circumstances will the patient’s data be posted on social media.

Social media conduct:

  • RMP can provide factually verified information/ announcements on social media.

  • Should avoid discussing treatment or prescribing medicines and soliciting patients on social media

 
 

     Telemedicine:

 

  • Principles of medical ethics that are mandatory for the profession must also be respected in the practice of telemedicine.

  • A RMP is eligible to provide telemedicine consultations from any part of India and should be familiar with guidelines, processes, and limitations of telemedicine practice, hence they need to undergo CPD training on the same.

  • Teleconsultations should not be anonymous, the patient and RMP should know each other’s identities.

  • In the case of a minor patient, teleconsultation should proceed only in the presence of a parent/legal guardian.

  • Patient confidentiality, privacy, and data integrity should not be compromised.

  • Mandatory consent.

 
  • Telemedicine Application types-

 

  1. Mode of communication – video, audio, text

  2. Timing of the information transmitted – real-time, asynchronous

  3. Purpose of the consultation – nonemergency (first consultation & follow up), emergency (first aid, counseling, referral)

  4. Interaction between individuals involved – patient to RMP, caregiver to RMP, RMP to RMP, health worker to RMP.

  • Patient management-

  1. Health education- related to health promotion & prevention

  2. Counseling- specific advice related to underlying condition

  3. Medicines- can prescribe any drug except schedule X drugs



Guidelines for technology platforms enabling telemedicine:


  • RMPs must not participate in telemedicine platforms that provide ratings by the patient or others including reviews, advertisements, and promotions of RMPs by any means (manipulation of algorithms/search engines).

  • Technology platforms providing telemedicine services are obligated to ensure that consulting RMPs are duly registered.

  • The platform must provide the name, qualifications, registration number, and contact details of every RMP.

  • In case of non-compliance with guidelines/ existing laws applicable to the

provision of services, appropriate legal action can be initiated against the

platform.

  • Artificial intelligence/ machine learning is not allowed to counsel the patients or prescribe any drugs but can assist and support the RMP on

evaluation, diagnosis, or management.

  • Technology platforms must ensure a proper grievance redressal mechanism for end-users of their services.

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Quality Assurance Mechanism

Author : Dr. Shilpa Bhatte (Chief Program Officer – Global Lead, Intelehealth)

Telemedicine is the remote diagnosis and treatment of patients using telecommunications technology. 

It is a reasonably new medium for providing and seeking healthcare services due to its sudden thrust into the limelight during the COVID-19 pandemic. As healthcare providers, we are still in the process of understanding and exploring how these services can be optimized and made effective and efficient to suit patients’ needs while also inculcating a sense of trust in the medium through which the advice is provided. 

At Intelehealth, we believe that healthcare providers will need ongoing user support and troubleshooting with tech-related issues to adapt to a new medium and will require support to deliver healthcare advice effectively.

 

To support our healthcare providers and standardize their skills – we maintain a rigorous quality assurance mechanism for our helplines and telemedicine platforms. Specifically, with helplines, we do a thorough and ongoing medical audit of a few core areas, such as: 

  1. Communication skills 
  2. Quality of the advice/information provided 

The clinical team conducts the audit based on details recorded on the app and given to them. But they can contact the concerned backend doctor/s, frontline health worker/s, or patient/s for further understanding.


With communication skills, our focus is to emphasize the need to engage the patients with empathy and compassion, understand their symptoms and ask relevant questions to understand the morbidity better. 

  • Introduction: Stating who you are and the organization/government you are calling on behalf of is extremely important, along with the reason for the call – it can be disorienting to a person/patient if they do not understand who you are and the nature of the call
  • Using speech effectively: Speaking slowly is essential, and so is pronouncing words well. Maintaining a calm tone is important, and mumbling or speaking fast may have a counter-effect in the person not being interested in the consultation. One has to also quickly assess if they can hear your questions satisfactorily and can respond accordingly.
  • Language: It is essential to adjust the language according to the listener/patient, optimizing their engagement and responses. It is also vital to always be respectful and empathetic in your questions
  • Minimize use of medical language: Health providers assume that patients will understand the nature of the morbidity under question. This may not always be true. Hence use descriptive language to explain the color, shape, size, etc.
  • Script: Having a written down prompt sheet is extremely important to ensure all the points that need to be covered are completed. This ensures that the call was efficient in receiving information from the patient in case the conversation drifts and hence helps bring back focus to the subject under scrutiny.
  • Listen well: Communication is about speaking and active listening, which shows the person/patient that you are paying attention to what they are saying.
  • Summarizing: Repeating important information/instructions on prescription helps ensure that the advice provided was well received and understood. Note down a follow-up schedule if required or pertinent 

