India’s rehabilitative care for cardiac patients is abysmal: How can a community approach solve for preventative and post-rehabilation of major heart surgery for a person.
Literature review and looking at numbers:
According to National Institute Of Health India: Coronary heart disease prevalence rates in India have been estimated over the past several decades and have ranged from 1.6% to 7.4% in rural populations and from 1% to 13.2% in urban populations.
Some of the causes that are outlined in the paper are:
Poor living conditions along with low education levels were also associated with higher CAD mortality.
Poor people in rich countries and rich people in poor countries suffer more CAD due to various metabolic, social, and cultural maladjustments.
Other causes may include rapid lifestyle changes due to urbanization and nutritional transitions that accompany such economic developments.
As per Indian Council of Medical Research–India Diabetes (ICMR–INDIAB) study, every second individual is physically inactive, and less than 10% of the studied population was involved in doing regular physical activity.
Treatment gaps: Three-fourth of patients with CAD are not on guideline-recommended basic therapy drugs
Strategies of prevention:
Promoting health education and awareness about the pathogenesis of CAD.
Discouraging smoking and tobacco use and adapting a healthy diet and exercise routine will promote better cardiovascular health.
Reducing high fat dairy, carbohydrates, saturated fats and increasing daily intake of fruit and vegetables will also improve overall health.
Aggressive screening tests beginning at an early age will be beneficial for early detection and treatment.
Promoting healthy group exercise activities such as walking, yoga and meditation to be practised regularly will certainly aid in preventing the rising epidemic of CAD.
According to this paper, currently the cardiac rehabilitation for heart patients stands at very low degree. The awareness of rehabilitation would make it easier to access and prevent the health risks.
If we have appointed volunteers to work on rehabilitation and community driven programs - then it would become a way for everyone learn and get the required awareness.
Each one teach one approach -
Each one Teach one is an Arican American proverb which has been adapted by many organisations. The motto’s motto is to ensure people pass on the education they received to underprivileged communities.
Bringing in that philosophy in healthcare and rehabilitative care, it would help pass on the burden of care from the medical caregiver to the community members, one member at a time.
From one member, they can teach the whole community which in turn would make it easier for people to access healthcare facilities and also know when to intervene to prevent any mishaps from happening.
Volunteering and ambassador approach in communities -
When we go for any user group program in community building, we document how are we going to pass on the baton to manage a user group. the documentations usually is a legally binding contract that outlines the roles and responsibilities of all the duties that the ambassadors are going to perform when they are made the ambassador.
Usually, being an ambassador for a company or an organisation means they have fulfilled a criteria to become a leader of the group. They are usually volunteers - but are incentivized through intrinsic motivation factors that allows them to keep going in the endeavor. They are the ones who believe in the mission of your company and helps scale the user group programs.
If we bring in the formula of getting ambassadors in the community and teach them to take on the responsibility of community healthcare, with daily or weekly monitoring activities, then we will be able to help the community of people with medical intervention at the right time.
During Covid, Naveen Pattnayak, the chief minister of Odisha used the village teachers, Asha workers, of each district and empowered them to go around the city to deliver medicines and check the health progress of people who are undergoing covid treatments.
this helped in mobilising the current workforce and made it effective for the people at the right time.
Read more: https://sdrc.co.in/asha-and-anganwadi-workers-the-unsung-foot-soldiers-in-the-war-against-covid-19/
Self-help groups in rural India -
Self Help Groups (SHGs) have a significant footprint in India, particularly in rural areas, where they have been instrumental in empowering women and promoting financial inclusion. SHGs are informal groups of women who come together to save money, access credit, and engage in income-generating activities.
According to the National Rural Livelihoods Mission (NRLM), which is a flagship program of the Ministry of Rural Development, there are more than 69 lakh (6.9 million) SHGs in India, with over 8 crore (80 million) women members. These SHGs have been instrumental in providing access to credit and financial services to rural women who were previously excluded from the formal banking system.
The self-help groups usually work like this -
Usually there will be a self-help group Non-banking finance corporation working with them to run the operations smoothly. We have Bandhan, Spandana Spoorthy financial limited, Mission Shakti to name a few which run these operations in the rural parts of India.
These NBFCs would go about survey the villages and settlements where there are women habituated, they will then- with the consent of the women go ahead and create a group.
Once the groups are formed, they go for a community based savings account which is then run by the NBFC and the NBFCs are responsible to give these women credit or loans after the money is pooled for saving.
the pool money then becomes the guarantor, reducing the risk of non-payment for the bank.
The weekly meetings and money lending activities happen in a very structured manner.
In these weekly meetings, the women are given trainings for income generation capabilities, like teaching sewing ans stitching. Or running a small business. and also sometimes they are given trainings on healthcare.
Using these weekly meetings, it would be helpful to train the rural women of India about rehabilitative care for cardiac patients.
By training them, we will make sure the army of women are trained to give first -aid or call the medical facility in case of any mishap.
These training would also bridge the gap between working and non-working participation of women. The women who are trained would further become empowered to stand on their feet by going back to employment using the certifications gained during the training.
Now, with this holistic approach, we would be tackling not only the rehab awareness problem but also a new way to bring in the women in economic activities.
In conclusion, these three ways of passing the baton methods would not only help us make general population get more awareness of the care that is required for most diseases but also empowering people into equation to scale community health.
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