MEDICAL / HEALTH INTERNSHIP IN NEPAL/ MEDICAL ELECTIVES IN NEPAL

Volunteer Society Nepal aims to mobilize medical students and volunteers with health backgrounds in rural places where people do not have access to any health institutes, as the government is not able to provide adequate health services. On the other hand, rural Nepali people are often reluctant to go to the hospital and other modern health services because of orthodox thinking, superstition and other cultural influences. Some of the Nepali people may visit a witchdoctor when they are suffering from an illness. Therefore, it is possible that they die without getting the benefit of modern medication. VSN is playing an active role in linking people in rural areas with volunteers from the west and health volunteers within the country who are really eager to serve the many unprivileged people in Nepal.

Volunteers will mainly be involved in following three activities:-

(1) Working in the Health Post/ Clinic/ Hospital in Nepal  Medical/ Premedical  students will be assigned to clinics, sub-health posts, hospitals and other health institutions. These are either run by the government or a local community in both rural and urban settings. Health students will work with health assistants, doctors, nurses or some combination within. Your daily work will include helping to perform the health staffs’ job. It will also involve researches of common diseases and health issues. Students will get the opportunity to learn about the basic medication system in Nepal. The work will be daily, 3 to 5 hours, 6 days a week.

The Health institutions provide health services to the poor and marginalized people in the community and volunteers will observe and practice following activities:

* Health Post Based Activities

1. General daily clinic

2. MCH

* Family planning (Temporary devices)

* Immunization

* Ante-natal and post -natal clinics

* Health education

* Health post based normal deliveries

* Immunization

3. Pharmacy

4. Simple surgeries

5. Community oral health Clinic

6. Nutritional Rehabilitation center

7. Health Post based nutrition follow up

8. TB Clinic

1. Maternal and Child Health Care

* Immunization

* Under 5 health screening

* Antenatal care

* Postnatal care

* Normal home and health post based delivery

* Identification and referral of high risk pregnancy

2. Family Planning Services

* DMPA

* COC Pills

* Norplant

* Condom distribution

3. General OPD Services

* General clinic

* Pharmacy

* Dressing and injection

* Minor surgery

4. TB dots clinic

* Identification

* Counseling

* Treatment

* Follow up

(2) Health Camps in Nepal

Part of volunteer’s program will be deployment to work in health camps for a predetermined amount of time: 1 day to 3 days. (Volunteers will work with their Nepali experience medical personnel. The students’ responsibilities are to distribute medicine and consult with citizens about health-care.

Through this Health camp, poor and marginalized people in the community will be provided general health services and students will observe and practice following activities:

Community Health Camp

* Examining patients

* Providing general medicines

* Identification and referral if needed

* Immunization

* Education on oral hygiene

* DMPA, COC Pills, Condom distribution

* Heath post based follow up

(3) Health and Sanitation Awareness

Volunteers will be mainly involved in teaching about proper health-care and sanitation and will work with youth clubs, women groups and other local organizations. In addition, they will provide HIV/Aids awareness, First-Aid information to the local people in rural villages and thereby providing them with a practical life-skill. Similar educational lectures will be given to children, by Groups, in government schools, lasting from several days to a week in duration. Again, the Groups’ major focus will be to educate and mobilize community groups who can then pass the information onto the community at large.

Following activities will be organized

Community and School Based health program Activities

* HIV/Aids awareness

* Community health education activities

* School health education activities

* Anti smoking program

* Oral health education

* Reproduction health and sexual education

* First aid training and FA box distribution

Others

Apart from, learning and experiencing health related issue, students will get a maximum benefit:-

* Developing work experience in a marginal society and third world country

* Developing their personal and life skills

* Developing a deep understanding of the Nepali people, their language, and their various cultures

* Making a contribution to the ongoing development process of Nepal

* Enjoying such opportunities as taking part in local festivals, weddings, farming, and visiting different areas in local villagers

Visit at www.vsnepal.orghttp://www.vsnepal.org

For details and reservation please contact at vsnnepal@ntc.net.np Application instructions:

To make reservation, please forward

+A brief resume

+A photo scanned small sized

+A cover letter mentioning the program of choice, duration of stay and arrival date

To

Mr. Sugandha Shrestha

VOLUNTEER PROGRAM DIRECTOR

Volunteer Society Nepal

Kathmandu, Nepal

Mailing Address:-

Volunteer Society Nepal

P.O.Box : 8975 E.P.C. : 1589

Kathmandu, Nepal

Phone No:

(+977)1-2040353

(+977) 9851009342

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About Author

I am sugandha Shrestha, I am the Program Manager of the Volunteer Society Nepal, I have been working for VSN Nepal for the last four years

Ginekolog is the surgical specialtiy dealing with the health of the female reproductive which includes the uterus, vagina and ovaries. Women face a number of gynaecological issues all over the world, starting from the onset of puberty till the menopause (cessation of the menstrual cycle). Typically, girls reach puberty around the age of 12 around the globe. The onset of puberty depends on a variety of factors including the environment, climatic conditions, and the genetic history of the girls. Gynaecologists are specialist consultants, to whom the patients are referred to after examination by the General Practitioners. As with other fields of medicine, the main diagnosis is through clinical history and examination. Examination by a ginekolog practitioner is quite detailed and intimate. The tools required in such examination are speculums. This consists f two hinged blades of metal which retract tissues of the vagina to examine the cervix. Most of the ginekolog issues faced by women all over the world are:

a) Cancer of the reproductive organs like the fallopian tubes, uterus, vulva and the vagina. b) Amenorrhea which refers to the state of women in which the menstrual cycle is absent. c) Dysmenorrhea which means extremely painful menstrual cycle experienced by the patient. d) Infertility which is the incapability of the women to conceive. e) Menhorragia which refers to a heavy blood flow during the menstrual cycle. f) Prolapse protruding reproductive organs due to the loosening of the ligaments.e

Sexually transmitted diseases are on the rise mostly in the poverty stricken areas of the world, where education in sexual health is limited to only a few people. Even in first World Countries, promiscuity prevails and does the instance o sexually transmitted diseases. One such disease is the kondilomi or more commonly known as the genital warts. These appear on the genetalia, in the anal area, internally in the upper vagina or cervix, and in the male cervix. The lesions are raised and pink in color. No symptoms are witnessed by the patient there is no itching or burning sensation or any pain during sexual intercourse or during urination. Kondilomi is caused by the human papillomavirus (HPV). Most of the sexually transmitted diseases are caused by the HPV. This virus I known to infect many cells but the appearance of visible warts may take several years, that too when the immune system is suppressed. Kondilomi can cause extreme psychological stress and the people who suffer from them can be a victim of guilt and embarrassment. Genital cancers and HPV have been found to have some kind of link which is why it considered extremely important to practice safe sex.