While assessing the quality of advice/information provided by the health provider, our focus is to evaluate: 

  • Ensure that evidence-based information is provided to the patients
  • Updated information based on local government guidelines is provided
  • Wherever possible – holistic information on preventative, curative, and/or treatment plans is shared with patients 
  • Treatment standards are applied to ensure that all patients receive appropriate care regardless of financial means

Overall the Medical audit includes the vetting of the following parameters: 

  • Registration: Process, Completeness, Closure of visit
  • Demographic details
  • Consent
  • Case history: Completeness of information by matching with an appropriate mind map and checking for ambiguity in the information given in the recording versus that registered on the app
  • Issues about past, family history, etc
  • Issues about measuring and registering vitals: Registering vitals, the correctness of values
  • Issues about physical examination including complete assessment: Diagnosis, investigations, prescription, follow-up, referral 
  • Turnaround time – TAT: time-lapse between upload of the case and a prescription issued
  • Time-lapse between consultation by backend doctors and patients receiving prescription
  • Patient outcome
  • Tech-related issues: app or user-related issues
  • Doctor patient communication 
  • Quality of advice and information provided

The quality assurance process is a fact-finding process rather than a fault-finding endeavor to provide regular feedback to the health providers to build their capacity to provide effective and efficient teleconsultations. This, in turn, has a virtuous effect on the trust-building process between patients and telehealth providers and increases the robustness of the telemedicine platform.  

20220527_102941
Dr. Gulhan Abdullaevna at Razzakov city headquarters checking the doctors web page at Batken, Kyrgyzstan
Renu Kumari, Community Health Officer using eSanjeevani app at Dorma Health & Wellness Centre, Khunti district, Jharkhand
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#10000Voices: Her Journey for a Better Future

Soni Prasad, Community Health Worker, Kamde

My name is Soni Prasad. I am posted at Health & Wellness Centre, Kamde as CHO (Community Health Officer). Like many others, I did not have a privileged childhood with a lot of parental support. I was driven and ambitious in my pursuit of a successful career. My parents eventually recognized my ambitions and became supportive of my dreams as I grew older. Fortunately, I was married to a man who was both supportive and understanding. It was difficult at first, but my determination never let me give up on my dreams. With the support of my family and husband, I was able to complete my B.Sc. in Nursing and later decide to become a teacher. After 5 years of a successful teaching career, I was given an opportunity to work as a CHO at a Health & Wellness Centre (HWC) in Kamde.

eSanjeevani is a platform that connects people in rural areas to remote doctors for quality healthcare services. The majority of the rural population earns minimum wage and lacks the financial means to access quality health care. They have received free consultations from certified remote doctors and specialists through HWCs. eSanjeevani is a great initiative for providing quality healthcare to the last-mile population where there is no doctor. I hope to serve those in need and put forth my best effort for the community’s well-being.

soni prasad
Soni Prasad, CHO, working under eSanjeevani telemedicine program

Jijabai Motiram Chaudhary, Anganwadi worker, Kapurne village, Nashik

“Jijabai Motiram Chaudhary has been working as an Anganwadi worker for the last 40 years. So it was no surprise that I (Dr. Shilpa Bhatte) found myself discussing the health needs of the community with her, at the Gram Panchayat meeting in Kapurne village, Nashik, during my community needs assessment visit. Jijabai shared her experiences of the various vaccination drives they had conducted in the village to the seasonal health challenges the villagers faced during monsoon. It was a pleasure hearing about her experiences in the field and the changes in healthcare that have happened over the years.

Her husband, Motiram, is a farmer and a huge supporter of her work. Her 95-year-old mother lives with them, and her grandson, who is 21 years old, recently married. As a result, four generations are living under the same roof, each contributing in some way to the village’s development.

Access to smartphones is always a challenge for women, especially in rural/tribal areas – however, Motiram made it quite clear that Jijabai was an important member of the community and needed to be the primary owner of the household phone. Kudos to the spirit of these “barefoot doctors”!

Jijabai with her husband Motiram
Jijabai (green saree) with her family and Dr. Shilpa Bhatte (black kurta)

 

Khalimun Khatoon, Sahiya Worker, Khujra village, Lohardaga District

“My name is Khalimun Khatoon, and I am from the Lohardaga district’s Khujra village. I live with my husband and other family members. I have been a housewife for a long time. My life after marriage was difficult. My in-laws and husband were frequently rude to me and used to harass me about household chores. I always craved respect in my life, which I never received as a housewife from my family.

