Express Healthcare (Vol. 18, No. 2) March 2025

Page 1


Chairman of the Board

ViveckGoenka

Sr.Vice President-BPD

Neil Viegas

Vice President-BPD

Harit Mohanty

Editor

Viveka Roychowdhury*

Editorial Team

Lakshmipriya Nair

Kalyani Sharma

Kavita Jani

Neha Aathavale

DESIGN

Art Director

Pravin Temble

Senior Designer

Rekha Bisht

Senior Artist

Rakesh Sharma

Marketing Team

Rajesh Bhatkal

Douglas Menezes

Ashish Rampure

Debnarayan Dutta

Production Co-ordinator

DhananjayNidre

Scheduling & Coordination

Pushkar Waralikar

CIRCULATION

Mohan Varadkar

CONTENTS

INTERVIEW

P8: RAJEEVSIBAL President – IRF, Lupin

HOSPITALINFRA

RADIOLOGY

P10: INTERVIEW

ARPITAMUKHERJEE

SENIOR VICE PRESIDENT OFOPERATIONS AND UNIT HEAD ATMAXSUPER SPECIALITYHOSPITAL, DWARKA

Express Healthcare®

22 GAME CHANGING REVOLUTIONARY NEWER LAB TECHNIQUES IN TB

PUBLIC HEALTH

25 URBAN HEALTH SYSTEMS NEED RENEWED ATTENTION, INNOVATION,AND ACTION

Regd.With RNI No.MAHENG/2007/22045.Postal Regd.No.MCS/162/2025 - 27.Printed and Published byVaidehi Thakar on behalf of The Indian Express (P) Limited and Printed at The Indian Express Press,Plot No.EL-208,TTC Industrial Area,Mahape,Navi Mumbai-400710 and Published at Mafatlal Centre,7th floor,Ramnath Goenka Marg,Nariman Point,Mumbai 400021.

Editor: Viveka Roychowdhury.* (Editorial & Administrative Offices: Mafatlal Centre,7th floor,Ramnath Goenka Marg,Nariman Point,Mumbai 400021)

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Will private hospitals' capex spur medical inflation?

ARight To Information (RTI) query to the Ministry of Health & Family Welfare on the dues payable to empaneled hospitals who have given free treatment to patients under Ayushman Bharat Yojana received a reply dated February 28, that dues of Rs 1,21,61,45,63,617 (approximately Rs 12,161.45 crores) are pending. Is it any wonder that quite a few hospitals are turning away patients under the scheme, until the ministry settles pending dues?

On February 10, 2023, in reply to a Lok Sabha query on the same topic, the health ministry stated that as of February 2, 2023, the overall percentage of the total claims paid against total claims submitted under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme is approximately 77 per cent while the percentage of claims paid to private hospitals is 86 per cent.

The query also asked for the measures taken by the Government to deal with such cases. The first of four initiatives listed that were taken to streamline the payment mechanism under AB-PMJAY was close monitoring of claim payments via various monitoring dashboards developed to trace claims pendency, claim payment, turn-around time of claim payment, etc.

Secondly, the National Health Authority (NHA) launched a Green Channel Payment (GCP) wherein the provision to pay 50 per cent of the claim amount automatically at the time of claim submission was integrated into the NHA’s IT system. Thirdly, the NHA deployed e-RUPI vouchers to pay beneficiaries for upfront payment for drugs and diagnostics services under AB-PMJAY and lastly, the claims query workflow was optimised to avoid delay in claims settlement.

The fact that more than Rs 12000 crores of dues are still pending two years after these replies in Parliament, hints that these measures are still not working and are not enough to tackle the problem. These payment glitches do not bode well for private healthcare providers as well as the patients they are obliged to serve.

Meanwhile, fueled by private equity (PE) and initial public offerings (IPOs),private hospitals are on a massive capacity expansion. A Crisil Ratings analysis of 91 private hospitals, with a combined revenue of about ~Rs 64,000 crore last fiscal, shows that private hospitals in India are slated to increase their capacity by over ~4,000 beds next fiscal, at an investment of ~Rs 11,500 crore. This is in addition to an aggressive addition of around ~6,000 beds this fiscal. The bed addition in just

As the number of private sector beds increase, and smaller players are nudged out of the market,will it spur medical inflation? Especially since these hospitals will continue to be wary of serving ABPMJAY beneficiaries until pending dues worth more than Rs 12000 crores are cleared?

these two fiscals will equal those added between fiscals 2020 and 2024.

Half of the new beds will come from greenfield expansions, about 40 per cent will comprise brownfield development, while the remaining 10 per cent will result from large players taking over under-construction hospitals and small and mid-sized hospitals. As the number of private sector beds increase, and smaller players are nudged out of the market, will it spur medical inflation? Especially since these hospitals will continue to be wary of serving AB-PMJAY beneficiaries?

One spoiler for the sector is the dip in medical value travel (MVT) from Bangladesh, given the diplomatic tensions between India and our eastern neighbour. A BNP Paribas India Healthcare Services Report dated February 2025 details that the country made up around 70 per cent of India’s MVT. The report quotes monthly data published by the Ministry of Tourism, which states that India’s MVT declined by 43 per cent-59 per cent y-y in Nov/Dec 2024, reaching the lowest monthly level for the year. The analysts expect international patient revenue in 4QFY25 to be similar to the last quarter, based on the current trend of monthly data published by the Ministry of Tourism.

With the recent resumption of freight services between India and Bangladesh, the analysts believe there is a possibility that the Indian government could scale-up visa operations in a gradual manner. Thus MVT from Bangladesh could slowly pick up for national chains like Apollo Hospitals, Manipal Hospitals,Aster DM Healthcare and Fortis Healthcare. Aside from short term pain, this incident has been a wakeup call for such hospitals, to diversify their MVT reach to other countries.

While the healthcare sector copes with these business cycles, we highlight the inspirational thought leadership of women leaders in the healthcare sector. Express Healthcare’s Women’s Day special in the March edition features 14 letters from exceptional yet unsung women leaders with messages to inspire the next generation of women leaders in the sector. As long as we have these torch bearers, India’s healthcare sector is in good hands.

VIVEKA ROYCHOWDHURY, Editor viveka.r@expressindia.com viveka.roy3@gmail.com

Range

Cardiagard

INTERVIEW

Women's heart health in India: Agrowing concern

Rajeev

Sibal, President – IRF,Lupin highlights

the increasing prevalence of heart disease

among women in India

and what measures Lupin is taking to address these concerns in an

interview with Kavita Jani

What is the prevalence of heart disease among women in India?

The escalating prevalence of heart disease among women in India is a pressing public health issue that demands urgent attention. More than 40 per cent of all deaths in women are attributed to cardiovascular disease (1). It is particularly alarming that there is a significant shift in the age of disease onset.

Research indicates that Indian women are experiencing heart attacks nearly a decade earlier than their western counterparts (2). Approximately 12-15 per cent of heart attack cases in Indian women occur before the age of 40, compared to just 3-4 per cent in the West. This requires immediate attention.

From an industry perspective, a more gendersensitive approach to heart health is necessary.

Traditional risk assessment models, primarily based on male patients, often fail to accurately predict heart disease in women, because women-specific symptoms are frequently misdiagnosed or overlooked.

At Lupin, we believe this is both a healthcare and social challenge. We are constantly working with healthcare providers to improve early detection and treatment accessibility, particularly in tier-2 and tier-3 cities. Our Women’s Heart Health initiative, Nova Shakti, is a testament to this commitment. Through Nova Shakti, we aim to educate

women about heart health and encourage routine cardiovascular check-ups. The programme also offers free heart health screenings and consultations in remote and underserved areas, with an aim of providing women from all socio-economic backgrounds have access to critical cardiac care. Furthermore, the initiative

focuses on empowering women with the knowledge and tools needed to make informed health decisions, ultimately fostering a community that prioritises and supports women's cardiovascular wellness.

Our initiative utilises a three-pronged approach: enhancing awareness about women-specific symptoms,

improving preventive healthcare infrastructure, and developing more gendersensitive diagnostic tools. It's not just about treating the disease; it's about transforming how we approach women's cardiac health in India.

What is currently being done to address women’s

cardiovascular health and what are the major challenges faced?

Women's cardiovascular health, once underrepresented in research and clinical practice, is now experiencing a significant shift in perception and delivery. This transformation is evident in the increasing focus on women’s health research and the emergence of key initiatives that are reshaping the landscape.

A substantial step in the direction is the increase in women-specific cardiovascular research. The NIH’s mandate for the inclusion of women in clinical trials, has led to a remarkable 42 per cent female participation in cardiovascular trials, a significant leap from just 25 per cent a decade ago. The healthcare industry is also prioritising awareness and early detection. We are supporting these efforts through our patient support programmes and have partnered with several women's health organisations to provide free cardiovascular screenings in underserved areas.

However, there remain several challenges: Biological complexity: Women often exhibit different symptoms than men during cardiac events (3). This biological variability makes diagnosis and treatment more complex.

Healthcare access: Despite improvements, women are

still less likely than men to receive preventive cardiovascular care (4). This gap widens significantly in developing markets, where we're working to improve access through our affordable medication programs.

Knowledge gap: There's still a concerning lack of awareness about women's cardiovascular risks. Studies show that only 44 per cent of women recognise heart disease as their leading cause of death (5).

Looking ahead, it's clear that a more targeted approach is necessary. We need to invest in women’s health research, improve healthcare access, and enhance education to address healthcare inequity. At Lupin, we're investing in AI-driven research to better understand gender-specific drug responses and developing more targeted therapies for women's cardiovascular health.

The most critical challenge is to bridge the persistent gap between knowledge and action. While we've made significant strides in understanding women's cardiovascular health, translating this knowledge into practical, accessible healthcare solutions remains our biggest hurdle.

We're optimistic about the future, but continued collaboration between pharmaceutical companies, healthcare providers, and policymakers is essential to create meaningful change in women's cardiovascular health outcomes.

How can technology be leveraged to better understand and tackle women’s cardiac health?

According to the American Heart Association 1 in 3 women dies from cardiovascular disease (6). Yet only 56 per cent of women recognise heart disease as their leading health threat (7). Additionally, women are more likely to receive an incorrect initial diagnosis during a heart attack compared to men.

Technology is playing a crucial role in addressing

the challenge and has become a beacon of hope.:

◆ First, AI and machine learning are helping us develop gender-specific diagnostic algorithms. At Lupin, we are particularly interested in how these technologies can identify gender-specific biomarkers and symptoms. Traditional cardiac diagnostic criteria were primarily based on male patients, but current findings indicate that women often present different symptoms during cardiac events.

◆ Second, wearable technology and digital health platforms are transforming preventive care. We are seeing remarkable success with remote monitoring devices that can track heart rhythms, blood pressure, and other vital signs in real time, allowing for earlier intervention.

◆ Third, big data analytics is a powerful tool that helps us understand population-level trends and risk factors specific to women. For instance, research has revealed that factors like pregnancy complications and autoimmune disorders significantly impact women's cardiac health. The insights that were made available through the computing power of AI to analyse large datasets. However, technology alone isn't the complete solution. We need to engage in a comprehensive approach that combines these technological advances with enhanced awareness programs, sexspecific clinical guidelines and better representation of women in clinical trials.

In my opinion, the future of women's cardiac health lies in personalised medicine powered by technology. The integration of AI-driven risk assessment tools, combined with genetic testing and digital health monitoring, will allow us to predict and prevent cardiac events more effectively in women.