As soon as a woman reaches puberty she is able to give birth to a child. The condition of carrying one or more off springs in the uterus of a female is known as trudnoca (or pregnancy). Multiple gestations are possible as in the case of twins or triplets. The total gestation period of humans is 38 weeks from conception. Ultrasound pictures are a result of sound waves. Ultrasound machines are used to send sound waves through the body, which upon reflection produce an image on the screen. Ultrazvuk trudnoca (Ultrasound during pregnancy) has revolutionized women care during trudnoca. Many fetal abnormalities are investigated, and taken care of via ultrazvuk trudnoca.

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I hope this information will help. If you need more information about gynecology or Ultrazvuk Abdomena then visit the below link, at antamedica.com you will get latest articles and information about Ginekolog and its related issues. www.antamedica.comhttp://www.antamedica.com/ “Let Take Care Your Health, Your Health Will Take Care You” Antamedica.com

Silais health clinics are government competency for the low income population. These clinics are located throughout the country. Their main objective is to provide basic health care, standard first aid, and providing continuation through pregnancy and post-delivery women, since 50% of pregnant women are under age. They also attend to newborns on follow up of their vaccines, and illness. Coordinate day’s journey on vaccination for the entire population, and provide the medication for different illness such as diarrhea, flu, lung infection, minor cuts and surgery. Another interesting fact is that the hospital offers pre-natal counseling on how to go through a healthy pregnancy, since in Carazo is the highest range of pre-natal death in Nicaragua

Volunteers can assist by doing following tasks:- 1- to assist doctors in hands-on work with patients. 2- help the population to understand the importance of preventing disease. 3- psychologist: we need seminars for the staff. 4- nurse training for the staff. 5- training in computer data base design and general programming. Volunteers must be of age 24 or above with minimum education of Undergraduation.

What is the purpose of this organization?   Silais Health Clinics are run by the Ministry of Health and cater to the low-income population.

These clinics are located throughout the country but the main location is in Diriamba. Their main objective is to provide basic health care, standard first aid, pre- and post-natal care to pregnant women (usually teenagers) and their infants. They also provide vaccinations and medications and serve as an emergency room for minor injuries and surgery.

What community(s) does this organization assist?   The main clinic is in Diriamba but they also run small clinics in the rural areas of La Trinidad, Casarez, San Gregorio, and Buena Vista. In addition they have 25 homes that they visit once a month to provide all of the services mentioned above. They have 50 certified midwives and 54 volunteers.

olunteers with the following special skills are preferred : Nurse Medical Student HIV/AIDS Awareness Training Public Health Sexual & Reproductive Health Training

Basecamp International Centers welcomes all the interested volunteers from around the world to volunteer and make a difference. If you are interested in this placement then please contact us for the details:

 Email: info@basecampcenters.com

Website: www.basecampcenters.comwww.basecampcenters.com

 Mailing Address :-186 Princess Street Kingston, Ontario Canada, K7L 1B1

Phone: 613.541.7862

Toll Free : 866.646.4693

Fax: 613.541.1604

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Republican Senator Tom Coburn Tells Women Crying About Her Health Care Coverage At Town Hall: “Government Is Not The Answer” – 08/24/09

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Basecamp International Centers believe international volunteering promotes cross-cultural learning that helps create global awareness, understanding between cultures and provides the platform for positive change. Our volunteers have taught in schools, provided disaster relief support for the International Red Cross, conducted essential research to improve the management strategies of threatened environments, built homes for impoverished people, provided vocational training and programs for street kids and have worked in co-operation with hundreds of local organizations to distribute aid and improve the quality of life for people throughout Asia, Africa and Latin AmericaWe have volunteer placement on Social, Heath and Medical, Environment, Children and Building Projects in Nepal, Peru, Ghana, Nicaragua, Tanzania, Costa Rica and Ecuador.Basecamp International Centers welcomes all the interested volunteers from around the world to volunteer and make a difference.

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Whether your female health questions are on early signs of menopause or how to reduce PMS symptoms, you can find answers online to important female health questions.

Busy women today have to keep up with their career, money issues and family. There is hardly time to prepare meals and care for the children and/or partner before and after work hours. Most women in the western industrialized countries become involved with career and family in their late twenties and early thirties. As responsibilities grow, women will typically experience a great deal of stress and have female health concerns.

Along with increased stress may come excessive caffeine or alcohol consumption, sleepless nights, cigarette smoking, lack of exercise, birth control pills, poor nutrition choices, obesity and exposure to the many environmental toxins found in daily life. These lifestyle choices add to the female health problems instead of helping the body to cope with the many demands placed on it.

It is no wonder that many women have female health concerns and begin experiencing health symptoms that make them wonder what is going on and to look for answers to questions such as the following:

Female Health Questions #1 – How Can I Have More Energy and Feel Better?

Lack of energy may be from overexertion or it may be your body telling you that it needs to rest. Anyone can feel tired occasionally. However, constantly feeling fatigued can be a symptom of disease or bodily imbalance and can occur at any age. It may be the first sign that your body is not working as it should and something should be done.

Female Health Questions #2 – Why Am I Gaining Weight?

Weight gain probably means you have gained unwanted weight around the mid-section even though no changes have been made in eating habits. Daily calories might have even been reduced but still the weight remains. Again the logical question is “Why?”

Female Health Questions #3 – Why Am I Having Hot Flashes/Night Sweats?

About half of all women experience hot flashes and night sweats during the years as changes happen in the monthly menstrual cycle. As menopause approaches, they frequently continue for several years following menopause if not treated. With the major changes in the body’s hormones, the brain thinks your body temperature is changing which causes your nervous system to want to cool your body down. Fluctuating hormone levels are the #1 cause.

Female Health Questions #4 – Why Is My Hair Thinning?