Around this time a ‘Sahiya’ representative came to our village. I had no idea what ‘Sahiya’ meant. The representative explained that a team of health workers constitutes ‘Sahiya’ workers. I was intrigued by their goals and desired to be a part of the team. I always assumed that if I worked like everyone else, I would be respected and perhaps even supported by my family. My husband and I talked about this opportunity and my desire to work with ‘Sahiya’ workers. He was thoughtful and supportive. I realized that now was the time for me to establish my own identity, to go out and learn new things, meet people from all walks of life, listen to their problems, and help them as much as I could. 

I was warmly welcomed to the ‘Sahiya’ team. I attended several training sessions with highly experienced health professionals, where I was guided through the complexities of healthcare. I was able to be a part of the eSanjeevani initiative, which aims to provide affordable and high-quality healthcare to every corner of the rural sector through Telemedicine. During the COVID-19 outbreak, we educated people about COVID safety protocols in rural areas as well as the HWC (Health & Wellness Centre) initiative. I’ve been working for 15 years. I got an opportunity to build my own identity, be self-sufficient, secure my life, and most importantly, earn respect.”

KK
Khalimun Khatoon, Sahiya Worker

Savitri Devi, Health worker (working under Ekal Arogya Telemedicine project, Ranchi)

“I am Savitri Devi, and I’m from Sanch Silli in Ranchi’s Anchal Ramgarh district. I have been living with my husband, Megnath Mahato, my father-in-law, and two children. I was a housewife before joining Ekal Arogya. Because I was the only woman in the house, I was responsible for all the household chores. It was challenging for me to manage both household activities and work at the same time. When I originally told my husband that I wanted to work for Ekal Arogya as a Frontline Health Worker, he was hesitant at first. But I had always wanted to help individuals struggling for a fulfilling life, and this was my chance. Despite numerous protests, I decided to take this opportunity and join Ekal.

I was always uncomfortable and afraid to talk in public. I didn’t have much experience in the medical field either. However, the team of doctors and specialists thoroughly described every area of healthcare to us and explained the fundamental procedure. For the first time, I was grateful to be a part of these innovative and interesting workshops with such experienced doctors. I gained a lot of confidence after joining Ekal. Ekal provided me with a unique identity. People from my village began to recognize me as a result of my efforts. 

My husband, too, was incredibly proud of me and my accomplishments. When I didn’t have access to transportation, he took me to conventions and health centers. Now that I have acquired a scooter, I have mastered the art of self-driving. I never imagined I’d be so self-assured and courageous in my life. I am extremely grateful to the Ekal Arogya Foundation for providing the opportunity to contribute to the delivery of high-quality healthcare services in rural areas through Telemedicine.

 

 

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Savitri Devi conducting meeting with Sevikas
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Savitri Devi (in black jacket) conducting meeting with Sevikas

Kamal Nikule, Health Worker, Arogya Sampada

I’m Kamal Nikule, I currently reside with my parents in Ghotpara a remote village in Nashik. I am married with a 4-year old daughter, but I have been living alone for quite some time. My husband was unable to support our family. He eventually couldn’t afford to provide us with the most necessities for our life. Every day, he grew more resentful of me, and eventually, he chose to disown me. I returned home and informed my folks of everything that had happened. With all the pressure from society, it was difficult at first, but I kept my cool. It’s been three years since my husband left me, and I’ve never looked back. I needed a job to make ends meet and provide my daughter with the life she deserved.

One day I was approached by the Intelehealth family to work as a Community Health Worker under the ‘Arogya Sampada Telemedicine’ project. I immediately agreed to work for a cause. Intelehealth has been important in assisting me in my quest to become self-sufficient and independent. They have been working hard to make life easier and more comfortable for those who live in rural areas and have little or no access to quality and affordable health care services. Intelehealth has provided me with a fantastic opportunity to advance in my life and protect my future. I am honored to be a member of such a prestigious organization.

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Kamal Nikule (in white coat) with her family
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A Pro-Woman Life: Empowering Women Healthcare

Health is an essential aspect for the enhancement of human resources as well as the quality of human life. Now, when we focus on the health of women in the country, it has something profound for primary health and education of the children and the economical wellness of households, along with the women themselves. Women in the rural sector experience inferior healthcare access compared to the women in the urban sector. Several rural regions have limited numbers of doctors and licensed practitioners, especially for women’s health problems.