Lupin is committed to advancing this cause through our research initiatives and digital health solutions. Our team of experts is dedicated to leveraging technology to improve women's cardiac

health. The challenge now is to ensure it reaches the women who need it most and is implemented in ways that addresses the unique aspects of women's cardiac health.

How has Lupin used AIpowered chatbots and remote monitoring tools, to cater to the growing demand for personalised care? Could you share a few case studies? At Lupin, we've strategically integrated AI-powered solutions to enhance patient care and support healthcare professionals. Let me share some specific initiatives and their impact:

Our AI-powered chatbot, 'ANYA', is not just a tool for healthcare professionals. It's a patient-friendly platform that has been a game-changer since its launch in 2018. It provides instant, evidencebased responses to queries about disease management and drug information.

Patients today are techsavvy and well-informed about managing their health conditions. However, there is a lack of trusted and comprehensive sources providing diseasemanagement information for patients. ANYA aims to bridge this gap by providing medically verified information and acting as a preferred partner for doctors in resolving patient queries anytime.

While AI and remote monitoring tools have significantly enhanced our ability to deliver personalised care, we must maintain a balanced approach. Technology should complement, not replace, human medical expertise. We are expanding our AI capabilities while ensuring our solutions remain accessible and user-friendly for both healthcare providers and patients.

We are focused on integrating predictive analytics and real-world evidence to personalise treatment protocols. This includes developing AI algorithms that can predict disease progression patterns and recommend personalised

interventions. We believe, this will be crucial in addressing the growing demand for individualised healthcare solutions while maintaining cost-effectiveness and scalability.

Does data show how digital therapeutics can slow disease progression and foster faster recovery? Yes, there is compelling evidence demonstrating the impact of digital therapeutics (DTx) on disease progression and recovery rates. In diabetes management, for instance, studies have shown that FDA-cleared digital therapeutics like BlueStar have helped reduce HbA1c levels by 1.7 to 2.0 percentage points. To put this in perspective, oral antidiabetic medicines typically achieve a 0.5 to 1.2 percentage point reduction.

Unlike traditional therapeutics, DTx platforms can continuously monitor patient progress and adjust interventions accordingly. We are seeing recovery times improve when personalised digital interventions are implemented.

The potential of AI and machine learning lies in predicting disease progression patterns. Early warning systems could potentially prevent acute episodes before they occur, offering a hopeful future for healthcare.

While these results are promising, it's important to note that digital therapeutics work best as part of a comprehensive treatment approach. They're not replacing traditional therapeutics but rather enhancing their effectiveness through better engagement, monitoring, and personalisation.

How does Lupin plan to further aid the cause of awareness and prevention of heart diseases among women in India?

Cardiovascular diseases (CVDs) are the leading cause of death among Indian women. What's particularly concerning is that most of

these cases go undiagnosed or are detected too late. Our strategy combines the onground programs and digital initiatives to ensure we reach out to women of all ages across urban and semi-urban areas.

We're also investing in research to understand Indiaspecific risk factors for women's heart health. Heart disease is the leading cause of death among women, accounting for almost 18 per cent of all female deaths in India, and cultural barriers often prevent them from prioritising their health. Despite the challenges, including cultural barriers, we are committed to improving cardiac awareness and prevention through ongoing persistent efforts and community engagement, thereby fostering a healthier future for all.

References

1. The Gamut of Coronary Artery Disease in Indian Women - Indian Journal of Cardiovascular Disease in Women

2. https://www.thelancet.com/ journals/lansea/article/PIIS277 2-3682(23)00016-1/fulltext

3. https://www.mayoclinic.org/ diseases-conditions/heartdisease/in-depth/heartdisease/art-20046167#:~:text= Chest%20pain%20is%20the%20 most,heart%20attack%20witho ut%20chest%20pain

4. https://pmc.ncbi.nlm.nih.gov/ articles/PMC4834856/#:~:text= Awareness%20of%20CVD%20a s%20the,men%20at%20similar %20ASCVD%20risk

5. https://www.goredforwomen. org/en/about-heart-disease-inwomen/facts#:~:text=Cardiovas cular%20disease%20kills%20m ore%20women,is%20their%20gr eatest%20health%20threat

6. https://www.goredforwomen. org/en/about-heart-disease-inwomen/facts#:~:text=Fact:%20 Losing%20even%20one%20wo man,the%20highest%20matern al%20mortality%20rates

7. https://www.cdc.gov/heartdisease/about/women-andheart-disease.html#:~:text= Over%2060%20million%20wom en%20(44,3

kavita.jani@expressindia.com kavitanjani@gmail.com

HOSPITAL INFRA

INTERVIEW

Sustainable practices in healthcare infrastructure

Arpita Mukherjee, Senior Vice President of Operations and Unit Head at Max Super Speciality Hospital,Dwarka,in conversation with Kalyani Sharma, emphasises the industry trends driving sustainability in healthcare infrastructure and the role of innovations in enhancing the sustainability of hospital infrastructure

What current industry trends drive sustainability in healthcare infrastructure, and how do you anticipate they will evolve in the coming years?

The healthcare sector’s/industry growing focus on sustainability highlights the need for circular strategies that promote reuse, extend product lifecycles, and improve reverse logistics. Transitioning to green solutions, such as renewable energy and net-zero plans, has become essential for longterm progress. Speaking upon the future, as the focus on sustainability grows healthcare infrastructure is expected to become smarter, greener, and more adaptable.

Hospitals face numerous challenges when adopting sustainable infrastructure practices. Could you highlight some of the key obstacles they encounter?

Hospitals face several challenges when shifting to sustainable infrastructure.

One of the main barriers to investing in greener alternatives or sustainable initiative as it involves the higher upfront capital costs associated with purchasing eco-friendly equipment, technologies, and infrastructure upgrades. Hospitals may face budget constraints that limit their ability to make significant investments in sustainability projects. Retrofitting old buildings to meet sustainability standards is often complex and expensive while adapting green infrastructure practices. However, as technology improves and costs come down, these barriers are

becoming easier to overcome. It is important to align with organisational goals with the right planning and support, hospitals can make sustainability a reality without compromising care quality.

Emerging technologies, such as AI, smart sensors, and automation, are making waves in many sectors. What role do these innovations play in enhancing the sustainability of hospital infrastructure?

We follow Smart Building Automation, facilitated by an advanced Building Management System (BMS), which has revolutionised how healthcare facilities operate. In modern hospitals and medical centers, where energy efficiency, patient safety, and operational reliability are critical, BMS plays an essential role. It helps in real time energy monitoring, optimised operations, predictive maintenance etc. In tandem with BMS, smart sensors and AI-enabled medical devices further enhance operational efficiency and patient care & we have an AI enabled Cath Lab, MRI machine & other bio-medical equipments.

Renewable energy is key to sustainable development. How do you approach integrating renewable energy solutions into hospital infrastructure?

Hospitals are essential pillars of society, and as India’s healthcare landscape evolves, sustainability has emerged as a critical focus area.

Renewable energy efficiency approach serves as a corner stone for eco- friendly hospital. Designing into

One of the main barriers to investing in greener alternatives or sustainable initiative as it involves the higher upfront capital costs associated with purchasing eco-friendly equipment, technologies, and infrastructure upgrades

hospital infrastructure follows a step-by-step approach — starting with renewable energy utilisation, integrated water management, energy optimization, and the use of sustainable building materials.

At Max Super Speciality Hospital, Dwarka, a green field project serves as a benchmark for eco-friendly hospital design, it incorporates sustainable practices such as solar power for daily operations, water recycling systems, and expansive green spaces to promote biodiversity. We have a zero-water discharge system where not even a single drop of used water goes waste. These features not only enhance energy efficiency but also ensure resilience against climate challenges, with robust ventilation systems and backup power solutions. By reducing reliance on fossil fuels and minimising waste, Max Hospital, Dwarka is driving a global push for a greener, more sustainable future. Through its commitment to sustainability, Max Super Speciality Hospital, Dwarka continues to set new standards for eco-friendly and resilient hospital design.

What sustainability practices is Max Healthcare implementing at Max Hospital in Dwarka?

Max Super Speciality Hospital, Dwarka, exemplifies sustainable healthcare infrastructure through a range of eco-friendly practices designed to reduce environmental impact and promote operational efficiency. The hospital operates on renewable energy, utilising solar power systems to minimise carbon emissions

and enhance energy performance. Advanced water management systems, including a 250 KLD on-site Sewage Treatment Plant (STP), support water recycling for flushing and irrigation, resulting in a 70.5 per cent reduction in potable water demand as per GRIHA standards.

Low-flow water fixtures, drip irrigation systems, and native drought-tolerant landscaping further optimise water conservation. The building incorporates energyefficient designs with more than 60 per cent of occupied spaces receiving natural daylight, reducing stress and energy usage. To promote green mobility, around 20 per cent of parking spaces are equipped with EV charging stations, encouraging the use of electric vehicles. Additionally, the hospital uses eco-friendly R134A refrigerants in its centralised air conditioning systems, reducing the impact on the ozone layer. Sustainable construction practices include the use of recycled materials to minimize the demand for virgin resources, and downward-facing exterior lighting prevents light pollution. With automated chemical dosing systems and robust ventilation technologies, Max Hospital, Dwarka, integrates modern sustainability features that align with global green building standards. By creating a resilient, ecofriendly environment. We at Max Healthcare demonstrates commitment to a healthier future for both patient and the planet.

Kalyani.sharma@expressindia.com journokalyani@gmail.com

Dear aspiring women leaders and colleagues

With the increased corporatisation of healthcare, we are seeing more women in executive roles, though not at the pace we might have hoped. Compared to other sectors, healthcare is fortunate that leadership is often in the hands of women. Traditionally, nearly 50 per cent of the hospital workforce is female, primarily in nursing and paramedical roles. However, the journey to leadership is not without its challenges, and apart from a few iconic leaders, it remains a male-dominated field.

Personally, I was blessed not to experience gender bias as a child. My parents always encouraged me to pursue my dreams, and my mother, in particular, instilled in me a strong sense of ambition and drive of success. I was always passionate about healthcare and fascinated by the inner workings of large hospitals.

My first job, through a campus interview, shaped my confidence and leadership personality. I had the opportunity to commission a Bajaj family-run hospital, where I handled everything from appraisals and starting a nursing college to writing SOPs and grooming staff. This experience gave me the confidence to navigate any challenging situation. I was so passionate that I would even take rounds at midnight to handle difficult situations and support patients and families. I was also fortunate to work with CEOs with military backgrounds, like Brig Joe Curian and Maj General Vijay Krishna, who supported my decision-making and new ideas. Working with Jupiter Hospital under Dr Ajay Thakker also provided a unique perspective.

Keeping the patient at the centre of healthcare delivery and ensuring ethical leadership are crucial to me. I feel that as women, we are both compassionate and courageous. I remember handling an angry crowd and even standing up to a local politician. I believe leading from the front is essential to setting a culture of justice and equity. I have faced defining moments, such as navigating the COVID19 pandemic and making difficult decisions to improve organisational performance. These experiences have taught me the importance of leadership, value system, and strong commitment to profession.

While balancing career and family can be challenging, we are blessed with the ability to multitask. I agree with Indra Nooyi that we don't need to be superwomen to achieve 100 per cent in all areas of life. Delegation and empowerment are essential in both professional and personal life. I am fortunate to have a strong support system at home, as I know many capable professionals who couldn't advance their careers due to family responsibilities. At times, I have even prioritised family over challenging roles.