Women experience thinning hair and even hair growth in the wrong places. There are various treatments like changing your hair style or using a shampoo and conditioner that makes your hair fuller. However, instead of purchasing female hair loss products, a woman should first look for the underlying causes that are related to hormone imbalance.

Female Health Questions #5 – Can I Find Online Information on These and Related Health Issues?

Yes! A woman should understand what are normal changes in her reproductive cycle and health and what symptoms indicate underlying hormonal imbalances or damage from poor eating habits, stress and other factors. And the health problems you may be having can definitely be related!

A woman with female health concerns should know which symptoms she has. And how mild or severe are those symptoms? What are you demanding of your body? Are you frequently stressed? Are you taking prescription drugs? What about caffeine and alcohol? What support are you giving your body? What do you eat and are you taking a high-quality women’s nutritional supplement? And what is your age? Your age is important because you need to compare your health with other women your age.

Find out more about your health, the symptoms you may have, what these symptoms mean and your options. There is an online test for hormone health related to symptoms that indicate hormones are out of balance. This health test has been developed by a leading womens health clinic, it is used in their practice every day and is available to women online at no cost.

If you are a woman in your thirties or older and you feel your health is not what it should be, get answers to your female health questions by taking the womens health test online and see what the clinic recommends for your health situation. Understanding what is healthy and normal and what is not is crucial when your energy, your health and well-being are at stake.

Copyright 2007 InfoSearch Publishing

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Scientists and community members speak about a variety of topics including: 1) the dramatic need for scientific information on women’s health and on gender-specific factors determining health and disease; 2) the scientific tradition of excluding women as participants in many clinical trials, and the continuing practice of “pooling” subject data rather than analyzing health outcomes by gender that have each contributed to this “knowledge gap,”; 3) the progress being made in reversing these …

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Read more about the early menopause symptoms that are signs that the online hormone health test should be taken. David Buster is VP of InfoSearch Publishing and writes for www.safemenopause…m indexhttp://www.safemenopausesolutions.com – a website of natural health information.

Health sector Reforms in Andhra Pradesh

    A review on Health sector reforms in India   The health sector reforms in India were started way back in 1970s .The Govt. of India identifies the need HSR and stated in the eighth five year plan. The Eighth Five Year Plan (1992-1997) was the first plan document to state the need for re-structuring of economic management systems, following the macro developments of the 1990s. During this period in the health sector, the concept of free medical care was revoked and people were required to pay, even if partially, for the health services (1). The Ninth Five Year Plan (1997-2002) emphasized the need to review the response of the public, voluntary and private sector health care providers as well as the population themselves to the changing health scenario, to reorganize health services to bring about greater efficiency and effectiveness and to introduce health system reforms to enable the population to obtain optimum care at affordable cost The Ninth Plan sought to increase the involvement of voluntary, private organizations and self-help groups in the provision of health care and ensure inter-sectoral coordination in implementation of health programmes and health-related activities as well as enable the Panchayati Raj Institutions (PRI) in planning and monitoring of health programmes at the local level so as to bring about greater responsiveness to health needs of the people and greater accountability; to promote inter-sectoral coordination and utilise local and community resources for health care(2) .The Tenth Five Year Plan (2002-2007) touches upon reforms at primary, secondary and tertiary level(3).                         Politics influence health systems in significant manner. The goals, priorities, and the strategies, variations in the commitment are largely decided through the political contingencies. There are competing demands on the health systems. The evolution of the health systems is largely shaped by the culture, history, and norms. Client satisfaction is very high. As per NFHS-2 data, an overwhelming majority of clients are satisfied by the services delivered by the public systems. May be the expectations are low or may be our people are so courteous. But on the hand, we have the report from Transparent International, ranked the health system in India is the most corrupt system (4)   The Government has taken several steps for improving the public health care institutions and Strengthening the primary health care infrastructure. However, the situation is compounded by severe resource constraints – financial, technical and human power related, which has resulted in policy makers as well as programme managers at differing levels being faced with difficult choices. In such a situation, attempts are being made through various reform initiatives to ensure that the health needs of the people are met One of the major reform initiatives underway is the Secondary Health System Strengthening Project funded by the World Bank in seven states (Andhra Pradesh, Karnataka, Punjab, West Bengal, Maharashtra, Orissa and Uttar Pradesh). The projects include strengthening FRUs/CHCs and district hospitals so as to improve the availability of emergency care services to patients, to reduce overcrowding at district and tertiary care hospitals, construction works, procurement of equipment, increased availability of ambulances, drugs; improvement in quality of services following skill up gradation training in clinical management, changes in attitudes and behavior of health care providers; reduction in mismatches in health personnel / infrastructure; improvement in hospital waste management, disease surveillance and response system. It is essential to assess both progress and problems in implementation of the reforms in each state and to appropriately modify the content and pace of implementation. Such an overview and analysis of all related issues is necessary to provide evidence to policy makers and other stakeholders in terms of the various dimensions and impact of health sector reform.(5) In the Indian Constitution, health is a state responsibility. During Adjustment, many state governments in India had recourse to Health Systems Development Project loans from the World Bank for carrying out health sector reforms (HSR), of which one of the key policies has been to raise public spending on health care from the abysmally low levels seen up to then. The Health Systems Development Project seeks to develop strategic management capacity; strengthen performance, accountability, and efficiency; and build implementation capacity. Further, it seeks to improve clinical service quality by renovating and expanding district, sub district, and community hospitals and improving access to services. In all seven reforming states, around 15% of the total project cost is borne by the state governments. All the project documents note the low levels of funding for secondary hospitals in the reforming states. This is attributed to the small share of overall public spending allotted to health, the limited portion of total health spending going to hospitals, and, within this, a skewed distribution of funds in favour of the tertiary hospitals. After analysis of the problems of the health sector, the governments of the reforming states have agreed-using terminology ranging from “assurances” to “commitments”-to several undertakings. These are: (i) to enhance the overall size of the health budget; (ii) to redress imbalances in public expenditure between secondary and tertiary care levels; (iii) to safeguard the operations and maintenance components of current expenditure allocations for the secondary health-care sector; (iv) to charge user fees for selected services; and (v) to address workforce issues. The Health Systems Development Project initiated in the seven states recognizes the need for enhanced public spending on health and identifies it as the foremost policy reform to be pursued. Nevertheless, such assurances and conditions have not succeeded in enhancing health sector budgets in states implementing HSR. Worse, HSR has not been able to arrest the decline in the share of health spending within total government spending. The Indian system is especially complicated, as the larger tax resources are controlled by the central government but the major responsibility for health-care spending is bestowed on the states (6).Andhra Pradesh is the first state to go with the HSR.               Health sector reforms in Andhra Pradesh   The state of Andhra Pradesh was formed on 1st November, 1956 under the States’ reorganization scheme. It is the fifth largest State with an area of 2, 76, 754 sq. km, accounting for 8.4 % of India’s territory and also the fifth most populous state with a Population of 75 crores. The state has varied physiographic features ranging from high hills, undulating plains to a coastal deltaic environment. Administratively, Andhra Pradesh is divided into 23 districts, 79 revenue divisions, 1123 mandals, about 27000 villages and 264 towns. AP’s economy grew at 7.2% during 2006-07 — the fourth consecutive year of 6% plus growth. The latest poverty headcount ratio stands at 16%, compared to 23% for India . the third-highest credit rating among the major Indian states; the third best investment climate in the country; and the fourth-lowest corruption level among Indian states Andhra Pradesh was the first Indian state to receive a multi-sector Bank operation – the Andhra Pradesh Economic Restructuring Program for US$ 550 million in 1997 – aimed at helping the state accelerate policy and institutional reforms across a wide range of sectors under a common fiscal framework. It is also the only Indian state where the Bank has disbursed three budget support operations – the First Andhra Pradesh Economic Reform Loan (APERL-1) in March 2002, the Second APERL in February 2004, and the Third APERL in January 2007 – that sought to support the state’s development program.(12) Within AP there are regional, social and gender disparities. Health outcomes are worst among Scheduled Castes (16% of population) and Scheduled Tribes (7% of population), especially those living in underserved areas in North tribal and South drought prone districts, and for women. Effective delivery of quality basic health services is hampered by demand and supply side issues, including poor health infrastructure and staffing.(15)     The reform history in health sector in the State can be traced to Andhra Pradesh First Referral Health System Project, one of the first World Bank aided health system projects in the country. This project, launched in 1995 had been implemented by AP Vaidya Vidhana Parishad (APVVP). Agencies like World Bank and DFID are supporting the reform process in the State. The Bank supported the AP Economic Restructuring Project which included improvement of primary health care as one of the component.(7) The priority reforms focus on improved access to quality and responsive health services, strengthened governance and management in health sector, improved institutional mechanisms for community participation and systems for accountability; and strengthened financial management systems.(15)  The government of Andhra Pradesh [GoAP 1999] Vision 2020 document identifies a seven-point set of priorities for health sector reform: providing universal access to primary healthcare; encouraging private investment in tertiary healthcare; focusing on specific programmes to promote family planning; focusing on improving health levels in disadvantaged groups and backward regions; ensuring a strong prevention focus; enhancing the performance of the public health system; and formulating a state information education and communication (IEC) programme to broadcast information on preventive healthcare.(13) The Government of Andhra Pradesh is embarking on a major health sector reforms to improve health care delivery in the State. D.F.I.D. has expressed its willingness to support these initiatives with a grant of 100 Million pounds over the next five years (2006-2011). The reform initiative will include measures to improve the effectiveness and accountability of public health services, measures to focus on community centric preventive healthcare system and enhance access to quality healthcare for the poorer sections of the population(14) DFID will provide up to GBP40 million health sector budget support to the DoHMFW, GoAP, over 3 years 2007 – 2010. The sector support will build synergy with National Rural Health Mission (NRHM) which is a health sector reform program of the central government for decentralisation, pro-poor focus, strengthening service delivery(15)     The health sector support will be provided over three years (2007-08 – 2009- 10). It aims at increased use of quality health services, especially by the poorest people and in underserved areas.(16) The main outputs will be: a) Improved access to quality and responsive services, especially in remote and interior areas; b) Governance and management of health sector strengthened; c) Institutional mechanisms for community participation and systems for accountability in functioning; and Financial management systems strengthened and improved public expenditure on health.   The performance of health services would be measured against(17)

