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Grover A, Bhargava B, Srivastava S, Sharma LK, Cherian JJ, Tandon N, Chandershekhar S, Ofrin RH, Bekedam H, Pandhi D, Mukherjee A, Dhaliwal RS, Singh M, Rajshekhar K, Roy S, Rasaily R, Saraf D, Kumar D, Parmar N, Kabra SK, Chaudhry D, Deorari A, Tandon R, Singh R, Khaitan B, Agrawala S, Gupta S, Goel SC, Bhansali A, Dutta U, Seth T, Singh N, Awasthi S, Seth A, Pandian J, Jha V, Dwivedi SK, Tripathi R, Thakar A, Jindal S, Gangadhar BN, Bajaj A, Kant M, Chatterjee A. Developing Standard Treatment Workflows-way to universal healthcare in India. Front Public Health 2023; 11:1178160. [PMID: 37663866 PMCID: PMC10472454 DOI: 10.3389/fpubh.2023.1178160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/22/2023] [Indexed: 09/05/2023] Open
Abstract
Primary healthcare caters to nearly 70% of the population in India and provides treatment for approximately 80-90% of common conditions. To achieve universal health coverage (UHC), the Indian healthcare system is gearing up by initiating several schemes such as National Health Protection Scheme, Ayushman Bharat, Nutrition Supplementation Schemes, and Inderdhanush Schemes. The healthcare delivery system is facing challenges such as irrational use of medicines, over- and under-diagnosis, high out-of-pocket expenditure, lack of targeted attention to preventive and promotive health services, and poor referral mechanisms. Healthcare providers are unable to keep pace with the volume of growing new scientific evidence and rising healthcare costs as the literature is not published at the same pace. In addition, there is a lack of common standard treatment guidelines, workflows, and reference manuals from the Government of India. Indian Council of Medical Research in collaboration with the National Health Authority, Govt. of India, and the WHO India country office has developed Standard Treatment Workflows (STWs) with the objective to be utilized at various levels of healthcare starting from primary to tertiary level care. A systematic approach was adopted to formulate the STWs. An advisory committee was constituted for planning and oversight of the process. Specialty experts' group for each specialty comprised of clinicians working at government and private medical colleges and hospitals. The expert groups prioritized the topics through extensive literature searches and meeting with different stakeholders. Then, the contents of each STW were finalized in the form of single-pager infographics. These STWs were further reviewed by an editorial committee before publication. Presently, 125 STWs pertaining to 23 specialties have been developed. It needs to be ensured that STWs are implemented effectively at all levels and ensure quality healthcare at an affordable cost as part of UHC.
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Affiliation(s)
- Ashoo Grover
- Division of NCD, Indian Council of Medical Research, New Delhi, India
| | - Balram Bhargava
- Department of Cardio Neuro Centre, Indian Council of Medical Research, New Delhi, India
| | - Saumya Srivastava
- Division of NCD, Indian Council of Medical Research, New Delhi, India
| | | | | | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Deepika Pandhi
- Department of Dermatology, University College of Medical Sciences, New Delhi, India
| | - Aparna Mukherjee
- Division of ECD, Indian Council of Medical Research, New Delhi, India
| | | | - Manjula Singh
- Division of ECD, Indian Council of Medical Research, New Delhi, India
| | | | - Sudipto Roy
- Indian Council of Medical Research, New Delhi, India
| | - Reeta Rasaily
- Division of NCD, Indian Council of Medical Research, New Delhi, India
- Division of BMI, Indian Council of Medical Research, New Delhi, India
| | - Deepika Saraf
- Department of Paediatrics, AIIMS, New Delhi, India
- Department of Pulmonology, PGIMER, Chandigarh, India
| | - Dhiraj Kumar
- Indian Council of Medical Research, New Delhi, India
| | - Neeraj Parmar
- Indian Council of Medical Research, New Delhi, India
| | | | - Dhruva Chaudhry
- Pandit Bhagwat Dayal Sharma PG Institute of Medical Sciences, Rohtak, India
| | - Ashok Deorari
- Himalayan Institute of Medical Sciences, Baksar Wala, Dehradun, India
| | - Radhika Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Binod Khaitan
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Anil Bhansali
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Usha Dutta
- Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
- Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
- Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Tulika Seth
- All India Institute of Medical Sciences, New Delhi, India
| | - Neeta Singh
- All India Institute of Medical Sciences, New Delhi, India
| | - Shally Awasthi
- Department of Paediatrics, King George's Medical University, Lucknow, India
- Department of Urology, King George's Medical University, Lucknow, India
- Department of Neurology, King George's Medical University, Lucknow, India
- Department of Nephrology, King George's Medical University, Lucknow, India
- Department of Cardiology, King George's Medical University, Lucknow, India
- Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, India
- Department of ENT, King George's Medical University, Lucknow, India
- Department of Pulmonology, King George's Medical University, Lucknow, India
- Department of Psychiatry, King George's Medical University, Lucknow, India
- Department of Gastroenterology, King George's Medical University, Lucknow, India
| | - Amlesh Seth
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Vivekanand Jha
- The George Institute for Global Health, New Delhi, India
| | | | | | - Alok Thakar
- All India Institute of Medical Sciences, New Delhi, India
| | - Surinder Jindal
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Anjali Bajaj
- Government of Himachal Pradesh, Himachal Pradesh, India
| | - Mohan Kant
- Department of Paediatrics, Indian Council of Medical Research, New Delhi, India
- Department of Opthalmology, Indian Council of Medical Research, New Delhi, India
- Department of General Surgery, Indian Council of Medical Research, New Delhi, India
- Dermatology, Indian Council of Medical Research, New Delhi, India
- Paediatric Surgery, Indian Council of Medical Research, New Delhi, India
- Oncology, Indian Council of Medical Research, New Delhi, India
- Orthopaedics, Indian Council of Medical Research, New Delhi, India
- Endocrinology, Indian Council of Medical Research, New Delhi, India
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Meena JP, Seth R, Chakrabarty B, Gulati S, Agrawala S, Naranje P. Neuroblastoma presenting as opsoclonus-myoclonus: A series of six cases and review of literature. J Pediatr Neurosci 2016; 11:373-377. [PMID: 28217170 PMCID: PMC5314861 DOI: 10.4103/1817-1745.199462] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The opsoclonus-myoclonus ataxia syndrome (OMAS) also called “Kinsbourne syndrome” or “dancing eye syndrome” is a rare but serious disorder characterized by opsoclonus, myoclonus, and ataxia, along with extreme irritability and behavioural changes. Data on its epidemiology, clinical features, and outcome are limited worldwide. The aim of the study was to evaluate the clinical profile and outcome of children with OMAS. A retrospective data of all children presented to Pediatric oncology clinic with a diagnosis of opsoclonus-myoclonus from 2013 to 2016 were collected. 6 patients with a diagnosis of OMAS were presented over a 4-year period. All 6 cases had paraneoplastic etiology. All Children had good outcome without any relapse. Paraneoplastic opsoclonus myoclonus had a good outcome in our experience.
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Affiliation(s)
- Jagdish P Meena
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sheffali Gulati
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Agrawala
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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