My advice to you all is to aim big. As women leaders, we are gifted with special abilities to connect with our teams, understand patient expectations, and drive success. We are often deeply involved in our work, and integrity is our hallmark. Even if we face setbacks, we should never abandon our goals. Support systems are not always given but must be created. In the workplace, have a process-driven approach, empower your teams, and support other women in their leadership journeys. Looking ahead, I believe in empowering the next generation of leaders. It is essential to provide them with opportunities and the freedom to innovate. As women leaders, we can understand and do this better.

Best wishes,

Dear future trailblazer

The path to leadership is seldom filled with moments of doubt, perseverance, and self-discovery. My journey has been no exception. Early in my career, I questioned whether I truly belonged in rooms where decisions were made. But with time, I learned that leadership is not about perfection, it is about conviction. I found my voice by listening to mentors, embracing failures as stepping stones, and continually pushing my limits. Healthcare is ever-evolving, and as leaders, we must remain open to change, innovation, and new perspectives. The ability to navigate uncertainty while staying rooted in our values defines true leadership. As I reflect on my path, I am reminded of the values instilled in me by my parents which are perseverance, integrity, and the courage to take risks. My father’s entrepreneurial spirit and ability to navigate the unknown inspired me to embrace challenges head-on, to see beyond the obvious, and to trust in my capabilities even in the face of adversity.

Breakingbarriersandovercomingchallenges

Gender equality in healthcare leadership remains a challenge that cannot be ignored. There were times when my expertise was doubted, my ideas were overlooked, or when my capabilities were doubted simply because of my gender. But I refused to let these barriers define me. Breaking these biases requires both individual courage and collective action. We must advocate for equal opportunities for women in medicine and healthcare leadership. It is our responsibility to create an environment where the next generations of women leaders do not have to fight the same battles we did.

Balancingprofessional-personallife

One of my greatest challenges was maintaining the delicate balance between professional responsibilities and personal well-being. The nature of our work demands long hours, emotional resilience, and constant decision-making. For years, I believed that self-care was a luxury, something that could be postponed. Achieving balance requires intentionality. It means prioritizing mental and physical health just as we do for our patients. Support systems, whether family, friends, or colleagues, are essential in this journey.

Leadershipandmentorship

Women in leadership often find themselves at the crossroads of expectation and ambition. We navigate administrative hurdles, coordinate logistics, and ensure the seamless delivery of care and services, often while balancing personal and societal responsibilities. At Wadia Hospital, my first challenge was restoring faith within the organization. The staff’s concerns about job security and the hospital’s future required more than just reassurances as it demanded action, involvement, and a collective vision for the future. I made it my mission to engage with every level of the hospital’s workforce, to listen, to understand, and to include them in the hospital’s revival plan. Leadership is not about dictating change but about nurturing an environment where change is embraced collectively. Success in any field, especially healthcare, is not solely measured by financial growth or institutional expansion. True success is reflected in the impact we make, which is the grateful smile of a patient, the sigh of relief from a worried parent, and the appreciation from a staff member who feels valued. These are the intangible yet profound rewards of leadership. To every woman striving to make a difference, never let challenges deter you. The path to success is seldom linear, and setbacks are merely stepping stones to growth. Learn, adapt, evolve, and transform obstacles into opportunities. Leadership is not just about guiding others but about inspiring them to reach their full potential.

Let us envision a future where healthcare becomes accessible to all, where every woman in the healthcare sector finds opportunities to lead and excel. Whatever challenges come your way, always keep smiling. True leadership is about ensuring that everyone around you thrives, that excellence is not just an aspiration but a reality, and that together, we create a world where success is defined by the lives we touch and transform.

Best Wishes

Dear future changemakers

Navigating the healthcare industry is a journey that demands resilience, innovation, and an unwavering commitment to improving patient care. It is a path filled with challenges, but it is also rich with opportunities to transform lives. As a woman in healthcare, my journey has been marked by numerous lessons, each shaping me into a stronger leader and a more compassionate healer. Today, I wish to share my story and the invaluable insights I have gained along the way.

My leadership journey has been shaped by reengineering processes within healthcare, particularly through reflex testing for conclusive diagnosis, self-sampling techniques, point-of-care diagnostics, and nurturing next-generation healthcare professionals through skill development programs to establish a Centre of Excellence in clinical & laboratory specialties. These strategies have not only improved patient outcomes but also contributed to reducing morbidity & mortality rates. I believe that behind every technological advancement lies the fundamental truth of data - the foundation of healthcare innovation. In an industry built on trust, data serves as the guiding force for decision-making and the compass for improving patient survival. While the healthcare industry holds immense potential, gender equity in leadership remains a significant challenge. There is a lot of conditioning around who you should be, how you should behave, what you are capable of, what you cannot risk, and so on. The journey for women leaders is often accompanied by systemic biases and outdated perceptions. Women often find themselves constantly having to prove their capabilities, battling stereotypes that question their expertise and leadership potential. However, there is always a silver lining. Women always tend to adopt a more democratic approach valuing everyone’s input and working towards a consensus. This natural tendency positions women as great leaders and consensus builders. The need of the hour is to create an inclusive healthcare solution not just for patients but within the industry itself. We must constantly challenge outdated norms and demonstrate consistent impact through data-driven decisions and transformational leadership. By doing so, women can reshape the narrative of healthcare leadership, which is predominantly a maledominated one. It is all about embracing our strengths, pushing boundaries, and challenging the status quo to ensure a lasting impact while taking everyone along on the journey to excel.

Mentorship has been one of the most powerful catalysts for my professional growth. The right mentors and networks have the potential to shape one’s leadership journey in remarkable ways. However, mentorship is not merely about offering guidance; it is about empowerment—inspiring others to recognise their potential and supporting them in pursuing their ambitions. I feel truly fortunate to have built networks of support along the way, fostering a culture of collaboration over competition. These communities have not only contributed to my personal growth but have also played a pivotal role in bridging gender disparities. By nurturing confidence and providing essential resources, they empower aspiring women leaders to excel. Being a woman, balancing a demanding career with personal well-being is a challenge. Over time, I have learned that achieving balance is not about perfection but about making small, manageable improvements such as ensuring healthier family meals, scheduling annual health checkups, or replacing screen time with interactive family time between loved ones is the key. As I look to the future, I am filled with hope and anticipation for the next generation of women leaders in healthcare. We need fearless innovators and changemakers— individuals who can drive technological advancements, shape healthcare policies, and champion inclusive leadership. We should not forget that women possess an incredible capacity for balance, resilience, and transformation, making them natural leaders in the healthcare space. Live life as a true woman, embrace your unique strengths and enjoy every step of the journey. The world needs more women who dare to lead, innovate, and inspire others to follow in their footsteps. To the future leaders reading this, I leave you with one question: What is one thing you can improve today? Whether at work, at home, or in society, small changes lead to lasting impact.

With courage and determination,

Weentered this field because we care deeply about others. We dedicate ourselves to healing, comforting, and ensuring the well-being of our patients. But in the process, how often do we extend that same care to ourselves? Women in healthcare carry more than their share of the load. We take on demanding shifts, manage patient care with unwavering dedication, and balance personal responsibilities—all while navigating unspoken expectations. An Mpower survey revealed that 56 per cent of female employees are at risk of poor mental health, compared to 41 per cent of men. Women, particularly in healthcare, FMCG, automobile, and e-commerce sectors, find themselves among the most vulnerable. Early in my career, I believed that strength meant never slowing down. I worked long hours, missed family moments, and ignored signs of exhaustion. It wasn’t until a mentor reminded me that taking care of myself was not a weakness but a necessity that I truly understood the importance of prioritising my mental health. How many of us have been conditioned to believe that asking for support or stepping back for our well-being is a sign of failure? In reality, it is the very thing that allows us to show up as our fantabulous selves—for our patients, our colleagues, and our loved ones.

Workplace biases persist. Eighty percent of women report facing stereotypes at work, particularly around maternity leave and career growth. Eighty-one percent feel their male colleagues lack sensitivity toward women’s health concerns. These challenges aren’t just statistics—they are lived realities for many of us.

And yet, despite all this, we continue to show up. We continue to care. But we must also ask: Who is caring for us?

The answer, in part, lies in each other. Something powerful happens when women support women. I have seen firsthand the strength of mentorship, the impact of community, and the resilience that comes when we uplift one another. When we create spaces to openly discuss our struggles, we not only help ourselves but also set a precedent for the next generation of women in healthcare.

To every woman reading this: Your mental health matters. Prioritising yourself does not mean you are any less dedicated to your profession. If you need time to rest, take it. If you need support, seek it. Your well-being is not a luxury—it is essential. The best care we can give to others begins with the care we show ourselves.

For those in leadership positions, we have a responsibility to drive change. Let’s create workplaces where women feel heard, where work-life balance is not just a conversation but a reality, and where young women in healthcare know they don’t have to choose between their careers and their well-being. To those just beginning their journeys—build your networks, seek mentorship, and remember: you are not alone. Commit yourself first and then plan for others. Highlight the changes you want to see and demand the support you deserve.

We cannot pour from an empty cup. When we take care of ourselves, we set an example for others. We create a culture where mental health is valued, where women are empowered to lead, and where no one has to prove their worth at the cost of their well-being.

This Women’s Day, let’s make a fantabulous commitment—to ourselves and one another. Let’s lead by example. Because when women in healthcare thrive, the entire system becomes stronger.

Let’s create spaces where women in healthcare are heard, valued, and supported—not just today, but every day. Because when we lift each other up, we don’t just transform our own lives—we shape the future of healthcare itself.

Here’s to us. To our resilience, our brilliance, and our unwavering commitment—to our patients, to each other, and to ourselves.

With hope for our collective mental health, Parveen Shaikh President, Mpower

Dear women in healthcare

Dear future trailblazer

If you are reading this, then you are at the cusp of ambition and purpose, ready to take on a path that is worth treading. I have walked this journey too, learnt a lot of lessons and hope that my reflections propel you to take on the world and change lives for the better.

Frommedicinetoleadership:Myjourneyinhealthcare

From being a young medical aspirant facing societal expectations to becoming a leader in healthcare, my journey offers valuable insights into overcoming challenges and inspiring the next generation of women leaders.

I trained as an ophthalmologist specialising in cornea treatment and was dedicated to refining my skills. However, through the journey, I also reaslised that delivering the best care is a combination of medical expertise and understanding the economics of the sector that can help drive meaningful change. This led me to pursue my MBA at Stanford University, to hone my business acumen which is often overlooked as part of your medical training.

That’s when I saw the bigger picture and understood how leadership plays a role in shaping the industry. From there, my journey toward healthcare leadership truly began.

After completing my MBA, I returned and found my own eye hospital, successfully running it before merging it with Dr Agarwals Eye Hospital. Joining the leadership team allowed me to leverage both my clinical and strategic expertise to make a broader impact in the field.

Genderbarriers:Breakingthemold

Growing up in the 1990s in Delhi, I encountered restrictions that many young women in India will relate to.

Despite securing a place in medical school, societal expectations didn’t change. The expectation of marriage loomed over me, and shortly after completing my MBBS, I got married. However, unlike many women who have to sacrifice career aspirations postmarriage, I didn’t have to thanks to my supportive husband.

Most of my education happened after marriage. When I wanted to pursue my fellowship, my husband and I were living in different cities. While he encouraged me, there were apprehensions from both families. Women are often expected to prioritize family over personal ambitions, but men rarely face such dilemmas.

The same resistance resurfaced when I decided to pursue my MBA. Even in leadership roles, women often encounter barriers simply because of their gender.