* greater effectiveness and improved outcomes of existing programs;

* improved efficiency in the allocation of resources;

* greater access and equity; and

* consumer satisfacfion

Reforms underway in health sector   The major reforms underway are classified under these categories and the activities are noted below and we will look each of them in detail  (I) Reorganization and restructuring of existing government health care system

• Establishment of Andhra Pradesh Vaidya Vidhana Parishad
• Strengthening of referral institutions and fixing of service norms
• Improvement in drug supplies
• Formation of Andhra Pradesh Health, Medical & Housing Infrastructure Development Corporation (APHM&HIDC)
• Strengthening of PHCs as 24-hour MCH centers
• Establishment of Comprehensive Obstetric & Neonatal Care (CEmONC) centres

(II) Changes in health system organisation, delivery and Management

• Formation of Hospital Advisory Committee/ Hospital Development Societies for all PHCs and FRUs/ teaching hospitals
• Provision of free travel bus passes to pregnant women for antenatal check ups
• Public Private Partnership

(III) Changes in financing methods

• Sukhibhava Scheme (Improvement of Institutional Delivery Services Scheme)
• User fees

(IV) Reforms related to human resources

• Integration and responsibilities of functionaries for planning, implementation and monitoring of programmes of HM & FW department

(V) Involving community in health service delivery and Provision

• Women Health Volunteers Scheme

(VI) Reforms to quality of care

• Performance indicators for grading the PHCs
• Performance rating of secondary hospitals

