Fwd: Rules for Health Sector

[Vaishnavi Jayakumar]

---------- Forwarded message ---------
From: Smitha Sadasivan <sssmi...@gmail.com>
Date: Mon, 3 Mar, 2025, 00:44
Subject: Re: Rules for Health Sector
To: Vaishnavi Jayakumar <jayakumar...@gmail.com>
Cc: Percy Cardozo <percyc...@gmail.com>, radhika.alkazi59 <radhika....@gmail.com>

Dear Percy and Vaishnavi, 

Pfa the document updated as requested by both of you. Sorry for the delay as too many things to deal with at my personal and health end. 

In case of any further changes, pl feel free to do it at your end, as I won't be available for the next couple of weeks.

Thanks and regards 

Smitha

On Mon, 17 Feb, 2025, 12:40 Vaishnavi Jayakumar, <jayakumar...@gmail.com> wrote:

Smitha please note input received in conversation below : 

[17/02, 12:04] P.N.Andhare: Hospitals in India are notoriously Inaccessible, not because of absence of ramps and handrails and special toilets, but because all

Examination chairs from which patients are examined that are higher than the height of wheelchairs.

Not only this all normal tests like Xray, Sonography, ECG, MRI have high height tables that are inaccessible to wheelchair bound patients.

In aspirational or desirable category of accessibility measuees, these tables and examination chairs could be of adjustable heights, so that wheelchair bound disableds can be shifted to them easily, but this will take a decade to materialise in all hospitals in India.The easy solution is to make 

Provisions of adjustable height wheelchairs mandatory in each hospital, so that inaccessibility of hospital infrastructure can be addressed immediately.

Such height adjustable chairs are available in market. Hence its a question of realisation of  their need and prompt buying.

Also these adjustable heights chair should have retractable arms so that lattaral transfers to examination chairs and tables become easier. The wheelchairs are of normal of 18 to 20 inches height and the normal height of tables are 30 inches.

So mandatory provision of adjustable height wheelchair should have the capability of adjysting height from 20 inches to 30 inches i. e. 10 inches above normal wheelchair height.

Also the arms of wheelchair must be retractable.

This simple provision can make Indian hospitals accessible in a major way and as this requires only purchases, it should take little time for implementation.

Hence I recommend 

Height adjustable wheelchair with Retractable arms as a mandatory provision in every hospital, new or old.

My whole life of 80 years I have to face innumerable difficilties in hospitals due to absence of such a wheelchair.

This week I have to take a ECG. Again I have to cope up with a ECG table of 30 inch height and my wheelchair of 20 inch height.

I don't want my current and next generation wheelchair bound disabledsvti suffer from this inaccessibility ever.

Hence this request to you to press for this measure yourself or pass it on to group working on hospital accessibility.

Banking upon your sensitivity towards differently ableds. Regards.

[17/02, 12:05] P.N.Andhare: Attention Dr. Satendra Singh and medicine for all cures Vaishnavi

[17/02, 12:35] Vaishnavi Jayakumar: Already included as below. In fact it's listed for Chennai Corporation advocacy itself as buying things is comparatively easier for Govt - we even have a scoop stretcher at the beach access path!

1) Height adjustable 

A) stretcher for CT scan etc 

B) Exam table

2) Dental chair - default swivel arms + wheelchair model 

Will pass this on to Smitha who is inputting on health.

[17/02, 12:36] Vaishnavi Jayakumar: Will add the height adjustable wheelchair and bed as well

[17/02, 12:37] P.N.Andhare: Thank you very much

[17/02, 12:39] Vaishnavi Jayakumar: Weighing machine solution for wheelchair as well. Remember when my Dad was in hospital, there was even a bed based weighing machine. Coming to think of it, a very easy fix.

On Mon, 17 Feb, 2025, 11:44 Percy Cardozo, <percyc...@gmail.com> wrote:

Dear Smitha,

Thank you for these points. May I request you to put it in a word document? I have attached an example of Rules that developed for training and awareness. It would be most helpful if we can get a similar document for health as well.

Best wishes

Percy

On Sun, Feb 16, 2025 at 10:59 PM Smitha Sadasivan <sssmi...@gmail.com> wrote:

Dear Percy and Radhika ji,

Pfa the points for health services:

1. Review and revise the accessibility health care standards notified by MOHFW, in consultation with Persons with disabilities.

2. Review all the existing health and rehabilitation policies and programs from the lens of accessibility and inclusion for all 21+ categories of persons with disabilities and other vulnerable groups such as LGBTQIA+, Rare diseases, elderly people etc

3. Ensure all Primary Health Care centres, tertiary hospitals and other health care facilities to ensure accessibility standards and accessible services for all. Universal design and accessibility should be the key Clause in all goods and services procurement agreement. Rent/Lease agreement for Hospitals/Institutions must include class for accessibility. Ensure building is accessible before signing agreement for rent.

4. Ensure all the technical infrastructure (all equipments including xray, mammogram, etc), products/ goods (such as medicines, tablets, etc), health information and communication technology in all health care facilities follow accessibility standards and be accessible for all. This includes all the electronic health records to be fully accessible to all persons with (print) disabilities, all labels of Medicines to have a QR Code furnishing all details of the required medicine, all range of diagnostic equipments to be accessible, all the processes required for availing any health care facility to include an accessible or alternate format version, etc. Help desk for assisting health care seekers belonging to vulnerable communities including priority queue to be worked out. Helicopter service/ emergency corridors for fully equipped accessible ambulance service to be enabled at both intra state and interstate health facilities. 