We need to ask ourselves—why are most leadership positions held by men? Women are equally capable, but societal factors, self-doubt, and systemic challenges prevent them from growing.

Changesinleadershiprepresentation:Havethingschanged?

Women’s leadership representation has increased over the years, even in healthcare, but not significantly. While progress has been made, there is still a long way to go. Some key factors driving this change include: Diversity initiatives: Many organisations are actively promoting gender diversity and mentoring women to take on leadership roles.

Social media influence: The rise of social media has amplified the success stories of women leaders, inspiring others to break stereotypes and pursue leadership positions. Equitable partners: In urban areas, men are increasingly sharing family responsibilities, making it easier for women to focus on their careers. Partners play a crucial role in enabling women to advance professionally by providing the backing needed to balance work and family expectations.

However, smaller cities still have deeply ingrained societal expectations. This needs to change one conversation at a time.

Challengesinleadership:Systemicbarriersintheworkplace

Interestingly, the story here is not very different from the rest of us. While I never faced gender discrimination per say, I would often see apprehensions among patients who would still ask me - ‘When is the doctor coming?’ As I ventured into business roles, I noticed the same continued.

One of the most striking moments was during my startup days, where I noticed

potential clients addressing my male junior instead of me. It was frustrating. Even though I was the founder, people preferred speaking to my male colleague. This is still a reality in sales and marketing roles—women have to work twice as hard to establish credibility.

Another challenge was securing funding. Investors were often hesitant to back startups led by women. They wouldn’t say it outright, but there was always an underlying concern—‘What if she gets pregnant? What happens to the company then?’ It was never verbalized but heavily implied.

And the only way to counter these is to be comfortable in your skin, confident in your skills and to set the tone right from the start. Never shy away from introducing yourself and establishing your right to be seated at the table.

Managingworkandpersonallife:Themythofwork-lifebalance

For women in leadership, the idea of ‘work-life balance’ often feels like an unrealistic expectation.

Work-life balance is a myth. Instead, I believe in work-life coordination. The key is to set systems that help manage both effectively.

Three essential strategies for managing professional responsibilities while maintaining well-being include:

1. Prioritise your well-being:

◆ Get enough sleep and exercise regularly.

◆ Maintain a healthy diet, especially when traveling for work.

2. Set clear systems:

◆ Use structured planning, such as meal charts for yourself & your family and time blocking among others to minimise daily involvement.

◆ Enlist help such that you can focus on things that only you can tackle.

3. Create boundaries:

◆ Set your priorities in terms of family, social obligations such that you can focus on what’s important

◆ Resources (time & effort) are limited. Use them wisely

Theroadahead:Policiesandvisionforinclusiveleadership

To ensure a future where more women take on leadership roles, organisations need to adopt policies that actively support career growth.

Key policy changes needed:

1. Mentorship & support: Senior women leaders must guide younger women through challenges like relocation, workplace biases, and career progression.

2. Structured growth plans: Companies should have dedicated leadership pipelines for women, ensuring equal opportunities.

3. Flexible work policies: Remote work options should be standard, especially for women managing caregiving responsibilities.

4. Maternity support: Career breaks for maternity should not impact promotions or appraisals.

Vision for the future

◆ Women leaders must actively support and uplift others, fostering a strong succession pipeline.

◆ Inclusive leadership should focus on structural changes, not just surface-level diversity.

Redefiningleadershipforwomeninhealthcare

My journey reflects the challenges, triumphs, and evolving landscape of women in healthcare leadership. While progress has been made, there is still a long way to go. The road to leadership is not without obstacles, but with resilience, support, and the right policies, the next generation of women leaders will redefine the future of healthcare.

Best wishes, Dr Vandana Jain

Dr Agarwals Eye Hospital

Dear future women leaders

Aswe stand at the helm of Phantom Healthcare, we are honored to witness and contribute to the transformation of the healthcare industry. Women have always played an integral role in medicine, research, and innovation, yet leadership representation remains a work in progress. To the next generation of women in healthcare, we say this: your time is now.

Breaking barriers and overcoming bias

Healthcare leadership has long been a space where gender biases have created roadblocks, but these are challenges that can—and must—be overcome. We have seen firsthand how knowledge, determination, and unwavering commitment break through these barriers.

Women leaders are reshaping diagnostics, leading groundbreaking research, and driving innovations that impact millions of lives.

At Phantom Healthcare, we firmly believe in equal opportunity, skill-based leadership, and fostering an inclusive work culture where merit determines success. We encourage women to step forward, take on leadership roles, and be the changemakers the industry needs.

As women, we often face unspoken challenges, but we also bring unique strengths—resilience, emotional intelligence, and an innate ability to lead with empathy. It’s time we own our space, speak with confidence, and lead without hesitation. The industry needs us, and we are ready.

The power of leadership and mentorship

Leadership is not about position—it is about influence, responsibility, and vision. Throughout our journey, we have seen how mentorship plays a vital role in shaping future leaders.

Strong mentorship and support networks provide women with the tools and confidence to take on greater challenges.

For aspiring women in healthcare, our message is simple: Seek mentors, build your network, and never hesitate to step into leadership roles. Likewise, when you reach a position of influence, become a mentor, uplift others, and create pathways for more women to rise.

Balancing career and personal life

Work-life balance is often seen as a major challenge for women in leadership. We understand that balancing career aspirations, family responsibilities, and personal well-being can be demanding. However, we also believe that with strong workplace policies, flexible environments, and supportive ecosystems, women can thrive in both their personal and professional lives.

At Phantom Healthcare, we advocate for workplaces that foster balance—where ambition and well-being go hand in hand. The key is not perfection, but prioritisation and self-belief.

Vision for the future

Our vision for the future is clear: A healthcare industry where women are at the forefront of innovation, leadership, and decision-making. A future where gender no longer defines capability and where women leaders are seen, heard, and celebrated.

To all the young women stepping into healthcare—believe in your expertise, push boundaries, and create impact. The future of healthcare will be shaped by those who dare to lead, and we have no doubt that you are among them.

With admiration and encouragement

Dear future changemakers

When I first stepped into the world of healthcare, I never imagined the incredible role that AI and technology would play in shaping the way we diagnose and treat diseases. Today, as I navigate the ever-evolving landscape of AI-driven healthcare, I want to share a few insights with you—ones that I wish I had known earlier in my journey.

Balancing career and personal life in healthcare

As a healthcare professional, you will experience immense fulfillment, but also face unique challenges. The demands of this field often require long hours, continuous learning, and emotional resilience. Balancing a career in medicine with personal well-being is not always easy, especially as healthcare technology evolves at an unprecedented pace.

At Nura, we use AI-powered screening technologies to revolutionise early detection and preventive care. This has transformed patient outcomes, but it has also introduced new challenges—learning to integrate technology while maintaining the human touch. The future of healthcare will require not only medical expertise but also adaptability and a commitment to lifelong learning.

Embracing AI without losing the human connection

AI is a powerful tool, but it will never replace the empathy, intuition, and decisionmaking skills of a doctor. It can enhance efficiency, reduce burnout, and streamline workflows, but ultimately, patients need a compassionate caregiver behind every diagnosis. As you step into this profession, embrace innovation, but never forget the importance of the doctor-patient relationship.

Work-life balance: A realistic approach

Work-life balance is often misunderstood. It’s not about perfectly dividing time between work and personal life—it’s about setting priorities, making intentional choices, and creating boundaries. Whether it’s through time management, mindfulness, or seeking support, taking care of yourself is just as important as taking care of your patients.

The future of healthcare will not only be defined by medical breakthroughs but also by how well we integrate technology while maintaining well-being and resilience. Organisations must foster a supportive environment with flexible work policies, mentorship, and mental health support, allowing professionals to thrive both personally and professionally.

My advice to you

As you embark on your medical career, remember this: success is not just about how much you achieve, but also about how well you sustain yourself on the journey. Stay curious, embrace change, and never stop learning. But most importantly, prioritise your well-being—because a healthy doctor means healthier patients and a stronger healthcare system.

Wishing you success and balance in your journey ahead! Dr Lubna Chingili Chief Medical Officer-Global Innovation Centre Nura

Dear aspiring women leaders

"Theonly way to do great work is to love what you do." – Steve Jobs.My life revolves around this motto. My passion for science and innovation began in my childhood. Radiation oncology wasn’t my first choice at first, but when I discovered its unique fusion of clinical care and physics, I knew I had found my true calling. Radiation is a physics solution to a complex biological challenge—cancer. I was fascinated by the potential of using radiation to treat complex diseases, and this curiosity has driven me to explore new possibilities ever since. Throughout my career, I have consistently questioned the status quo, asking "why" and "how" to find innovative solutions for patient care.

With over 35 years of experience in healthcare, I have seen the landscape of medicine evolve dramatically. When I first stepped into the field, opportunities for innovation were limited, especially in developing countries like India. As I trained in some of the most advanced centres in the West, I witnessed firsthand how cutting-edge technology was revolutionizing cancer treatment. My goal was clear—to bring those advancements back home and make world-class cancer care accessible in India. Determined to bridge the technological gap, I introduced radiation oncology techniques and pioneered innovations that transformed patient care. I was fortunate to establish and lead the Department of Radiation Oncology at renowned health institutes, including Medanta-Gurugram. The knowledge and experience I gained from the institutes and the mentors helped me shape my approach to patient care, ensuring that cancer treatment in India met global standards.

Earlylifeandinnovations

My mentors and teachers further played a crucial role in shaping my journey. At Leeds University’s Cookridge Centre and Manchester’s Christie Holt hospital, where I completed my AROI Fellowship and Commonwealth Scholarship, I was exposed to a culture of innovation and problem-solving. My professor, who was an electrical engineer before becoming a doctor, taught me the value of practical solutions in patient care. Watching him develop groundbreaking devices reinforced my belief that innovation does not always require expensive resources but rather an inquisitive mind and the willingness to think beyond conventional boundaries. I carried this philosophy back to India, where I encouraged my team to develop cost-effective, locally viable solutions for our patients.

The ‘Aha’ moment

Transitioning to a private centre brought an "aha" moment when we lacked funds for corneal shields for an eye tumour patient. Collaborating with a physicist and a jeweller, we created an affordable alternative, which were used until commercial shields were available. Similarly, in the late 90s, I treated a badminton champion with cutaneous lymphoma and built a cost-effective electron therapy stand, still used in NCR hospitals today. These experiences reinforced my belief that resource constraints should never hinder quality

patient care.

Trained under brilliant minds, I returned to India with a mission to foster innovation that directly benefits patients. Most recently, my team and I developed MAOLO, an applicator designed to target advanced cervical cancer with image guided brachytherapy, while minimizing organ damage. After two years of refinement, we successfully treated nearly 50 patients. At Medanta, we have integrated cutting-edge technologies like CyberKnife, TomoTherapy, VMAT, and IGRT, ensuring precision, reduced toxicity, and improved cure rates. Each advancement is a testament to years of learning, collaboration, and mentorship, reinforcing my commitment to pushing the boundaries of radiation oncology in India.

Breakingbarriersandovercomingbias

Growing up in a joint family , I was raised with the same opportunities and expectations as the male siblings and cousins. This upbringing instilled the confidence to navigate a predominantly male-dominated field. While I acknowledge the privilege I had, I recognize that many women do not receive the same encouragement. Playing badminton sharpened my individual skills, while playing as a center-half in hockey taught me the essence of teamwork—passing, receiving, and creating opportunities for the best goal shots.