    1.Reorganization and restructuring of existing government health care system   A)Andhra Pradesh Vaidya Vidhana Parishad   AP, has created the Andhra Pradesh Vaidya Vidhana Parishad (APVVP) by enacting an Act in the Legislative Assembly in 1986(8) This was done with the objective to lay greater emphasis on development of both preventive as well as curative health care  and to strengthen necessary linkages at appropriate levels to ensure comprehensive medical and health care services. APVVP has undertaken World Bank assisted Andhra Pradesh First Referral Health Systems Project (APFRHSP) in 1994 for a period of seven years. This has been one of the major projects undertaken by APVVP. The objectives of the project included improvement of efficiency in the allocation and use of health resources through policy and institutional developments and enhanced performance of health system by improving the quality, effectiveness and coverage of health services at the first referral level.   B)Strengthening of referral institutions and fixing of service norms   basic service norms for various categories of hospitals under the administrative control of APVVP have been fixed thereby creating a hierarchy of hospitals according to services and facilities. This system of service norms and referral linkages had been developed with a view to optimise utilisation of resources, avoid duplication and wastage of resources, regulate patient flow and reduce cost of treatment by reduction of patient burden at tertiary hospitals. the district hospital has been prescribed to provide services in eleven specialties for which 9 civil surgeon specialists, 18-20 civil assistant surgeons, 54-84 paramedical staff and other supporting staff have been Posted. C)Improvement in drug supplies To ensure regular supply of drugs at all times and in all situations, a system of three sources of drug supply has been put in place for the hospitals under APVVP: (a) centralised drug procurement system under which the institution has been allotted drugs worth a particular amount based on bed strength (Rs 2000 per bed per quarter); (b) an emergency provision for drugs (Rs 100 per bed per month) has been made to every institution from where emergency procurement of drugs is made; (c) drugs which are in short supply and for which regular rate contract suppliers are not available have been stocked at the office of District Coordinators of Health Service. Under the APFRHSP, const-ruction and repair of 160 hospitals including 81 CHCs, 58 area hospitals and 21 district hospitals had been undertaken.(10)         D)Formation of Andhra Pradesh Health, Medical & Housing Infrastructure Development Corporation (APHM&HIDC)   a separate corporation has been set up in 1987 exclusively for developing housing and other infrastructure for medical and paramedical staff and constructing sub centers, PHCs, hospitals, dispensaries, clinics and other health care centers One of the major projects undertaken by APHM&HIDC has been the World Bank assisted India Population Project-VIII launched for improving the medical care facilities in urban slums in 74 municipalities.   E)Strengthening of PHCs as 24-hour MCH centers   In a move to make available maternal and child health care at all times, 470 PHCs in backward districts have been designated as round the clock Mother and Child Health Centre (earlier called women health centres). One staff nurse, one ANM and three support staff have been appointed in each centre on contractual basis. Staff nurses have been trained to conduct normal deliveries and refer emergency cases. Additional facilities like telephone and vehicle have been provided to the PHCs in order to assist communication and transport for referral of emergency cases. Provision has been made to conduct fortnightly specialist clinics of gynaecology and paediatrics in these centres to detect high risk pregnancies and neonates for referral to FRUs.   F)Establishment of Comprehensive Obstetric & Neonatal Care (CEmONC) centres   The State Government has decided to establish 108, CEmONC centres spread across every district so that pregnant mothers requiring emergency care do not have to travel more than 40-50 kms to receive specialist care. Training of MBBS doctors in anaesthesia, neonatal care and blood transfusion is also planned to support this scheme.   2)Changes in health system organisation, delivery and Management A)Formation of Hospital Advisory Committee/ Hospital Development Societies for all PHCs and FRUs/ teaching hospitals   Hospital Development Societies have been constituted in all tertiary hospitals under the control of Directorate of Medical Education.(18) and after implementing NRHM rogi kalyam samithi at every PHC were formed to ensure the adequate participation of local institution,with an aim to improve effective and efficient services with allowed flexible financial powers. These societies are examples for decentralization . Activities of the society include maintenance of the hospital (including sanitation & water supply, electricity, building & civil works and equipment), purchase of drugs & medicine supplies and equipment. The government has set norms and limits for undertaking these works which are to be adhered to by the Society. The ‘system works’, observed an Unicef team which assessed the impact of RKS towards the end of 2000. The system, however, is not without any lacunae. For, it was pointed out that “overall control of the local RKS bodies remain in the hands of the collector and if he is not interested in health care then the whole thing might just drift(13)   B)Provision of free travel bus passes to pregnant women for antenatal check ups(19)   The Government of Andhra Pradesh has started an innovative scheme in order to enable pregnant women in rural areas to avail antenatal check ups at the nearest PHC/area hospital or FRU. It has tied up with the State Road and Transport Corporation to issue free transportation bus tickets pass to be utilised for three visits. The ANM issues the bus passes to the pregnant women on her house visits.       C)Public Private Partnership(20)   *         Management of Urban Health Centers by NGOs   Under the World Bank assisted Andhra Pradesh Urban Slum Health Care Project (APUSHCP), 192 urban health centers (UHCs) have been established in 74 municipal towns in 21 districts covering 1848 slums. After withdrawal of support by the World Bank, the project has been funded by the state government since 2002. The outcomes of the project show marked improvement in ANC coverage, institutional deliveries, post natal care and immunisation in the slum population.   *         108 emergency services                           Govt. has tied up with satyam computers to provide emergency transportation which proved to a most successful programme and many states are following the same like Gujarath. The objective of 108 Ambulances is to save people in life emergency . One ambulance is given for three mandals. Each ambulance fitted with equipment worth Rs.17 lakhs renders its services in life emergencies, road and fire accidents (22)   *         Rajiv arogya sree    The innovative Govt. insurance scheme to serve people of  poor from the serious ailments now attracting the nation as this programme succeeded. this scheme provides financial support to families of BPL upto 2 lakhs per anum for treating serious ailments. it is proposed to cover the entire state by 2nd October 2008 with the govt. paying the insurance premium for all the beneficiaries .an amount of rs.450 crores are provided to implement the scheme during 2008-09. (21)       3)Changes in financing methods   A)Sukhibhava Scheme(23)   Under the Scheme, a cash assistance of Rs.300 (Rs 200 towards transportation charges and Rs 100 for food and incidental expenses) is paid to pregnant women belonging to below poverty line families who come to government hospitals/APVVP hospitals/ teaching hospitals/PHCs/CHCs for delivery serv-ices. This assistance is payable only to those women with no living children or with one living child.   B)User fees:-   If user fees are charged their main use may lie in optimization of expenditure patterns and better allocation between facilities and within facilities(24). Reddy and Vandemoortele (1996), based on a comprehensive review of user financing of basic social services carried out for UNICEF, point to three other discouraging features of user fees: (1) user financing can result in a sharp reduction in the utilization of services, particularly among the poor; (2) gender biases, seasonal variations and regional economic disparities can aggravate the effects of user financing on equity; (3) user financing  quires adequate capacities, effective decentralisation and continued government support; and (4) user financing can undermine political support for the goal of universal coverage of basic social services. In 2001, the Commission on Macroeconomics and Health (2001) also reached a similar conclusion that user fees end up excluding the poor from essential healthservices, in 2005, the Millennium Project’s recent Report to the UN Secretary General (2005) titled “Investing in Development – A Practical Plan to Achieve the Millennium Development Goals” also forcefully argues for abandoning user fees. The health sector in India has acquired a notorious reputation for inefficiency and corruption at all levels. There is little accountability in both the public and private sectors. Quality standards are practically non-existent as are performance measures and honest reporting. A recent report on human resources for health brought out by Harvard University’s Global Equity Initiative (2004) argues that it is people – health workers alone – who can produce an effective health system and deliver good ealth.(25) 4)Reforms related to human resources Integration and responsibilities of functionaries for planning, implementation and monitoring of programmes of HM & FW department At district level, District Health Coordination Committee (DHCC) has been constituted to ensure proper planning, implementation and monitoring of all programmes/activities of HM&FW Department in the district.  The Committee has been entrusted with the primary responsibility of planning, finalizing, implementing and monitoring the District Health Action Plans and institutionwise health plans in a participatory manner including all concerned officials, other concerned departments and NGOs.   5)Involving community in health service delivery and Provision  

