2018SourceThe Lanc

2018.Source:The Lancet These deaths led to economic welfare losses of $6 trillion (Rs 429 lakh crore) in 2015 the commission estimated The total number of deaths from poor-quality care globally–5 million per year–is estimated to be five times as many as the annual global deaths from HIV/AIDS (1 million) and nearly three times more than deaths from diabetes (14 million) according to the study that was part of a two-year project that brought together 30 academics policy-makers and health systems experts from 18 countries to examine how to measure and improve health systems’ quality worldwide Given the current global focus on universal healthcare (UHC) the commission found that expanded thehealthcare coverage does not always mean better quality “The central role of quality is not yet sufficiently recognised in the global discourse on UHC and is underappreciated in many countries” the report says “The impact of poor quality care goes well beyond mortalitybut can lead to unnecessary suffering persistent symptoms loss of function and a lack of trust in the health system” commission chair Margaret E Kruk of Harvard TH Chan School of Public Health Boston USA said in a statement “Other side effects are wasted resources and catastrophic health expenditures” Kruk said “Given our findings it is not surprising that only one-quarter of people in low and middle-income countries believe that their health systems work well” Quality as important as access More than one million of 86 million preventable deaths were from neonatal conditions and tuberculosis in people who accessed the health system but received poor quality of care in 2016 An estimated 81 percent of cardiovascular deaths 81 percent of vaccine-preventable diseases 61 percent of neonatal conditions and half of maternal road injury tuberculosis HIV and other infectious deaths were due to thepoor quality of care the report says Just access to healthcare is not enough and good quality care is needed for better outcomes the report says citing the example of India’sJanani Suraksha Yojana(Maternal Safety Scheme) Started in 2005 the programme offers cash incentives to encourage women to give birth in health facilities It has “increased facility delivery but did not measurably reduce maternal or newborn mortality” the report notes While it led to 50 million births in health facilities many of them occurred in primary care centres that did not have sufficiently skilled staff to address maternal and newborn complications High-quality care involves thorough assessment detection of asymptomatic and co-existing conditions accurate diagnosis appropriate and timely treatment referral when needed for hospital care and surgery and the ability to follow the patient and adjust the treatment course as needed This is often found lacking in middle- and low-income countries Adherence to evidence-based guidelines is low across countries–on average healthcare providers only fulfil 47 percent of recommended care duties with the median performance ranging from 44 percent in family planning and 64 percent in labour and delivery care In Uttar Pradesh? said in a statement. according to some legal scholars.” said Noah Bookbinder of Citizens for Responsibility and Ethics in Government. well, who will become the first African-American editor to the lead the 163-year-old publication.com.

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