Throughout my career, I have worked to challenge gender biases in healthcare leadership. Talent and determination—not gender—should define one’s path. By fostering inclusivity, I hope to inspire young women to break barriers and take on leadership roles in medicine. Every aspiring female oncologist should know that they belong in this space and that their contributions are invaluable. However, breaking barriers comes with its own challenges, particularly in balancing professional and personal responsibilities.

As rewarding as my career has been, maintaining this balance has not been easy. Oncology demands immense dedication, but I have always prioritized well-being and boundaries. Self-care is not a luxury—it is essential for sustaining a fulfilling career. I encourage young professionals to find this balance early to keep their passion for medicine strong.

Lookingahead

My journey has been one of continuous learning, resilience, and innovation. As I look ahead, my mission remains the same—to provide accessible, high-quality cancer care and inspire the next generation of medical pioneers. With dedication and perseverance, we can push the boundaries of what is possible in the fight against cancer.

Best wishes Dr Tejinder Kataria, Chairperson- Radiation Oncology, Cancer Care Medanta

Dear future trailblazer

My journey in public health is marked by challenges and triumphs. As a woman aiming for leadership, I encountered systemic biases and the constant need to prove my expertise. This is my story of navigating those hurdles, balancing my career and personal life, and inspiring the next generation of leaders.

Driven by a desire to create lasting impact, I chose public health as my field. However, I quickly learned that as a woman, recognition often required extra effort. These challenges only fuelled my determination to break down barriers. My career has spanned both academia and consulting, and while academia honed my technical expertise, consulting gave me the opportunity to apply those skills in the development sector. Despite my technical expertise and international recognition, rising to leadership within academia proved difficult. Leadership roles were often reserved for men, requiring me to work harder for acknowledgment, and opportunities were limited. During this time, I learned the importance of a strong support network. Mentorship and advocacy from established professionals helped opened doors, and those early struggles built my resilience.

After 25 years in public health, I transitioned to consulting, hoping that my expertise alone would speak for itself. Yet, I encountered the same biases from academia. I had to work harder than my male counterparts for leadership roles. Younger leaders sometimes overlooked my experience, perhaps due to insecurity or a preference for newer approaches. By focusing on delivering results and demonstrating strategic value, I eventually earned leadership roles that aligned with my expertise. Balancing a demanding career with personal responsibilities was another challenge. Women are often expected to manage both seamlessly, despite the lack of institutional support. I learned to set boundaries, prioritise, and build a strong personal support system. While sacrifices were necessary, I ensured neither aspect of my life suffered.

A turning point came when I worked under mature leadership that valued experience, sought wisdom, and understood the impact of informed decision-making. Under their guidance, I thrived in leadership roles, with my contributions not only acknowledged but actively sought. The contrast between mature and insecure leadership was stark: one fosters collaboration and growth, while the other breeds stagnation and competition. Reflecting on my journey, I believe resilience, adaptability, and strategic perseverance were crucial. My lessons include: resilience is essential, the right environment matters, mature leadership fosters growth, supporting other women is vital, and competence should be the defining factor.

To the next generation of women in public health: believe in your capabilities and never let biases define your worth. Push for innovation, challenge outdated policies, and demand inclusive leadership. Support each other, mentor those who follow, and create workplaces where talent is recognised regardless of gender.

I hope more organisations will prioritise leadership that values talent over gender and drives policy changes for an equitable future. My story is part of a collective narrative of resilience and empowerment. Sharing these narratives is vital - not only to celebrate achievements but also to highlight challenges that remain.

In public health's evolving landscape, leaders must be adaptable, embracing change while staying grounded in core values. Collaboration is also a powerful force. The most impactful projects I've been involved in brought together diverse voices and perspectives, harnessing the full potential of teams. I encourage emerging leaders to cultivate relationships across disciplines and seek collaborations that challenge the status quo.

I am optimistic about the future. The next generation of women in public health is brimming with knowledge, creativity, and passion. It's our responsibility to provide platforms for their voices, and ensure access to resources.

I urge all women to embrace their unique journeys, recognise their value, and persist in their quest for leadership. Challenges present opportunities for growth. Let us continue breaking barriers, supporting one another, and paving the way for a more equitable future in public health and beyond. Together, we can create a legacy of leadership that transcends gender and inspires.

Best wishes

Dear future changemakers

AsI reflect on my journey that began in 1980, I feel obliged to share my story—not just as a testament to my own experiences but as an inspiration for each and every one of you who have dedicated your lives to the noble profession of nursing. I never set out to be a nurse; rather, nursing found me. As a bright student with aspirations of a career in medicine, I excelled academically. However, life had other plans, and when my dream of studying medicine did not materialise, I found myself exploring new possibilities. I pursued a degree in Statistics honours, but something felt incomplete. I longed for a career that would allow me to communicate, influence, teach, and lead.

Then, as if by fate, I came across an advertisement for nursing on a roadside—an unexpected sign that changed the course of my life. Despite never having set foot in a hospital, I felt an inexplicable pull toward this profession. I secured a spot on the merit list and stepped into the unknown, driven by curiosity, determination, and a deep sense of purpose. Looking back, I realise that it was the best decision of my life.

Nursing has been my calling, shaping me into the person I am today. From the corridors of the Armed Forces to leadership roles in Columbia Asia Group India and now Max Healthcare, I have witnessed the profound impact that nurses have on the lives of those they serve. We are not just caregivers—we are healers, advocates, educators, and leaders. We bring new life into the world and stand by our patients in their final moments. We are pillars of strength in times of joy and sorrow.

Throughout my career, I have faced many challenges, from overcoming stereotypes about nursing to working tirelessly to elevate its professional stature. However, I have also seen the rewards—small moments that make it all worthwhile. I still vividly remember a young 17-year-old patient who went into cardiac arrest in the ICU. Instinctively, I initiated CPR, identified an abnormal rhythm, administered a shock, and watched as he regained consciousness. That moment reaffirmed why I do what I do. Moments like this fuel our commitment and passion every single day.

Nursing is not an easy profession. It requires resilience, empathy, and an unwavering dedication to service. We take on multiple roles—teacher, manager, safety officer, leader—often without recognition or expectation. Yet, we continue, because we know that our work changes lives.

To my fellow nurses, I want to remind you that you are the backbone of healthcare. You are invaluable, irreplaceable, and truly extraordinary. You hold the power to inspire change, to advocate for better healthcare, and to uplift future generations of nurses. I envision a future where nurses are confident, empowered professionals who command the respect they rightfully deserve.

On this Women’s Day, I urge you to stand up for what is right—not just for yourselves but for your patients, your colleagues, and the future of nursing. Be fearless in demanding what you deserve, invest in your personal and professional growth, and never underestimate the impact you have. You are the cornerstone of the healthcare team, and your dedication and compassion make the world a better place.

Best wishes Col.

Dear future changemakers

Female workforce has the unique potential to change the way industries work today as they are blessed with not simply great analytical skills but also empathy to manage situations effectively. However, we see less women rising the career ladder because juggling their personal and professional lives for long becomes too overwhelming for them. When, at times, I meet female colleagues for counselling or difficult conversations or just over coffee, I can sense the emotional weight on their minds. Women voluntary or involuntarily cannot seem to absolve themselves of their domestic obligations irrespective of their professional achievements. Apart from this, lack of self-confidence to imagine themselves achieving BIG in life, makes it not worthy of so much sacrifices. Healthcare being even more challenging place to work, owing to regular life-and-death situation at work and physical demands of being on toes, further ads to the challenge. However, appropriately adopted Emotional strength of female leaders can make them Great Leaders!

I personally took a back step in my career when my second child was born, and my professional life came to a standstill for 4+ years. My friends advised me against this career break, but I followed my heart and did what I felt was right at that time. During this sabbatical period, I started reading motivational books which brought a paradigm shift in my attitude. This break took a downhill trajectory in my career path however my second innings were nothing short of a comeback. I was wiser and more determined than before. I now had unobstructed vision of what I wanted from my life and had clear goals to pursue. I was enlightened and had visualised myself at the top HR position already. Situations which I found quite overwhelming earlier, now became small irritants. My will power to succeed became stronger than the challenges. The path did not become easier, I became resilient! I was too motivated to bow down to problems and run away; I had to prove myself not to the world but to myself!

To all the young ladies, who have started working up the corporate ladder, remember to keep repeating to yourself- WHATEVER HAPPENS, I CAN HANDLE IT. AND IF ANYONE IN THIS WORLD CAN DO IT, SO CAN I!

Not everyone can be self-motivated, lot of us need Guides/ Mentors in life! The mentor could be your senior, colleague or any well-wisher who wants to see you succeed. Right guidance would mould you to become flexible in your approach and you start looking for solutions instead of dreading over problems. Slowly you would get a grip on how to navigate life’s challenges. You would realise the need for a good support system to manage domestic anxieties and succeed at both personal and professional fronts. When the hygiene factors are taken care of, you can focus on building a good, satisfying life for self and family. If you feel valuable personally, you would be content and the people around you would be happy!

Nowadays many women of Grit are reaching pinnacles of success. They are becoming role models for women of future generation. This is opening the gates of possibilities for young girls who lack conviction in their talent. We women leaders can identify and nurture such talent by creating policies and systems that are supportive of women’s unique requirements- be it flexibility of working shifts to manage their personal lives or support for their mental health! We need to collaborate with young minds and generate innovative policies which are not just inclusive of needs of wide spectrum of talent but also creative enough to offer plethora of opportunities of growth.

Future leadership need people with open, inclusive, accepting, innovative and driven mind-set who really believe in providing equal opportunities based on talent!

Best wishes

To the next generation of women in healthcare

AsI write this letter, I think back on the journey that brought me to where I am today—a journey full of challenges and moments that taught me resilience and determination. As a women's health expert, I've seen the strength that comes from compassion and persistence in healthcare. I share my experiences hoping they will inspire you as you find your way in this changing field.

Choosing a medical career was more than just a professional decision for me; it was a calling. Born in uncertain circumstances, I survived against the odds, which fuelled my passion for medicine. It was never easy decision and not even journey. The long hours, demanding studies, and need for emotional strength were always there. Yet, every challenge was a chance to grow and strengthen my resolve to enhance women's health and support those dealing with infertility and reproductive issues.

Women in healthcare often face biases—some subtle, others overt. Whether it was being questioned on my ability to balance work and family or proving my leadership capabilities in a predominantly male-led environment, I learned that competence and perseverance are the strongest rebuttals to scepticism. We must challenge outdated norms, push for equal opportunities, and uplift each other. As you step into leadership roles, remember: your voice matters. Speak up, challenge biases, and create spaces where women are seen, heard, and respected.

True leadership is about making a difference, not just holding a title. A good leader lifts others up, offers guidance, and opens doors. I've been lucky to have mentors who helped me grow, and now I aim to mentor the next generation of doctors. Look for mentors who inspire you and be a mentor to others. A supportive network—colleagues, seniors, or peers—is invaluable. Working together, not competing, leads to real success.

The myth of “having it all” is often misleading. The truth is, balance is dynamic—it shifts with time and priorities. As a doctor, wife, and mother, I have learned that setting boundaries, prioritising well-being, and seeking support are essential. Healthcare as sector is demanding, but burnout helps no one. Taking care of yourself is not a luxury; it is a necessity. Find what replenishes your energy and make time for it. A well-balanced leader is a stronger, more effective leader.

There is need to be more women in leadership roles, as well as more innovation and inclusivity, to improve the future of healthcare. Women should be the ones making policy decisions, directing research, and changing patient care. The goal is to develop a society where women can support each other without facing any gender-based barriers and where leadership in healthcare is based on compassion and diversity.

