Dr. Deepak Sawant, Minister of Public Health and Family Welfare in the Government of Maharashtra, provides insights into some crucial achievements with regards to the state’s infant and child mortality rates, the improvement of Maharashtra’s emergency response and ambulance system, and the prevention of oral cancer. While highlighting the state’s openness to join forces with private healthcare companies, he also calls for a boost in telemedicine to tackle the dearth of healthcare professionals in the state.

What would you highlight as some of your key achievements and priorities since taking over the position of Minister of Public Health and Family Welfare for the state of Maharashtra in December 2014?

First of all, it must be highlighted that over half of the state’s 112 million inhabitants exclusively rely on the Maharashtra Health Department to access healthcare services and products.

In this regard, one of our main priorities has been to improve Maharashtra’s emergency response system, which has serviced more than two million people over the past three years. Maharashtra holds around 937 ambulances covering the entire state, including both advanced life support vehicles and basic life support ambulances, and our objective has been to upgrade our overall emergency system by implementing some features pioneered by the urgent and emergency care system of London. In this regard, we recently set up ten motorbike ambulances to cope with the high traffic congestion affecting some of the state’s largest cities. Over the past four months, over 1,200 patients were treated thanks to this new ambulance capacity, where the riders themselves are qualified doctors and can stabilize the patient until an ambulance arrives. Looking forward, we plan to double the number of motorbikes in operation within the coming months.

Boat ambulances stand as another key measure recently implemented in the Gujarat – Nandurbar district, and every month up to 1.000 patients are provided help and assistance thanks to this innovative project. We are now planning to extend the service from Alibaug to Gateway of India, which will cut down the travelling time from 3.5 hours to just 40 minutes. Furthermore, our boat ambulances will be equipped with advanced medical equipment to ensure patients can be stabilized before reaching the closest hospital. Looking forward, we plan to launch an air ambulance service for all accidents occurring on the Mumbai- Pune, Mumbai- Goa and Mumbai – Nashik highways. All these emergency services will be free of charge in order to ensure that all citizens can access them.

In the meantime, we are tirelessly upgrading the state’s neonatal care capacities, which will help further driving down the state’s infant mortality rate (IMR). The latter has dropped from 24 for to 19 per 1.000 live births within the past three years – placing Maharashtra as the state with the third lowest IMR in the country, and we would like to see this number being reduced even further. In the same vein, Maharashtra’s child mortality rate has decreased from 24 to 21 per live 1,000 lives, which proves that our recently updated infection control program and the inclusion of new range of antibiotics in the state’s treatment protocol are starting to yield positive results. Overall, our objective is to ensure Maharashtra soon emerge as the state in the country boasting the lowest IMR and CMR.

You just mentioned that over half of the population relies on the state’s Department of Health to access healthcare products and services. How have you been extending this coverage since the beginning of your tenure?

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The state’s insurance scheme, called “Mahatma Jyotiba Phule Jan Arogya Yojana’, covers almost 90 percent of the population and currently includes 971 medical products and procedures. Looking forward, its coverage will soon be extended to include 1113 products and procedures, including some of the most common surgeries such as hip joint replacements, angiography and angioplasty, as well as products and procedures for breast and cervical cancer.

In this regard, we recently conducted a large-scale screening campaign for oral cancer, which probably stands as the largest one ever conducted in the world, as over 20 million people received physical examination by doctors in December 2017 to detect possible cancer cases, before being referred for confirmatory tests. Leveraging on the recent extension of the state’s insurance scheme, we will be able to start taking care of these patients before the end of this year.

We however do not limit our efforts to the coverage of chronic diseases, as we recently initiated the ‘Baba Saheb Thakeray Accident Benefit Scheme’, which aims to cover people involved in road accidents in the state of Maharashtra. As part of this new scheme, all people injured in road accidents will receive up to Rs30,000 [or USD465] or be provided for a free, two-day hospital stay, whereas so far many patients do not even seek medical attention because of associated costs.

India displays one of the lowest doctor-population ratios in the world, with less than one doctor for more than 10,000 people. How do you go about ensuring the state of Maharashtra is among the frontrunners in this critical area?

We have put a special emphasis on this crucial matter since the beginning of my tenure and granted permission to recruit doctors at all levels. As a matter of fact, the vacancy rate in the medical field has decreased from 65 percent to just 12 percent over the past three years, while the hiring of local physicians has allowed increasing access to care in isolated areas. We also set up a new replacement scheme for physicians pursuing post-graduation and super-specialty in order to ensure that hospital staff are not affected.

Although some initiatives in this regard fall within the scope of responsibilities of the state’s Ministry for Medical Education, the Ministry of Public Health and Family Welfare just set up a College of Physicians, which provides diploma courses in anesthesia, pediatric, gynecology and ten other specialties under the supervision of specialists. We expect that a first batch of physicians will graduate from this new program within the next six months.

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Finally, we have been strengthening our ties with some of the most advanced health systems in the world. In this context, Sir Malcolm Grant, the Chairman of NHS England, has been guiding our efforts with regards to the training of the Maharashtra’s nursing capacity. In this vein, we plan to open a new medical position placed above the nurse but below the doctor, with the specific mission to take care of the patients in emergency care.

What is your vision for public -private partnerships?

The Department of Public Health is open to any kind of support or partnerships with private companies, whether it relates to prevention, treatment or the management of our healthcare capacities and centers.

As part of their CSR activities, leading multinational companies have already joined forces with the government of Maharashtra to boost public health in the state. For example, the Government of Maharashtra and Johnson & Johnson India will work together to address pressing public health issues such as tuberculosis (TB), maternal and child health, infection prevention, diabetes, obesity and menstrual hygiene and will support healthcare professionals and nurses in the state to further develop their skills in these areas. Moving forward, we look forward to partner with pharmaceutical and healthcare companies to jointly shift the healthcare paradigm in India’s second most populated state.

What is your final message for our international readers?

Whether it relates to densely populated or rural areas, we need to communicate with patients, doctors and healthcare workers. There is a shortage of doctors, and to fill that gap, there must be technology to communicate real time. Telemedicine is the need of the hour, and we must develop technologies that go beyond video conferencing. In this regard, the industry and healthcare providers must work together on developing advanced digital systems that would entitle physicians to truly engage and follow patients remotely, including real time ECG and auscultation monitoring.