• Women Health Volunteers Scheme

  One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist – ‘ASHA’ or Accredited Social Health Activist. Selected from the village itself and accountable to it, the ASHA will be trained to work as an interface between the community and the public health system. Following are the key components of ASHA(26) A woman, usually a daughter-in-law of a house who has studied upto 7th class and preferably from SC/ST community has been selected as WHV by the Gram Panchayat Health Committee. The selected WHV has been given one month training in health care aspects of pregnancy, antenatal, delivery, post natal and new born care, immunisation, diarrhoea, acute respiratory infections, first-aid and treatment of minor ailments. The training has been provided at Telugu Mahila Pranganams for three weeks and one week field level training at PHCs. Academy of Nursing Studies has been designated as the nodal agency for providing training to WHVs.   6)Reforms to quality of care   A)Performance indicators for grading the PHCs   One of the components of World Bank assisted AP Economic Restructuring Project is improvement of primary health care. In order to improve the quality of primary health care services, a system of performance rating has been developed to rate PHCs and CHCs. The grading has been accorded A to C in descending order   B)Performance rating of secondary hospitals   A performance rating system for secondary hospitals under APVVP has been  introduced. The indicators related to general services (outpatients, inpatients, bed occupancy), emergency services (emergency-OP, emergency-IP, emergency major operations, emergency minor operations), clinical services (major/minor operations, tubectomy, deliveries) and diagnostic services (X-ray, ECG, lab tests and USG) have been developed for the purpose. Normative targets for each type of hospital (district hospital, area hospital, community health center) have been fixed against which the performance is measured and rating assigned. Highest grading is A while lowest grading is C.(27)   Conclusion:-   Introduction of user charges and subcontracting of services to the private sector are the main elements of health sector reforms. The health sector reforms are only a part of drastic reforms in other major sectors undertaken as a part of Andhra Pradesh Economic Restructuring Project (APERP) and the overall impact on the health conditions of people and their access to medical care depend more on the changes proposed outside the health sector. For instance, while exempting the white ration card holders i.e. the poor from the user charges in the government hospitals, it proposes to drastically reduce the number of white card holders to half in the state. The net affect would be to reduce the percent of population eligible for free treatment.(29)   On the other hand the success of 108 EMRI services and overwhelming response from Rajiv Arogya sree scheme are the examples for HSR success. Just like every thing has gots its own pros and cons HSR should be done in such a way where the need exist and according to necessities .   Referances:- (Note:-most part of the article was taken from ref.no 28 otherwise reference specified)

1. (Government of India, Eighth Five Year Plan, (1992-1997) Planning Commission, New Delhi.)
2. (Government of India, Ninth Five Year Plan, (1997- 2002) Planning Commission, New Delhi )
3. ( Government of India, Tenth Five Year Plan (2002-2007) Planning Commission, New Delhi)
4. ( D. Agarwal Health Sector Reforms: Relevance in India, Indian Journal of Community Medicine Vol. 31, No. 4, October-December, 2006)
5. Health Sector Reforms in India, Initiatives from Nine States
6. ( http://www.idrc.ca/en/ev-118491-201-1-DO_TOPIC.html.The international development research centre)
7. http://www.worldbank.org.in
8.  (The Andhra Pradesh Vaidya Vidhana Parishad Act 1986 (Act No. 29 of 1986 with Amendaments upto 31.03.1989
9. Dr. MCR Human Resource Development Institute of Andhra Pradesh (Undated). “Andhra Pradesh Vaidya Vidhana Parishad Departmental Manual”
10. 6http://www.aponline.gov.in/apportal/departments/ departments.asp?dep=16&org=98
11. GoAP (2006), Response to Questionnaire on Health Sector Reforms from MOHFW, GoI.
12. http://www.worldbank.org.in/WBSITE/EXTERNAL/COUNTRIES/SOUTHASIAEXT/INDIAEXTN/0,,contentMDK:20970681~pagePK:141137~piPK:141127~theSitePK:295584,00.html#Ongoing_projects
13. Grish kumar,promoting PPP in health services,EPW commentary,july19,2002
14.  (G.O.Ms.No.130, HEALTH MEDICAL AND FAMILY WELFARE (K2) DEPARTMENT. Dated the 24th April, 2006)
15.  ANDHRA PRADESH HEALTH SECTOR REFORM PROGRAMME (APHSRP) Terms of reference for Technical Cooperation (TC) to DoHMFW, GoAP
16.  PRESS INFORMATION BUREAU GOVERNMENT OF INDIA, HEALTHCARE PROJECT IN AP FUNDED BY DFID, New Delhi, March 5, 2008)
17. http://lnweb90.worldbank.org/oed/oeddoclib.nsf/DocUNIDViewForJavaSearch/0CFD6217A8A5BDA2852567F5005D32BD
18.  G.O.Ms.No.403, dated Sept 7th 1998
19.  GoAP (2006), Response to Questionnaire on Health Sector Reforms from MOHFW, GoI.
20. Power Point Presentation of Govt of AP at the 2nd Regional Workshop on Health Sector Reforms: Experiences of Select States at Hyderabad, 14-15th February 2005 and ECTA Working paper 2002/61 Public-Private Partnership: Operational Framework used in Andhra Pradesh and Assam
21. http://www.scribd.com/doc/2208678/AP-Budget-Speech
22.  http://pibhyd.ap.nic.in/er27070702.pdf
23.  Dept. of Health Medical Family Welfare, GoAP (undated), “Sukhibhava (Improvement of Institutional Delivery Services Scheme): Implementation Guidelines to PHC/Hospital
24.  http://mohfw.nic.in/NRHM/Documents/CRM_report_full_report_version.pdf
25.   (A.K.Shiv Kumar,,Budgeting for health ,some considerations) Economic and Political Weekly April 2, 2005
26.  http://mohfw.nic.in/NRHM/asha.htm#abt
27. http://health.ap.nic.in/apvvp/apvvp_stat.html
28.  (http://www.whoindia.org/linkfiles/health_sector_reform_hsr_vol_ii_-_andhra_pradesh.pdf)
29.  (Impact Of Health Sector Reforms On Hospital Services In Andhra Pradesh – A Study Of Trends In The Structures Of Provision And Utilisation Pattern)(centre for economic and social studies) (http://www.cess.ac.in/cesshome/research6b.html)