To all young women embarking on this journey, self-belief is key. You are capable, you are necessary and you are the future of healthcare. Keep shattering barriers, keep studying and most importantly, never underestimate the positive impact you can make. As time goes by, remember that the path you take is a journey of immense learning. Appreciate every lesson you can gain from obstacles and failures alike, as well as from victories. Every single event is important, turning you into a competent and caring leader. Move forward with a gentle spirit and strong determination, a clear goal in mind, and ever ready to be the voice that speaks against obsolete healthcare systems and guide those that come after you.

Best wishes Dr Supriya Puranik Director – Obstetrics, Gynaecology and IVF Sahyadri Hospitals MomStory

Dear women in healthcare

Personal journeys and lessons learned

Navigating the world of medicine has been difficult but incredibly fulfilling. Every step of the way has reinforced the principles of resilience, flexibility, and continuous learning. My most memorable moments were not merely clinical triumphs but also the relationships I formed—meaningful ones with patients, colleagues, and students. I have learned that leadership has nothing to do with authority but is all about motivating and empowering others.

Breaking barriers and conquering bias

Gender equality in healthcare leadership is becoming a reality! Competence is being recognised more and more, and doors are opening. We're creating this change through mentorship, positive advocacy, and policy changes that put merit first. The future is diverse leadership teams, where every voice is heard, and innovation flourishes. It's a great time to be a physician, seeing this positive change happen right before our eyes!"

Leadership and mentorship

I attribute much of my development to mentors who directed me early in my career. Their counsel informed my leadership style. Now, I focus on mentoring young physicians, particularly women, to overcome obstacles and gain confidence. A robust professional network offers opportunities, partnerships, and encouragement.

Balancing career and personal life

Medicine is demanding, but burnout is not an option. I’ve learned to set boundaries, delegate effectively, and prioritise self-care. Supportive family and team dynamics are crucial in maintaining a balance.

Vision for the future

The future doctors need to be the drivers of innovation, embrace technology, and be champions of inclusivity. Leadership must be diverse, patient-focused, and visionary. I urge young professionals to disrupt the norms, lead with empathy, and demand policy reforms that deliver a more equal healthcare system.

Best wishes

Dear

My journey as a developmental pediatrician and co-founder of Continua Kids has been both challenging and transformative. I've devoted my career to making sure that every child, no matter their abilities, gets the care and opportunities they need to grow and thrive. This mission has shaped how I view my role as a healthcare professional and a leader, pushing me to constantly learn and adapt.

One of the biggest lessons I've learned is that leadership isn't about having power; it's about making a real difference, inspiring others, and always looking to grow, both personally and professionally. Real leadership calls for empathy, vision, and the ability to uplift those around you. It’s all about committing to lifelong learning and selfimprovement, which eventually enhances the quality of care we provide and how effective our teams are. Through all the challenges I’ve faced in my field, I’ve found that listening, collaborating, and enabling others is way more valuable than just giving orders.

As a woman working in healthcare and leadership, I’ve seen and experienced the gender biases that can hold women back from decision-making roles. These biases come in different forms, like fewer chances for leadership roles or not getting recognition for our contributions. To overcome these obstacles, it takes resilience from women, a dedication to continuous learning, and support from a solid network. We also need widespread changes in the healthcare world to create a more comprehensive environment.

When we talk about gender equality and equity in healthcare, it’s not just about having women at the table; it’s about building policies and an atmosphere that lets different voices be heard. This means tackling gaps in professional development, ensuring fair treatment at work, and creating a culture that respects and includes everyone. Advocacy and mentorship are key to breaking down these barriers. I’ve been lucky to have mentors who’ve guided me, believed in my potential, and helped me find my way. Their support has been critical in building my confidence and skills, and I’m committed to doing the same for others.

Creating a strong network is so important because leaders don’t succeed on their own. Working together, sharing knowledge, and finding solutions as a group are essential for making real changes. When healthcare professionals join forces, we can come up with innovative solutions, improve patient care, and work towards a fairer system. Welcoming diverse perspectives and encouraging teamwork can only boost our efforts to reach these goals.

Finding a balance between personal and professional life is an ongoing challenge that requires prioritizing, managing time effectively, and setting clear boundaries. The demands of our jobs can often overshadow our personal well-being. But maintaining that work-life balance is really essential for long-term effectiveness and success. By making self-care and mental well-being a priority, we not only give our patients the best care but also look after our own health and happiness.

Building a supportive system, both at work and at home, is key to handling the pressures of a demanding career. Open communication, shared responsibilities, and mutual respect in our personal and professional relationships help create a more balanced and fulfilling life. By nurturing a supportive environment, we enable ourselves and others to excel.

Looking ahead, I hope to inspire more young healthcare professionals to welcome new ideas, support comprehensive policies, and confidently step into leadership roles. The healthcare field is changing quickly, and we must equip the next generation with the tools and mindset to drive this evolution. By encouraging creativity, collaboration, and inclusivity, we can create a healthcare system that goes beyond responsive but also compassionate.

As a developmental pediatrician, I’m dedicated to challenging the norms, welcoming technology, and focusing on a patient- and child-centered approach. By putting the needs and well-being of children front and center, we can make sure every child gets the care and support they deserve. Together, we can build a more equitable, compassionate, and effective healthcare system for everyone.

Let’s unite in this mission, collaborating to ensure a brighter future for the children we serve. By supporting inclusivity, pushing for change, and having each other’s backs, we can reshape healthcare and make a lasting difference in the lives of countless children and families.

Best wishes Dr Himani Narula Khanna Developmental Behavioural Paediatrician and Adolescent Mental Health Expert Co-Founder Continua Kids

women in healthcare

RADIOLOGY

Game changing revolutionarynewer lab techniques in TB

Dean,Professor & Head ( Radiology ),LTMMC & LTMGH explains why adopting new technologies for TB diagnosis and treatment is important

My co-bacterium TB ! TB poses a significant occupational hazard for healthcare workers in India, which carries the world's highest TB burden (28 per cent globally), surpassing all other infectious diseases in mortality [1,2] .

Annually, India sees approximately 2.8 million new TB cases and 480,000 deaths [1]. MDR-TB and XDR-TB are critical challenges, with India accounting for 27 per cent of the global MDRTB burden (~124,000 cases in 2019) [3-4]. Approximately 9.5 per cent of MDR-TB cases exhibit XDR-TB, rising to 38 per cent in

some studies [3-5]. This crisis leads to substantial economic costs too. Treatment success rates for MDR-TB in India are 46 per cent, with a 20 per cent mortality rate [6], and MDR-TB patients have a significantly higher transmission rate (48-99 per cent) [7]

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Date :1/3/2025 Publisher

Current TB Diagnosis And Treatment: Scope For Improvement

Conventional TB diagnosis takes 4-6 weeks [8], causing unacceptable delays. Moreover, DOTS requires patients to collect medication thrice weekly, incurring costs due to lost earnings and transportation. Despite current guidelines, MDRTB is often only considered after 4 months of standard antiTB drug treatment (AKT), likely due to the significantly higher cost: Rs 4,000-9,000 for regular TB treatment versus Rs 4-7 Lakh for MDR-TB, with an outlier study stating MDRTB drug costs being 135-fold higher [9], excluding indirect costs [10] .

Isn’t it time we change? Why should an average poor patient have to wait for 3-4 months to know whether his TB is MDR or not? In fact, he is expecting a cure by then, or at least being half way through. One should not forget the heavy toll the side effects of AKT takes. Ask me, I’ve been there ! Hence, many simply stop believing in the doctor and discontinue treatment. Thus contributing to the wider spreading of MDR-TB [7]. The incessant rise of MDR and extensively drug-resistant (XDR) TB also poses immense other chal-

lenges, including a huge financial burden on the exchequer [5]

Do we just sit by and watch?

Definitely not ! Recent advances in TB diagnosis have the potential to be a game changer; especially revolutionary PCR based technologies ( that amplify DNA segments ) which diagnose TB within 90 mins, including knowledge of MDR-TB. As Rifampicin is a surrogate marker for INH, if the patient is Rifampicin resistant on these tests, he can be diagnosed as an MDR-TB case, right up-front and treated thus; instead of commencing initial treatment with regular anti-TB drugs. It’s as simple as that !

Gene-Xpert MTB/RIF, is a 2010 year WHO recommended primary test. It is a cartridge based nucleic acid amplification technique [CBNAAT] to increase TB detection and improve diagnosis of rifampicin (RIF) resistance in pulmonary and extra-pulmonary TB specimens [11] and has already reduced TB mortality by 35 per cent [12]. It requires no special technicians/rooms, can literally be run by anyone; and barely occupies the space of a computer printer. Line Probe Assay (LPA) systems on the other hand are very elaborate, large systems that diagnose TB within 2 days. However they give evidence of resistance to 1st and 2nd line of AKT directly [13]

We should roll out many more GeneXpert/ similar machines throughout the country for quick diagnosis, screening high-risk groups etc. The initial investment is totally worth it, just considering reduction in the long term costs incurred. The Math is very simple. Although, India has performed over 35 lakh CBNAAT tests in 2020 [14], much more needs be done, especially utilising its role

Fig.2 : Integrated Diagnostic & treatment Algorithm for Drug Resistant TB : ( from MOHFW’s 2021 Guidelines for Programmatic management of drug resistant TB in India - we could thinkof replacing the LPAwith the much more compact ‘budget and user’friendlyXpert MTB/XDR )

to diagnose MDR-TB upfront. A newer GeneXpert, MTB/RIF Ultra has shown a ten-fold improvement in the lower limit of TB detection as well as improved differentiation of [a] certain silent mutations, [b] RIF resistance; and reduced falsepositive results in detecting RIF resistance in paucibacillary specimens [15]. GenXpert MTB/XDR detects resistance to isoniazid (INH), fluoroquinolones (FQ), second-line injectable drug (SLI) (amikacin, kanamycin, capreomycin) and ethionamide (Eto), in a single

test [16]. Truenat MTB and Truenat MTB-Rif Dx are recent indigenous chip-based, micro real-time PCR-based NAAT systems for TB detection and rifampicin resistance detection respectively. Results are comparable to similar GenXpert systems; and being portable and battery-operated, are ideal for point-of-care testing [4] Although GenXpert was initially standardized for only sputum and pleural effusions, knowing that DNA is present even in avascular structures such as hair, nails etc; and hav-

ing amongst the first few GenXperts, we were the first in the world ( 2012 ) to successfully use the same on a lymph node sample to diagnose TB (and Rifampicin sensitivity ) in 90 mins. How did this innovation come about? I was fortunate that while motivating some teenagers at Georgia Tech University, Atlanta, USA, I had learnt about the discovery of PCR there, by a tipsy student. Despite the extremely odd late night timing he was able to work in the lab there and make this remarkable discovery. I

have mentioned this repeatedly since then; no, not to encourage tipsiness, but to remind everyone that permitting students to use the lab 24 hours a day is probably what enabled this remarkable discovery. Maybe our universities can do the same. Who knows what brilliant young minds can come up with?