In India, 70% OF INDIA’S TOTAL POPULATION RESIDES IN RURAL REGIONS and males significantly outnumber females, an imbalance that has increased over time. The typical female advantage in life expectancy is not seen in India and this suggests there are systematic problems in women’s health care. 

Taking a Dive Down into the most prevalent Women Health Issues in the Country

Hike in the Women Mortality Rates

Indian women have high mortality rates, particularly during childhood and in their reproductive years. India’s maternal mortality rates in rural areas are among the world’s highest. From a global perspective, India accounts for 19% of all live births and 27% of all maternal deaths. Women in poor health are more likely to give birth to low-weight infants. They are less likely to be able to provide food and adequate care for their children. In rural areas where women are less educated and economically deprived, their health condition is worse. 

Violence against a Woman affecting her Mental & Physical Health 

Research by Usha Prabhakar published in 2003 shows that the effects of violence can be devastating to a woman’s reproductive health, as well as to other aspects of her physical and mental wellbeing. In addition to causing injury, violence increases a woman’s long-term risk of several other health problems, including chronic pain, physical disability, drug and alcohol abuse, and depression. Women with a history of physical or sexual abuse also have an increased risk for unintended pregnancy, sexually transmitted infections, and adverse pregnancy outcomes.

Mother bearing Underweighted and Malnourished Child

Numerous studies indicate that malnutrition is another serious health problem for Indian women. The negative effects of malnutrition in women are compounded by heavy work demands, poverty, childbearing and rearing, and the special nutritional needs of women, resulting in increased susceptibility to illness and consequent higher mortality. 

An unhealthy mother gives birth to an unhealthy child. According to the NFHS, Indian children have among the highest incidence of malnourishment in the world. More than half (53%) of all girls and boys under 4 years were malnourished, and a similar proportion (52%) was stunted. An estimated 16 million abortions happen in India each year. The majority of these abortions (73%) are medication abortions.

[Data Source: National Family Health Survey]

How has Telemedicine impacted Women’s Healthcare in the Country? 

In many parts of the world, it’s a challenge for women and girls to travel to a doctor’s office or pay for a doctor’s services once they get there. More often, many victims of domestic violence are hesitant or afraid of coming out and being open about the issues they are suffering, hence, a virtual source like telemedicine service acts as a support mechanism.

At Intelehealth we have found that such barriers are reduced after the introduction of telemedicine services via our telemedicine app. It is an effective approach to handle geographic and cultural difficulties in countries facing similar problems. 

Intelehealth’s Initiatives towards the Acknowledgment and Elimination of such Core Issues

We at Intelehealth have also focused on the dynamics of healthcare programs and initiatives that focus on addressing the issues about women’s health in the country such as reproductive, maternal, sexual, newborn, adolescent, and child health. 

Intelehealth collaborates with grass-root NGOs, INGOs, State Govts. and hospitals to provide the right kind of telemedicine solution & implementation support; training & health information to the frontline health workers and enable them to deliver quality healthcare to every individual who does not have sufficient health care resources in their respective regions. 

Intelehealth responds to this critical need for women’s healthcare through empowering women, young people, and children. Here is a brief about what we are working towards:

IBIS Vikalp Sansthan has set up a helpline (1800-309-4120) for women to provide information about safe abortion, sexual and reproductive health. The helpline aims to provide general information about female pregnancy, birth control, sexually transmitted infections, and services for women undergoing abortion or experiencing domestic violence, with a primary focus on safe abortion practices for women. “Today, I am a much stronger woman than ever. I urge survivors of domestic violence and sexual harassment, to call on the helpline (1800-309-4120) and seek support. You are not alone. We are here to listen to you and help you in every possible way” – Shamina, a domestic violence survivor now working as a counselor with the Vikalp helpline

We at Intelehealth believe in the vision of Universal Health Coverage – that one should be able to receive the health services they need, when and where they need them, without facing a financial hardship (WHO). Our mission is to “deliver quality healthcare where there is no doctor”. This vision & mission requires the collective efforts of an entire ecosystem. We aim to be a catalyst to empower existing health programs to do more through well-designed user-centered technology.

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Doorstep delivery of essential healthcare services in rural areas through Hand in Hand India telehealth

12-year-old Khusboo Kumari from Kalidih village, Jharkhand suffered burns all over her foot during a freak bonfire accident.