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Pregnancy and Postpartum Depression, Women’s Health Dr. McCarthy explains what happens to a womans body during pregnancy and after child birth and the effects this can have on a womans hormones, health, stress and wellness. Dr. Peter McCarthy, CTN Peter is the Chief Executive Officer and Wellness Director of Life Energy Holistic Partners, Inc. He is a Nationally Board Certified Traditional Naturopath and is a member of the Advisory Committee of the American Naturopathic Certification Board …

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a.)The folate supplementation prevents pernicious anemia, which increases the risk of spina bifida
b)The folate supplementation is needed to ensure a large store that can be utilized by the growing fetus
c.)As long as supplementation begins the day pregnancy is confirmed, there is no risk of defects
d.) The neural tube develops early on in pregnancy, oftentimes before most women realize they are pregnant

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6 yrs experience in public health working with Govt. of Andhra pradesh of INDIA

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Sarah Hyllok is an expert on sexually transmitted diseases. She has spent 15 years as a sex therapist helping bored couples.

Women’s Excessive Facial Hair Growth – there’s no need to suffer!

Excessive facial or body hair in women is a condition called hirsutism. Hirsutism either runs in the family, usually presenting at menopause and puberty, or it can be an indicator of a larger underlying problem. Research indicates that up to 10-12% of the Australian female population is affected by Polycystic Ovarian Syndrome which can be linked to excessive hair growth and hirsutism.

Hereditary hirsutism is largely an aesthetic rather than a health concern. When not hereditary it is most likely the result of excessive male hormone production (adrenal virilism), or an increased sensitivity of the hair follicle to normal male hormone levels. It is important to both a woman’s health and her self-con dence to have this condition diagnosed by a doctor. Hirsutism and any hormone imbalance that may underlie this condition can be treated. Excessive facial and/or body hair can be managed. Electrolysis is one means of managing excess hair but this can be painful, slow and very costly requiring many visits as only one follicle at a time is usually treated by sending an electrical pulse down the hair shaft.

Laser hair removal (as distinct from the much less effective IPL) is a much more manageable maintenance procedure as it treats a larger number of follicles at a time, is more comfortable than electrolysis and provides fast effective treatments. Hormonal hair growth via Laser Hair Removal therapy is efficient and manageable but not always a permanent solution as it is likely that hormonal hair regrowth may occur although usually at a much slower rate and usually much thinner than before, so hirsutism sufferers should be wary of claims by any service provider that they will achieve a permanent solution.

A woman might consider bleaching her facial hair, which makes it less visible alternatively regularly waxing can also assist. All of these methods should be used as means to treating the symptom, but any woman with progressing hirsutism should consult a doctor for a diagnosis in order not to compromise her health, or her self-confidence.

Nad’s Laser Hair Removal Clinic treats a number of hirsutism sufferer’s however warns that when it comes to facial hair, clients need to carefully select their treatment provider as Nad’s Clinics see a large number of clients that have been treated by inexperienced IPL and Laser Clinics. Inappropriate treatment can result in additional hair growth to facial or hormonal areas. Nad’s Laser Hair Removal Clinic warns that ONLY the affected areas should be treated by highly skilled therapists that have a sound understanding and many years experience in dealing with skin as inappropriate treatments may result in adverse side effects.. Additionally, certain medications are photosensitive and can result in an adverse affect if a pre treatment Consultation is not accurately conducted by skilled Therapists. For more information on laser hair removal visit www.nadsclinic.com.au

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Women tend to ignore their pains and aches. They also put off going to the doctor or taking routine tests that are recommended once in every two-three years. The result is that their health usually suffers a great deal as they grow old. There are many health concerns that women face as they age. Among the most common are breast cancer, pelvic pain, menopause (which by itself is not a disease, but it comes with a host of problems), heart disease, endometriosis, infertility and many others.

Finding the Right Type of Care and Guidance

Going to doctor is okay. However, sometimes women need a little more attention, a little more focus, a little more guidance and understanding. Here is where women’s health care clinics offer an invaluable service. These are good because they specialize not only in women health care, but also the psychology that accompanies these diseases and their cure and care.

Aging women need a bit more than medical care; they need understanding, they need assurance and guidance about the changes that happen in their body. This is because as they enter their late forties the menopause plays havoc with the mind and body. When other diseases affect the body, this causes depression, sense of hopelessness and sometime deep panic.

Women’s health care clinics concentrate on offering a holistic method of medical attention which encompasses care of both body and mind. It is very important for women to have reassurance about how things are and would be; it is also very important for them to understand what the problems they are going through are and what are the problems that they should anticipate. The women’s health care clinics are excellent at providing the right support and specialized care – just like a friend.

Women’s health care clinics have another very important feature – since they cater singly to women health, these clinics are highly equipped to recognize, diagnose and treat women’s diseases. Though general hospitals too are excellent, the women’s health care clinics are in a modest way more focused on women’s needs. This is why women feel more relaxed when treated here.

