Tag Archives: COVID-19 & India Healthcare

“Different Types Of Tests Used To Detect Coronavirus”

Every day we are interacting with a surging number of cases across the country, every day we add another significant number of digits in confirmed cases, Active cases and total deaths and tolls are growing in each segment with a huge margin. today means ( on 02 July 2020 ) we have significant Number of Covid-19 reported cases that are terrifying increasing every minute rapidly Confirmed cases are (607416) Total Deaths are (17880) and Active Cases are (228410) Country had reached more then half a million cases and tolls are growing day by day. In this Scenario of helplessness where we can only witness the increasing tolls there is a big challenge for the Health Ministry to conducted tests all across the country or where the situations are worse or the possibility of vulnerability is high, and with this one of the most important parameter is to choose the type of test. There are a lot of discussions going on regarding the reliability of the test, cost of the test.

What kind of test one should prefer? What is the Reliability of the Test?

Picking the test is an important criterion or choosing between risk and safety. You are infected by Coronavirus or not how would you know it? Definitely, your body will respond to your symptoms will tell the story but conformity will be determined by a ‘Right test’. Undergoing a reliable authentic and preferred test is very crucial because it is the only test that determines the are you positive or negative hence choosing a test is a question of choosing life and death. There are criteria, parameters, and factors that categorized the kind of tests. Mainly there are three types of tests available or carried out to detect the presence of coronavirus or determines whether a person is tested positive or negative, they are Anti-Body test, RT-PCR test, and ICMR test.

Anti-Body Test: Antibody tests are also known as a serological test, they are carried out on a large scale throughout the country because of cheap availability. An antibody test is carried out to detect the presence of coronavirus by quantifying the number of Antibodies produced within the body. this test does not detect directly the presence of coronavirus a conclusion regarding the infection is measured by quantity of antibodies produced by immune system. Blood samples are taken and used to determine the number of antibodies released. this test is carried out to detect the presence of Immunoglobulin M and G. but overall this test is not reliable, it has not that preciseness and competence to detect the presence of coronavirus hence it is not reliable and data produced on the basis of Antibody test is not up to the mark.

RT-PCR TEST: According to a statement by the Health Ministry of India RT-PCR, the Real-Time reverse transcription-polymerase chain is a gold standard frontline test that can detect the presence of Coronavirus or whether a person is positive or not. this method of testing involves taking a Nasal / throat swab from the infected one, and from this sample RNA ribonucleic acid is extracted which is also the genetic code of Coronavirus patter of the genetic code obtained from RNA of the sample taken from the patient is undergone for matching if Pattern Of genetic code of patient match with the pattern of coronavirus Patient announced to be Positive or infected from Coronavirus. this method of testing is more reliable accurate, but this method requires machines for extracting RNA, skilled Lab technicians, chemicals, and best experts who can carry this test with preciseness, and all this makes this test expensive it costs about 4500 Rupees per test. Overall RT-PCR test is a reliable and accurate test for the detection of coronavirus.

ICMR TEST : This involves usage of the tests discussed above Antibody test and RT-PCR test both. According to the availability consumption and Number of infected Patients.

Benchmarking in the Healthcare System

The right to health has so far not been accorded the status of a Fundamental Right to the Indian citizens. It is not even a statutory right, unlike education.
Moreover, health is a subject which is assigned to State Governments as per our Constitution. This is reflected in the way we finance it, with about two-thirds of the total governmental expenditure on health coming from the State Governments and the balance one-third being provided by the Government of India. Despite this, it is also a reality that the Government of India has significant influence in the policy space with pathbreaking schemes such as the National Health Mission (NHM) and Ayushman Bharat, with its twin prongs of the Health and Wellness Centres to deliver comprehensive primary health care and Pradhan Mantri Jan Arogya Yojana (PMJAY).

India is also a signatory to the 2030 Agenda for Sustainable Development, whereby it has committed as a nation to “ensure healthy lives and promote well-being for all”. In the last decade, millions of Indians have escaped from extreme poverty because of rapid economic growth. As would be expected of a rapidly growing economy, the health system and population-level health outcomes have also improved significantly albeit at a much more gradual pace. Despite notable gains in improving life expectancy, reducing maternal and child mortality, and addressing other health priorities, our health system needs a lot of improvement judged by the rather modest benchmark of countries with similar levels of economic development. Furthermore, there are huge variations across States in their health outcomes and health systems’ performance. It is unfortunate that by and large, health has not received the kind of political and administrative salience that this vital sector deserves. With the federal compact among the Central and the State Governments having been clearly defined in the Constitution, the key questions that motivated the team involved in the design of Health Index were as

a. Can we develop a tool to bring health into greater political focus to ensure that what gets measured gets done?

b. Can we benchmark the performance of the health system of various States which can be put forth in the public domain promptly? Is it possible to capture the diversity and yet ensure that high performing states do not get complacent and the low performing States are not discouraged?

c. Can appropriate instrument or incentives be put in place that can nudge the States to try and radically improve their health system performance? Can this be done in a manner that respects the federal compact and allows autonomy to individual State Governments to make policy choices to achieve the specified benchmarks?

d. What are the parameters that could credibly capture the complex story of health system performance? Can those parameters capture outcomes at the system level rather than merely tracking inputs such as budget, number of facilities or outputs such as number of OPDs/IPDs? Is data relating to those parameters available from the third-party source? Is the data of reasonable quality and available at least annually? What is the emphasis (weights) to be provided on each of the individual parameters? The answer to these questions– admittedly imperfect-was to craft a Health Index – a journey which NITI Aayog embarked upon in 2017 in collaboration with the Ministry of Health and Family Welfare (MoHFW) and the World Bank. It is the first-ever systematic exercise for tracking the progress on health outcomes and health systems’ performance across all the States and Union Territories (UTs) in India on an annual basis. The Health Index is a weighted-composite
Index based on select indicators in three domains:

(a) Health Outcomes;
(b) Governance and Information; and
(c) Key Inputs and Processes, with the health outcomes carrying the most weight across the different category of

States/UTs. For the generation of ranks, the States are classified into three categories (Larger States, Smaller States and UTs) to ensure comparability among similar entities.

A range of indicators such as the neonatal mortality rate (deaths occurring in the first 28 days of life), full immunisation coverage, treatment success rate of confirmed tuberculosis cases, stability of tenure of key administrators, vacancy of doctors and specialists in health facilities, and functionality of primary health centres, first referral units and cardiac care units, are included in the Index. In February 2018, the first round of the Health Index report on ranks and scores was released which measured the annual and incremental performance of the States and UTs throughout 2014-15 (base year) to 2015-16 (reference year). This was followed by the second round of Health Index that tracked performance for the period 2015-16 (base year) and 2017-18 (reference year). The same set of indicators and weights were used for the first two rounds.

The Health Index is a useful tool to measure and compare the overall performance and incremental performance across States and UTs over time. It is an important instrument in understanding the variations and complexity of the nation’s performance in health. The critical factors that contributed to the success of the Health Index include a) Timelines of the report so that it stimulates action and not merely academic discussions; b) Provision of financial incentives based on the annual incremental performance of states under the National Health Mission; and; c) Verification of self-reported data by states by a third party, independent verification agency to enhance credibility. However, there are limitations to the Index as no single index can purport to comprehensively capture the complex story of the evolution of the health system. Also, due to constraints of availability of quality data critical areas such as non-communicable diseases, mental health, and private sector service utilisation could not be captured. Thus, the Health Index is a work in progress and continuous refinements will be made as additional quality data becomes available and data systems improve.