Unfortunately due to poor economic situation, villagers fail to give importance to their health. Khusboo and her family avoided visiting the doctor due to the travel distances to far-flung hospitals and costs of medication and consultation. Around the same time of this incident, Hand in Hand India telehealth was launched. A telemedicine initiative providing maternal & child care and primary healthcare services and making it accessible to the rural population where there is no doctor.Anita Minj, a health worker working under the hand-in-hand telehealth project while doing home-visits, visited Khusboo’s house. As the nurse noticed her wound, she immediately decided to refer to a doctor in a city hospital as this was a critical case. Owing to the family financial crisis and poverty, Hand in Hand bore all the medical costs and also provided food for 10 days.

Khusboo – “I thank Hand in Hand for saving my life. They diagnosed my condition at the right time and referred me to a good doctor, we otherwise wouldn’t be able to afford. There are no hospitals or doctors in our village, but due to door-to-door visits by these doctors, my burns were diagnosed at the right time. Due to medication and timely diagnosis, my foot is healing gradually. I can now stand on my foot and walk comfortably”

Health worker Minj(white coat) at Khusboo’s house during her home to home visit
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NISHTHA Swasthya Sampark Helpline- Caring for people with post-COVID illnesses

Post-COVID complications could be disturbing your mental health, read how this beneficiary received complete support from the helpline

 

NISHTHA Swasthya Sampark Beneficiary Testimonial

I contracted COVID-19 during the second wave, however, my symptoms were mild. As was the norm prevalent at that time, I had to isolate myself at home in my small village in Palamu district, Jharkhand. Home isolation was challenging as I was away from my family whilst also managing household chores and cooking for myself. Being alone was only making me feel all the sicker. During my isolation, I had severe stomach aches, chest pain, excess sweating, and gastro issues. Due to the lack of doctors in the village, I had spoken to a few doctors whose details I got thru references, however, their medication didn’t work.
I felt all the more isolated and it took a toll on my mental health. I then decided to look for COVID-19 care-related helpline numbers when I came across NISHTHA Swasthya Sampark helpline that provided free teleconsultation by a remote doctor. I immediately called the helpline and I was connected to a remote doctor. The doctor queried about my name, address, age, and the health issues I was facing and carried out a thorough diagnosis. The doctor suggested a couple of exercises, asked to drink plenty of water, eat nutritious food and meditate.
I began following the doctor’s advice. What amazed me through this entire process was that I received multiple follow-up calls from the NISHTHA Swasthya Sampark helpline checking on my health status and my well-being. Seeing the rising number of infections, deaths of young and old couples with being isolated, I feared for my life. But with this helpline, I was totally relieved and received immense support from the NISHTHA Swasthya Helpline team. It just felt like a family member checking on my health status which helped me recover soon.
I thank all those involved in launching the NISHTHA Swasthya Sampark helpline for this excellent initiative and for helping people in isolation. I feel much better today. They were there for me when I needed emotional support the most”

Remote doctor shares his experience in consulting covid recovered patients suffering from post covid complications.
Dr. Arvind Singh – Working under NISHTHA Swasthya Sampark telemedicine platform

I am a physiotherapist based in Jharkhand and President of Arogya Foundation of India, Dhanbad Bagh. During the second COVID wave, there was a rise in post covid complications amongst recovered patients. To address this issue, we started consulting patients as remote doctors for the NISHTHA Swasthya Sampark helpline – a helpline for post-COVID care. This helpline was launched by the Govt of Jharkhand in partnership with USAID-NISHTHA.
I have been working on this helpline for the last 2 months and have attended multiple calls with regards to post- COVID breathing problems, muscular weakness, emotional and physiological problems. Being a physiotherapist, I aim to improve patients’ quality of life and ensure that their lives are back to normal.
In these months I have attended to multiple patients calling in with breathing problems & spondylitis issues. For those with breathing problems, I demonstrated breathing exercises virtually, while those with spondylitis issues were shown different yoga exercises  and postures. I also attended to patients who suffered facial and hemiparesis (one side body paralyzed) paralysis. These patients were anxious about their health. I showed them specific exercises for their paralysis and also counseled them to boost their confidence.
During my follow-up calls with the patients, I received plenty of positive feedback about the helpline. They were satisfied with the helpline’s services. Patients were also happy with the treatment they received.
“The NISHTHA Swasthya Sampark helpline has helped many COVID recovered patients who needed constant care during their post covid recovery. I was trained virtually on the features of the app and on connecting with patients through this tech-based platform. I thank all the stakeholders involved in launching this helpline that can help patients who are in dire need of immediate care and treatment”

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