You should keep in mind that a women’s health care clinic is indeed like a true friend; which is exactly why you should visit them once in a while. Women over 30 years of age should have periodic check-up at least once in every three years. Adopt this habit, and it might save your life.

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Be My Friend – www.myspace.com Women’s Health, Hormones, Sun & Postpartum Depression Dr.Vincent Bellonzi is a chiropractor and is certified in Clinical Nutrition. He has been in practice for over 12 years. He received his Doctorate from Los Angeles College of Chiropractic in 1991. Since 1998, Dr. Bellonzi has practiced in the Austin area. He works with athletes at every level to provide sports conditioning and rehabilitation. Visit Dr. Bellonzi’s website at www.austinwellnessclinic.com This …

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Seems to me that perhaps a disproportionate amount of federal resources goes to funding women's health. Don't get me wrong, women are cool and all. But men already have a significantly shorter life span due to several factors…

Maybe the government just understands that men are men (The doctor said it was cancer… I CALL IT A CHALLENGE!) ?

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There are many sorts of medical clinics and medical halls in Singapore and it is difficult to point out which one is best for you. The questions you have to ask are; what are your needs?, what are you suffering from?. I know most of you will not be able to understand what you are suffering from; we are familiar with the carousal of confusion that some symptoms can bring us on. The good news is that Singapore is a world class medical country, with an integrated medical framework that has everything for everyone and their need.And with the dedicated health care professionals which will be able to help you in the journey to a healthier life.

One of the great features about medical clinics in Singapore is the fact that there a lot of private medical clinics that operate on a 24 hour basis. One such example is Novena Clinic 24 Hours. As its name says, its a 24-hour surgery centre catering to medical and surgical enquiries 24 hours a day, 365 days a year. It has a private Accident & Emergency (A&E) facility with recovery suites for post surgical nursing care. Various specialist of different specialty are on call 24 hours. Others include walk in clinics, travel clinics, man health clinic, women clinic, skin care clinic and private practices that are also located within public and private hospitals all over Singapore. They are quite easy to find and their services after normal operating hours are not compromised.

I think that we can divide this category into public healthcare medical clinics and private organizations and practices that are abound in many of the local neighborhoods. Public healthcare medical clinics are managed by the government and regulating bodies like SingHealth, who ensure the quality of the healthcare through many programmes and initiatives that maintains its relevance and adds different disciplines on a yearly basis. Private healthcare is no different, although their price ranges may be slightly different and more costly. There is almost no difference in the treatment but private clinics usually are centered either within the city officer or scattered across many of the suburbs and small towns in and around Singapore. They come in the form of family practices or private specialist clinics that can specialize in anything from chiropractic, neurosurgery, cardio-vascular, pediatric and gynecology. There are many more departments but you get the idea. Many people go to private clinics for less queues and more personal treatment – something the public healthcare find it hard to give because of the amount of people they treat.

A simple search online will reveal a whole host of clinics from all over Singapore, specializing in different departments and areas of health. With more than 500 private and public healthcare general and specialists practitioners, there is a niche for everyone, with big names like Johns Hopkins thrown into the mix. In truth the standard of medical clinics in Singapore is very high so you will be assured of the best, everywhere you go.

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Growing a healthy baby is one of the most important jobs of your life. Prenatal Health examines proper diet and nutrition to best ensure that you and your baby get all the vitamins, minerals and calories needed for a healthy pregnancy. Learn basic ways to maintain a healthy diet during pregnancy. How you feel emotionally and physically during pregnancy directly affects you and your baby’s well being. Prenatal Health explains how you can control and manage your stress, and how proper exercise …

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Incoming search terms:

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Depending on your education and work experience there can be many opportunities available for you to start up your new home business, it simple comes down to putting previous job duties and responsibilities to work for you. Many times individuals find themselves suddenly unemployed due to mergers, downsizing or the company closing down and sometimes even retired persons want to do something to get out of the house and earn a little extra money but are hesitant to look for a job with another employer.

Some of the quickest growing online home opportunities are Affiliate programs, an affiliate marketing program is where you promote and sell goods and services for big companies, basically how it works is you find a product that you can sell then find a company that have that type of product and sign up with them. What make affiliate marketing so popular and successful is that most affiliates help you set up your website and offer support and training to help you make money. You are not bombarded collecting payments, delivering of goods, keeping stock and all these business related activities. All you do is sell and collect commission checks.

Former Female executives and managers are discovering that having there own consulting business can pay a nice part-time income while tapping into the experience learned thought there years of working in that field. Marketing, finance and labor negotiating are some fields that can offer fantastic opportunities. Management training on specialized areas of management can be used to start classes for new businesses that are just getting started.

The medical area is totally open for allot of non-patient procedures, like transport services, accounting and billing. With these backgrounds it would be very easy to have your very own business offering a contract to contract basis to health clinics, doctors and hospitals. If you have experience in transcription many legal offices need this service frequently and most can’t afford to pay a full-time person to do this so they hire people part-time.

A job opportunity that needs no specialized training or education is a personal shopper. Most business executives don’t have the time to go to the store or supermarket for necessary supplies and are very eager to hire someone else to do there shopping for them. The biggest challenge with this kind of service is that you need to be available all the time and to be objective about there product preferences. You can end up purchasing everything from personal items to clothing as well as food, even birthday cards for the kids but always remember they are paying you for a service so you have to remain objective and not criticize.

If you find yourself constantly helping friends and family with there computer issues,

you could consider a home business as an IT consultant. If somebody want some

additional memory to there computer or upgrade software you can become an expert at this,

if you would like to know more on this topic check out Dotcomology the art of making money

with your home business.

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Dr. Popper loves addressing women’s health issues since women not only are responsible for their own health, but often control diet and health issues for children and families. Her talk includes information about weight loss, osteoporosis, breast health, hormone replacement and how to reverse aging. This is a 10-minute excerpt from Dr. Popper’s presentation at the Healthy Lifestyle Expo 2007. To get a DVD with the full talk as well as the talks of 11 other fascinating experts, see: secure2 …

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Andy The Home Biz Wiz recommends for more information subscribe to my FREE Internet Home Business tips newsletter and get hundreds of money making tips and tricks along with FREE Software delivered to your inbox. A $147 value, yours
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