A few years later a senior journalist friend, who normally was a very strong and composed person (having fought many a hardy battle, including his wife's chronic illness) broke down while talking to me, stat-

ing that his wife was now suspected to have cancer. I told him not to worry and get her for an Ultrasound examination, during which I assured him that it wasn't cancer but TB (based on an unpublished sign of mine). Despite the same his wife was operated upon to get a better sample of the lymph node in question. I requested for a tiny piece from there and knowing fully well that PCR technology required just a bit of DNA I got the tiny tissue sample processed on our new GenXpert machine. Voila,

Fig.1: Time taken in starting treatment bytraditional pathways v/s GenXpert/Truenat systems

RADIOLOGY

within 2 hours we had a TB positive diagnosis (+ rifamipicin sensitive TB); which offered immense relief to my senior journalist friend. An Indian's jugaad ( based on scientific knowledge, used innovatively) had paid extremely rich dividends; setting off a worldwide phenomenon in the bargain ! This is now widely used worldwide for all kinds of pulmonary and extra-pulmonary samples and offers humongous potential to revolutionize TB diagnosis & treatment, including MDR-TB [17,18,19,20] .

Virtually any sample including - Pleural, Ascitic and other sterile/nonsterile fluids, tissue specimens from FNACs, biopsies, abscess aspirates, stool specimens and any material collected during PHC/OPD/ ward/imaging/related procedures, including from extra-pulmonary sites, should be routinely sent for GenXpert/ similar testing too. What took weeks earlier via cultures etc, can now be diagnosed within 2 hours.

Recent Advances : CRISPER has captivated the imagination of researchers worldwide. TBQUICK is a novel rapid and ultrasensitive MTB detection platform which combines loopmediated isothermal amplification (LAMP) and CRISPRCas12b reaction for TB detection [21]. It is highly sensitive (with a near single-copy sensitivity), demands less sample input and offers shorter turnaround time than GenXpert. The CRISPR-MTB test exhibited an overall improved sensitivity over both culture (79 per cent vs 33 per cent) and GenXpert (79 per cent vs 66 per cent), without comprise in specificity (62/63, 98 per cent), thus offering great potential as a new diagnostic technique for both pulmonary and extra-pulmonary tuberculosis.

The initial time loss in diagnosis of MDR-TB can be minimised with the use of GeneXpert/Truenat; greatly reducing the frequency and impact of unnecessary empiric treatment, contact investigation [22], also providing substantial patient and programmatic benefits if used in management decisions [15]. It could also be used for developing treatment strategies

to end TB [23]

It is also time to endorse the indigenous Truenat MTB and Truenat MTB-Rif Dx chipbased, micro real-time PCRbased NAAT for TB detection and rifampicin resistance detection respectively. They have results comparable to similar GenXpert systems and are much cheaper. Being extremely portable and battery-operated, they are advantageous for remote areas where [a] electricity could be a problem and [b] sending samples to GenXpert Labs is a herculean task [24] .

In Summary: India faces a significant TB burden, exacerbated by rising MDR-TB rates. Traditional diagnostic methods are slow, delaying appropriate treatment. Rapid PCRbased diagnostics, like GeneXpert/ Truenat offer a game-changing solution for upfront MDR-TB detection, leading to faster treatment initiation, reduced transmission, and improved patient outcomes. By investing in widespread implementation of these tools and embracing indigenous inn ovations, India can significantly curb the TB epidemic and move closer to achieving TB elimination.

The Future: Next-generation molecular imaging offers unparalleled holistic 3D characterization and non-invasive monitoring of TB disease dynamics within individual patients, surpassing current diagnostic tools, allowing detailed insights into the dynamics and spatiotemporal disease heterogeneity noted with TB. These readily available technologies hold the potential to advance fundamental TB biology research, accelerate therapeutic development, and serve as precision tools for diagnosis, monitoring, and prognostication in clinical management [25]

Bibliography:

1. Global Tuberculosis Report 2024. World Health Organization; 2024. [Accessed on Feb 14, 2025]. ISBN 978-92-4-010153-1 https://iris.who.int/bitstream/h andle/10665/379339/ 9789240101531-eng.pdf?sequence=1

2. National Tb elimination Program. India TB report 2024.

GOI,MOHFA, Central T division.

[Accessed on Feb 14, 2025]. https://tbcindia.mohfw.gov.in/w p-content/uploads/2024/10/TBReport_for-Web_08_10-20241.pdf

3. Global Tuberculosis Report 20217. World Health Organization; 2017.

[Accessed on Feb 14, 2025]. https://www.who.int/publications/i/item/9789241565516

4. Mansi Gupta, et al. Recent updates in diagnosis and management of drug-resistant tuberculosis in India: A paradigm shift and the way ahead during the COVID-19 crisis, Indian Journal of Tuberculosis, Volume 69:3, 264-267, 2022. https://doi.org/10.1016/j.ijtb.2021 .08.013. https://www.sciencedirect.com/science/article/pii/S001 9570721001554

5. Prasad R, et al. Extensively drug-resistant tuberculosis in India: Current evidence on diagnosis & management. Indian J Med Res. 2017 Mar;145(3):271-293. doi: 10.4103/ijmr. IJMR_177_16. PMID: 28749390; PMCID: PMC5555056.

6. Report of the first anti-TB drug resistance survey 21042016. MOHFA, GOI.

[Accessed on Feb 14, 2025]. https://tbcindia.mohfw.gov.in/w p-content/uploads/2023/05/4187947827National-Anti-TB-Drug-Resistance-Survey.pdf

7. Kendall EA, et al. Burden of transmitted multidrug resistance in epidemics of tuberculosis: a transmission modelling analysis. The Lancet Respiratory Medicine 2015; 3: 963-972. DOI: https://doi.org/10.1016/ S22132600(15)00458-0.

8. Zaporojan N, et al. Evolution of Laboratory Diagnosis of Tuberculosis. Clin Pract. 2024 Feb 23;14(2):388-416. doi: 10.3390/clinpract14020030. PMID: 38525709; PMCID: PMC10961697.

9. Kundu D, et al. Innovative social protection mechanism for alleviating catastrophic expenses on multidrug-resistant tuberculosis patients in Chhattisgarh, India. WHO South East Asia J Public Health. 2015 JanJun;4(1):69-77. doi: 10.4103/22243151.206624. PMID: 28607277.

10. Sinha P, et al. How much do Indians pay for tuberculosis treatment? A cost analysis. Pub-

lic Health Action. 2020 Sep 21;10(3):110-117. doi: 10.5588/pha.20.0017. PMID: 33134125; PMCID: PMC7577002.

11. Xpert MTB/RIF implementation manual: technical and operational ‘how-to’; practical considerations. World Health Organization. [Accessed on Feb 14, 2025].

https://www.who.int/publications/i/item/9789241506700

12. Stevens WS. Et al.2017.Impact of the GeneXpert MTB/RIF Technology on Tuberculosis Control. Microbiol Spectr5:10.1128/microbiolspec.tb tb2-0040-2016. https://doi.org/10.1128/microbiolspec.tbtb2-0040-2016

13. Line Probe Assay [LPA]. Knowledge base for National TB elimination Program. [Accessed on Feb 14, 2025].

https://ntep.in/node/478/CPline-probe-assay-lpa

14. National Tb elimination Program. India TB report 2024. GOI,MOHFA, Central T division.

[Accessed on Feb 14, 2025].

https://tbcindia.mohfw.gov.in/w p-content/uploads/2023/05/India-TB-Report-2020.pdf

15. Osei Sekyere, J., et al. A Comparative Evaluation of the New Genexpert MTB/RIF Ultra and other Rapid Diagnostic Assays for Detecting Tuberculosis in Pulmonary and Extra Pulmonary Specimens. Sci Rep 9, 16587 (2019). https://doi.org/10.1038/s41598019-53086-5

16. Pillay S, et al Xpert MTB/XDR for detection of pulmonary tuberculosis and resistance to isoniazid, fluoroquinolones, ethionamide, and amikacin. Cochrane Database Syst Rev. 2022 May 18;5(5):CD014841. doi: 10.1002/14651858. CD014841.pub2. PMID: 35583175; PMCID: PMC9115865. 17. Vankayala VR, et al. Efficacy of cartridge-based nucleic acid amplification test (CBNAAT) in comparison with line probe assay and liquid culture in the evaluation of tubercular lymph node abscess. J Family Med Prim Care. 2024 Jun;13(6):2260-2265. doi: 10.4103/jfmpc.jfmpc_1284_23. Epub 2024 Jun 14. PMID: 39027873; PMCID: PMC11254079.

18. Sachdeva K, et al. CBNAAT: A Boon for Early Diagnosis of Tuberculosis-Head and Neck. Indian J Otolaryngol Head Neck Surg. 2018 Dec;70(4):572-577. doi: 10.1007/s12070-018-1364-x. Epub 2018 Apr 16. PMID: 30464918; PMCID: PMC6224834.

19. World Health Organization. Xpert MTB/RIF implementation manual: technical and operational ‘how-to’: practical considerations. 2014. ISBN: 978-92-4150670-0 [Accessed on Feb 14, 2025].

https://www.who.int/publications/i/item/9789241506700. 20. Perez-Risco D, et al. Evaluation of the Xpert MTB/RIF Ultra Assay for Direct Detection of Mycobacterium tuberculosis Complex in Smear-Negative Extrapulmonary Samples. J Clin Microbiol. 2018 Aug 27;56(9):e00659-18. doi: 10.1128/JCM.00659-18. PMID: 29950333; PMCID: PMC6113499.

21. Sam IK, et al. TB-QUICK: CRISPR-Cas12b-assisted rapid and sensitive detection of Mycobacterium tuberculosis. J Infect. 2021 Jul;83(1):54-60. doi: 10.1016/j.jinf.2021.04.032. Epub 2021 May 2. PMID: 33951419. 22. WHO Global TB report 2021. https://www.who.int/publications/digital/global-tuberculosisreport-2021/tb-diagnosis-treatment/diagnostic-testing#fig--3-2 -8

23. Chauhan A, et al. The prevalence of tuberculosis infection in India: A systematic review and meta-analysis. Indian J Med Res. 2023 Feb-Mar;157(2&3):135151. doi: 10.4103/ijmr.ijmr_382_23. PMID: 37202933; PMCID: PMC10319385.

24. Gomathi NS, et al. Validation of an indigenous assay for rapid molecular detection of rifampicin resistance in presumptive multidrug-resistant pulmonary tuberculosis patients. Indian J Med Res. 2020 Nov;152(5):482-489. doi: 10.4103/ijmr.IJMR_2557_19. PMID: 33707390; PMCID: PMC8157890.

25. Ordonez AA, et al. Visualizing the dynamics of tuberculosis pathology using molecular imaging. J Clin Invest. 2021 Mar 1;131(5):e145107. doi: 10.1172/JCI145107. PMID: 33645551; PMCID: PMC7919721.

PUBLIC HEALTH

Urban health systems need renewed attention,innovation,and action

Dr N Swaroop, Thematic Lead,Comprehensive primary health care,Karnataka Health Promotion Trust (KHPT) highlights that cities offer advanced healthcare services but also expose deep inequities,particularly in informal settlements where marginalised groups reside

Urban areas are vital engines of economic growth but have increasingly become arenas of health inequities and systemic challenges. While rapid urbanisation fuels development, it also produces unplanned and environmentally degraded cities. These conditions overwhelm healthcare systems, disproportionately impacting marginalised populations with minimal access to resources. This editorial emphasises the urgent need for a comprehensive, equitable, and sustainable transformation of urban health systems.

Urban health refers to the physical, mental, and social well-being of city populations. With 56 per cent of the global population living in urban areas—a figure projected to reach 68 per cent by 2050 (UN, 2018)—urbanisation is placing unprecedented strain on already burdened healthcare infrastructures.

Cities offer advanced healthcare services but also expose deep inequities, particularly in informal settlements where marginalised groups reside. These areas are underserved, with limited infrastructure and medical professionals, forcing residents to rely on private healthcare which in turn imposes high out-of-pocket expenses, pushing the urban poor into further financial distress.

