|LETTER TO THE EDITOR
|Year : 2016 | Volume
| Issue : 2 | Page : 167-168
Changes in the health care system of India have effects on management of human immunodeficiency virus infection and acquired immune deficiency syndrome epidemic
Aditya Shivram Nar1, Despena Andrioti2, Pranav Ganatra3
1 MSc, Public Health, Unit of Health Promotion, University of Southern Denmark, Denmark; Department of Pharmacy, Bachelor of Pharmacy, University of Mumbai, Mumbai, Maharashtra, India
2 Senior Scientist, Centre of Maritime Health and Society, University of Southern Denmark, Denmark
3 Department of Pharmacy, Bachelor of Pharmacy, University of Mumbai, Mumbai, Maharashtra, India
|Date of Web Publication||23-Jun-2016|
Aditya Shivram Nar
011/B-Wing, Sukh Sagar CHS Ltd, Linking Road, Borivali-West, Mumbai - 400 091, Maharashtra, India
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nar AS, Andrioti D, Ganatra P. Changes in the health care system of India have effects on management of human immunodeficiency virus infection and acquired immune deficiency syndrome epidemic. Indian J Public Health 2016;60:167-8
|How to cite this URL:|
Nar AS, Andrioti D, Ganatra P. Changes in the health care system of India have effects on management of human immunodeficiency virus infection and acquired immune deficiency syndrome epidemic. Indian J Public Health [serial online] 2016 [cited 2019 Dec 6];60:167-8. Available from: http://www.ijph.in/text.asp?2016/60/2/167/184578
In India, a high number of human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) cases are reported.  The National AIDS Control Organization (NACO) bestows some rights for HIV patients the right to informed consent, the right to confidentiality, and the right against discrimination that enables the patient to access to court if their rights are violated.  After the formation of National AIDS Control Program (NACP), policy makers focused on the high-risk groups such as commercial sex workers and drug users due to the perception that HIV/AIDS will only be restricted to high-risk groups. The current NACP IV focuses more on reducing the incidence of HIV by 50% compared to NACP III, highlighting the need for increased awareness among the population and their active participation.  A study showed that shared and informed decision along with involving patients in decision-making is one of the key steps to achieve high quality health care. 
The fight against HIV/AIDS needs commitment from the policy makers and other actors, because most of the patients are ostracized by their family members and even some are left untreated by professionals. Anti-HIV/AIDS interventions were not promoted in time, and till today, it's a gigantic task to control it. , This letter focuses on the communication and bottom-up strategy, as important tools that show effect on HIV/AIDS policies.
A doctor who is at the top of the pyramid of societal hierarchy is blindly trusted by patients; but doctors take advantage of this trust and never involve or discuss the problem with patients;  communication gap between the doctors and patients is widening, and in this process, patients remain unaware of their medical conditions.
It is a task for the health professionals to communicate with patients and they should be involved in the decision-making process. Although relevant guidelines on how to involve patients exist, physicians usually do not comply with them. The doctors may argue that they lack relevant training on how to communicate such issues with patients as well as the lack of time to provide prevention and counselling information because there are more than 50 patient visits per practitioner per shift.  The situation is substandard in the lowest social class where more cases of HIV/AIDS have been reported and there is an urgent need in reforming the policy to address the respective population's needs.
Communications via top-down policies are adopted, where practitioners and policy makers implement rules on the higher level. India should adopt successful policies from other highly populated countries such as China and Brazil and put HIV/AIDS higher on the political agenda. The proposed policy should be designed considering all the spectrum of the society with an idea of the lifestyles of low-income group who are illiterate and unable to understand medical terms. Training of medical practitioners and other health professionals on prevention and health education of the population would be very helpful in population empowerment.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ramani KV, Mavalankar D. Health system in India: Opportunities and challenges for improvements. J Health Organ Manag 2006;20:560-72.
National AIDS control organisation, government of India 2015.
Objectives/. [Last accessed on 2015 Mar 30].
Barry MJ. Shared decision making: Informing and involving patients to do the right thing in health care. J Ambul Care Manage 2012;35:90-8.