5. Ethics committee under health research with regard to all vulnerable groups including people with disabilities, rare diseases, critical illnesses/  chronic conditions, elderly persons, LGBTQIA+ citizens, sexual violence survivors,  suicide attempt survivors, homeless and migrant/ displaced citizens should be set up / revived with clear guidelines in consultation and represention with people with lived experiences, towards ensuring accessible and inclusive health services, supporting in informed consent/ health decisions and advance directives as well.

6. MoHFW and every State Health Department in India must gather disaggregated data on people of disabilities, rare diseases, chronic ailments, LGBTQIA+, elderly and other vulnerable groups in all surveys/evaluations/ research studies in addition to the statistics of persons with disabilities who accessed policies, programs and services under the health depts.

7. AYUSH and other alternate therapies / health treatments should be made fully accessible and include specific services to all vulnerable population groups such as persons with disabilities,  Rare diseases,  chronic / critical ailments,  elderly, etc.

8. National Quality Assurance Standards (NQAS) must include ‘Assessment of Disabled Friendly facilities and services in all government health care facilities.

9. Swacch Bharat Sarveshan, Kayakalp and NABH accreditation initiatives must include disability access as a component for evaluation  and accreditation of (government and private) hospitals and health care centres. WASH programs to be inclusive for vulnerable groups and follow accessibility standards.

10. Expense on accessible transport and higher cost of medical services deter people with disabilities and other vulnerable groups from accessing health services. Ensure people with disabilities, rare diseases and other vulnerable groups are provided health and rehabilitation services including dissemination / maintenance of assistive aids at their doorstep.

11. Include all vulnerable groups in PMJAY - Ayushman Bharat Scheme irrespective of their socio- economic level.

12. Ensure all health insurance policies and products are fully accessible for all persons with disabilities.  Towards this, full medical insurance must be extended to all people with disabilities, elderly, people with rare diseases, chronic health conditions and other vulnerable groups without any condition or restriction. Insurance cover must include diagnostic measures, curative treatments, rehabilitation / maintenance therapies, assistive aids / technology,  palliative care and OPD consultations. Subsidised insurance premiums may be introduced with a cover of 1 crore towards treatment of health conditions that need expensive repeated therapies. Insurance cover should be available for every child from birth to enable screening and treatment of congenital and other health defects / impairments.

13. Health information/ awareness material should be accessible to all people with disabilities. This should include all Tele health and e health services as well. Usage of health technology such as Remote sensing for health and wellbeing should be extensively promoted in accessible formats. ABHA.. DIGITAL HEALTH MISSION SHOULD be made ACCESSiBLE TO persons with disabilities, ELDERLY AND CHRONICALLY AILING AND PEOPLE WITH RARE DISEASES. Large scale awareness programs on various health schemes and programs of the government should be organised across India, in accessible formats.

14. A trained cardre of community health and rehabilitation workers may be evolved at village and block level to support the accessible health,  rehabilitational, palliative care and social support needs of people belonging to all vulnerable communities.

15. Periodic training and orientation programs on inclusive and accessible health care services for persons with disabilities, Rare diseases, elderly,  LGBTQIA+ and other vulnerable communities should be carried out among health professionals and health workers.

16. Demystification of disabilities and stigma (against leprosy, psychosocial disabilities etc) at the level of health care workers to be carried out systematically at the ground level.

17. For facilitating the above points setup an accessibility and inclusion cell as well as inclusion focal points from the under represented communities at national, state, district and block levels within the Ministry of Health and Family Welfare and State Health Ministries / departments.

Pl feel free to edit as you think will suit  best.

Thanks and regards 

Smitha

On Mon, 10 Feb, 2025, 11:22 Smitha Sadasivan, <smitha...@gmail.com> wrote:

Sorry didn't mean services but sensitisation domains.

Regards

Smitha

On Sun, 9 Feb, 2025, 21:05 Smitha Sadasivan, <sssmi...@gmail.com> wrote:

Dear Percy

Thanks for your email. Yes thats right. I saw the document drafted by both you and Radhika Ji which excellently points out the accessibility requirements for any service and am still figuring how to include specific health aspects into it, as I remember Amita ji saying in one of the meetings, only focus on accessibility and not to get other domains like data, services into it. So thinking about it. Will be able to comeback on Thursday 13th feb with some points from my side. - basically about the health care accessibility guidelines. 

Sorry about the silence, as I also got tied up with continuous work and parents health.

Best regards 

Smitha 

On Sun, 9 Feb, 2025, 14:33 Percy Cardozo, <percyc...@gmail.com> wrote:

Dear Smitha,

Hope this email finds you well. I am reaching out to you to check about the annexure for health services. I believe you had offered to work on this. Not sure if I have got it right.

Do let me know.

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Best wishes

Percy

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Best wishes

Percy

[Amar Jain]

All health equipment's that are ICT based and used by consumers to comply with IS17802. The formats for health information and e-health services to mandatorily comply with IS17802.

The final text to be in line with final ICT standards as adopted.

Regards,

Amar Jain

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