Day Five Report
Feedback for Day Four
We started the day with the feedback from the participants for the evaluation report. We had suggestions from some of the participants to have a brief summary of the sessions in Hindi language and others suggested to have session/discussion on cross country comparisons in terms of health and health systems.
Health Differences – A Challenge
We had a session on ‘Health differences – A challenge’ by Dr. Narendra Gupta. He gave an overview of how differences in social determinants of health and so the differential access to resources creates differential health status through two interesting case studies.
The presentation led to an interesting discussion among the participants. Participants from Sri Lanka made a point that there is no remarkable difference in access to health of people in Sri Lanka. However the people living in conflict area are facing denial in access to health and many other basic services. Narendra Gupta stressed that the aggregate data hides differences in health of people across dimensions of gender, social status, income, education etc.
Following one of the slide that showed comparison among health of the people from different quintiles across India, Brazil, Indonesia, and Kenya, Dr. Armando commented that its interesting not only to compare health status of people across the country but also to compare health status of people from different economic quintiles across the country. Because then we understand that even the people from richest quintile with best health may be in poor health conditions compared to people from the lowest quintile of the other country.
As a concluding remarks Dr. Narendra made recommendations including the need to collect segregated data around gender, cast, income and other such divides and the role of social movements like PHM to exert pressure on governments to work towards reducing socio-economic differences in society.
Following the presentation, Dr. Armando explained a model adopted by Brazilian health system to understand the inequalities among individuals and in society.
We then had a tea break.
After returning from the tea break, participants worked in groups to see how they can apply the learning’s in the project ideas they are developing around particular issues i.e. Access to Medicines, Maternal Mortality Rate, Occupational safety and Infant mortality rate.
We then proceeded for a group photo before the lunch.
Spirit and Meaning
Afternoon session started with the presentation on ‘Spirit and Meaning’ by Dr.Mira Gupta along with the welcome note for Dr.Amit Sen Gupta. She made the participants to think about, often ignored but important aspect of life, how the activist can maintain his/her spirit and how to find a meaning to our work and life.
After the tea break we had a group work where groups discussed on various points made by Mira and in particular to address two questions of
1. What keeps you (activist) going? (Motivation/inspiration factors)
2. What should be the role of PHM?
Regardless of different region experience, the groups realized and came out with the real understanding about their meaning and the reason for their meaning and spirit of the life and work. Some of the participants questioned themselves the basic question of who I am and how far we are in compliance in terms of ethical, moral and empathy issues.
Reports from Different Countries
We had reports (in form of presentations) from our colleagues from Sri Lanka, Bangladesh and Nepal, each followed by an open discussion.
1. Health and Health Systems in Bangladesh
Nazmun gave an overview of Health and Health systems in Bangladesh explaining the country profile through the various factors such as demographic and socio-economic differential in the structural set up of the health systems and health status, trends and achievements made in past years (brief facts and figures of the country).
2. Health Policies in Nepal
Presented an overview of health status in Nepal and made a reference to the inclusion of right to basic health services which is to be provided free by government in their constitution. Some participants raised a point that the word ‘basic health services’ can be catchy as it may be interpreted in very restrictive sense at the desire of the government. However at the same time, it was pointed out that India lacks any such explicit commitment for right to health. Participants from Nepal felt that the Nepal is facing nearly similar problems as India and there are opportunities for mutual learning.
3. The Sri Lankan Health System
Jinani presented the problems and challenges faced by Sri Lanka in improving the population health along with giving overview of the current health scenario. The point that came out clearly and was also stressed by Dr. Amit Sen Gupta is that the rich people moving out of public service provision and going for private provision reduces overall political will to strengthen the public service provision.
Cultural event
Evening we all had a fantastic entertainment program, took away us from the regular course of activity to a new fresh thought. We were served with the traditional food of Rajasthan placed in Rajasthani style. “Holiâ€- the colour festival of northan India was also celebrated, where all of us danced and enjoyed to the fullest.
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