Strengthening urban health systems

By 2030, 40 per cent of India’s population will reside in urban areas, compounding issues such as overpopulation, pollution, and the dual burden of communicable and non-communicable diseases (NCDs).

The National Family Health Survey (NFHS)-5 reveals stark

Strengthening healthcare infrastructure and data driven planning to address these diverse challenges is essential

disparities in urban health. The under-five mortality rate among the poorest urban populations is 63 deaths per 1,000 live births, compared to the national average of 32.

Vulnerable communities, such as those in slums, face barriers including affordability, distance, and inadequate infrastructure. For instance, NFHS5 data shows higher rates of child malnutrition and maternal mortality in urban slums compared to city averages. The rising p revalence of NCDs due to sedentary lifestyles, poor nutrition, and stress further burdens urban healthcare systems. Infectious diseases like dengue and tuberculosis thrive in overcrowded areas with inadequate sanitation. Also, unregulated urbani-

sation has exacerbated pollution and climate risks, leading to respiratory and cardiovascular diseases. Mental health issues, stemming from urban life stressors and social isolation, also require attention.

Another significant issue is the shortage of frontline workers (FLWs) in underserved urban areas. Weak outreach mechanisms hinder preventive care, early diagnosis, and treatment. Overlapping responsibilities among multiple agencies often result in poor accountability, compounded by inadequate funding, and limited use of technology. Such challenges underscore the pressing need for redesigned urban health systems. They also reveal how health determinants influence city productivity, resilience,

and quality of life.

Strengthening healthcare infrastructure and data driven planning to address these diverse challenges is essential.

Challenges to systemic reform

Critics argue that urban health challenges stem more from societal failures, such as poverty and inequality, than from healthcare shortcomings alone. They caution that healthcare investments alone will not suffice unless broader reforms address social determinants like housing, sanitation, and education. Urban health reforms also face logistical and economic barriers.

Modernising primary health centers (PHCs) across cities requires substantial investment and skilled personnel. Administrative inefficiencies and competing government priorities often delay these reforms, making longterm commitments difficult to achieve.

Strategies for urban health system strengthening

A holistic an strategic approach is essential to address urban health challenges. Expanding and strengthening urban primary health centers (UPHCs) should be prioritised, ensuring they are strategically located, well-equipped, and capable of providing preventive and curative primary care. Community awareness for disease prevention, regular health camps for early diagnosis can reduce longterm system strain.

Urban planning must integrate green spaces, pedestrianfriendly zones, and air pollution control strategies to promote healthier environments. Improving housing, sanitation, water supply, and waste manage-

ment can reduce communicable diseases. Partnerships between public and private sectors can enhance funding, infrastructure, and service delivery.

KHPT’s initiative

KHPT has adopted a multidimensional approach to urban health system strengthening. Its model focuses on equitable access to comprehensive primary healthcare (CPHC) services for vulnerable populations in informal and slum-like settlements. KHPT collaborates with local authorities to implement mapping of vulnerable populations, increasing access to social protection schemes, and piloting resource mapping exercises to address healthcare delivery gaps.

Initiatives like Arogya-One kiosks and extended service hours at UPHCs improve access to primary care for marginalised groups. Self-assessment tools for health facilities and quality improvement committees ensure consistent service delivery. By fostering community ownership through platforms like Mahila Arogya Samithi (MAS) and Urban Health Sanitation and Nutrition Committees (UHSNC), KHPT enhances community participation in healthcare decision-making. Its efforts exemplify sustainable, scalable solutions for tackling urban health inequities.

Conclusion

Cities thrive when all residents have access to quality primary healthcare, p reventive measures, and robust infrastructure. By reimagining urban health systems, we can transform cities into both economic growth centers and spaces that prioritise human well-being and equity.

Email: rajesh.bhatkal@expressindia.com rbhatkal@gmail.com

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HEALTHCARE TRACKER

Plastic Pinch Clamp

Ami Polymer's autoclavable polypropylene

Plastic Pinch clamp tubing flow valves are designed for easy one-handed operation, providing users with unmatched convenience, especially in environments where quick adjustments are needed. Available in mini, medium, and maxi sizes, these versatile valves accommodate a wide va-

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Small footprint in urine automation: The game changer

Shobhit Jain, Sr.Manager,Product-Clinical Chemistry & Urinalysis,Sysmex talks about about UF-1500,the fully automated urine particle analyzer which is a downsized model of UF-4000 and UF-5000

As we have ventured into the year 2025, Sysmex reflects upon the journey of innovation and technologies. With immense pride we are together with healthcare professionals in their healthcare journey to help with faster diagnosis and better patient care. In the last decade, Indian IVD industry witnessed paradigm shift in laboratory operations in which automation, technologies and AI tools are very well accepted for an early and accurate diagnosis.

However, Urinalysis is still one of the IVD segments, which is still not in the mainstream and most of the laboratories are still preferring conventional/ manual techniques for the urine examination over urine automation. A lot of vital information can be obtained through urine examinations, still its clinical utility is affected mostly by limitation of its conventional manual methods including biochemical and microscopy. Biochemical analysis is improved with reagent strips, but challenge remained in microscopic part. Other challenges like non standardisation of process, person to person variation, centrifugation and slide preparation needed a whole automated system in place with minimum human involvement and maximising automation.

Sysmex believes that Urinalysis is an informative and noninvasive diagnostics tool for clinicians to diagnose multiple ailments like UTI and CKD. Sysmex is continuously doing innovation in urinalysis testing and in the last 10 years we have started our journey from Fully automatic Urine particle analyzer (Fluorescence Flow Cytometer), then integration of fully automated urine particle and Urine chemistry analyzer and now

The UF-1500 is expected to enhance automation of urine sediment analysis in the small sized laboratory,GP’s and urological offices.The UF-1500 can also serve as a backup instrument for the UF-4000 and UF-5000

proved to be an important marker as far as early diagnosis of CKD, Urothelial malignancies and other routine diagnosis. In addition to that, this system can also be used for body fluid investigation without license activation or added reagents.

Technological advancement in biochemical analysis and microscopic examination in urinalysis has helped to set and standardise process. Automation has changed the way of testing, reporting and documentation of laboratories with improved quality and lowered TAT. Some of the key features of automation in Urinalysis are standardisation, quality control, added clinical values, data management, accuracy, and reproducibility. However, such solutions are limited to laboratories with medium to higher workload, which triggered the need of high-quality urine automation with small footprints.

sults from UF-4000, UF-5000 with a smaller footprint. The reagents and differentiation algorithms are consistent with those used with the UF4000 and UF-5000 analyzers. Therefore, the UF-1500 is expected to enhance automation of urine sediment analysis in the small sized laboratory, GP’s and urological offices. The UF-1500 can also serve as a backup instrument for the UF4000 and UF-5000. The UF1500 is ideal for a small sized laboratory or a site that has limited resources and/ or budget since it offers the same quality results and clinical value as the flagship model. Unlike the larger analyzers, body fluids analysis is not available on the UF-1500. Scattergrams and histograms are displayed in the main unit of the UF-1500 without the u-WAM (Urinalysis work area information management system).

we are offering composite solution of Urine particle analyzer (Fluorescence Flow Cytometer), Urine chemistry and Urine digital imaging by 2.5-million-pixel camera. This technology brings changes in urine examination with the in-

clusion of unique parameters like Bacteria gram’s classification, Epithelial cells classification (RTEC, EC, Non-Sec and transitional), RBC Morphology, UTI and AtypC flagging, osmolality and conductivity. These parameters have

To offer the small footprints of Sysmex fully automation, we are pleased to announce the launch of Sysmex Fully Automatic Urine particle analyzer “UF-1500”. This instrument can be offered as a standalone system or can be integrated with Urine chemistry for a complete solution. UF-1500 UF-1500, the fully automated urine particle analyzer is a downsized model of UF4000 and UF-5000. As well as those existing instruments, the UF-1500 can analyze the birefringence of particles and the nucleic acid content and size information of the cell, coupled with internal structural components, using a blue semiconductor laser (488nm). Detailed analysis of signal waveform originating from each particle generated detailed differentiation of casts, epithelial cells, etc. which are equivalent to the re-

Keybenefits of UF-1500 are-

◆ Compact size

◆ Fast and reliable particle analysis with fluorescence flow cytometry

◆ Advanced parameters to support clinical decision making

◆ Automate and standardise manual workflow procedures

◆ Flexible configuration options to find your perfect match

Urine examination is an important diagnostic tool for UTI, CKD, urothelial malignancies and considering increasing awareness, automation will be gamechanger for small size diagnostics labs. The future of urine examination lies in automation and with such small footprints, these technologies will be affordable for the small workload sites and tier 2 and 3 cities and enable them to enhance the effectiveness of urine examinations.

HEALTHCARE TRACKER

Wipro GE Healthcare launches Versana Premier R3

The integration of AI with ultrasound technology aims to help advance clinical efficiency and accuracy and improve patient outcomes

Wipro GE Healthcare has announced the launch of the Versana Premier R3, an advanced AI-enabled ultrasound system designed to enhance clinical efficiency and accuracy, streamline workflows, and improve patient outcomes.Catapulting Government’s ‘Make in India’ vision, the state-ofthe-art ultrasound system will be manufactured at Wipro GE Healthcare’s PLI factory in Bengaluru.

India’s 1.4Bn population, and a burgeoning NCD problem, underline the need for advanced technologies to enable precise diagnosis, improve clinical accuracy, and reduce the administrative burden. An extension of the Versana ultrasound range, Versana Premier R3 integrates artificial intelligence and offers automation and AIenabled productivity tools to improve workflow and clinical features designed to enhance clinical efficiency and accuracy. The advanced ultra-

The advanced ultrasound system aims to help clinicians deliver more personalised,ubiquitous, and preventive care.Addressing the skill gap,the system will optimise dynamic tissue imaging, assist with volume calculations,and streamline workflows

sound system aims to help clinicians deliver more personalised, ubiquitous, and preventive care. Addressing the skill gap, the system will optimise dynamic tissue imaging, assist with volume calculations, and streamline workflows. Its self-learning onboarding tool will empower the clinicians to enhance their skills and adapt to new workflows.

Chaitanya Sarawate, Managing Director, Wipro GE Healthcare South Asia said, “At WiproGE Healthcare we continue to make advance-

ments in AI, investing in foundation models that can help enhance precision care, ease clinical workflows and enable better patient outcomes. AI is central to building a future where healthcare is personalized, p reventiv e, and affordable. The launch of our Versana Premier R3, is yet another testament to our commitment towards the delivery of ‘Made in India medtech – for India and the world.”

Anup Kumar, Business Head, Ultrasound, Wipro GE Healthcare added,“We are

very proud to launch the Versana Premier R3,our stateof-the-art our ‘Made in India’ ultrasound system. With the growing NCD burden in the country, there is a pressing need for advanced patient centric technologies that can provide faster, personalized, and more accurate diagnosis. Powered by AI, Versana Premier R3 delivers exceptional image clarity, and versatile organ scanning, enhancing diagnostic precision, and empowering clinicians to make timely and well-informed decisions.”

A recent report by PwC in-

dicates that 57 per cent of healthcare providers in India are using AI, significantly higher than the adoption rates globally. As India embraces the potential of artificial intelligence in healthcare, Versana Premier R3 represents a significant leap in diagnostic capabilities. The product’s cutting-edge ‘VisionBoost architecture’ and 8-millionchannel digital processing deliver exceptional image clarity. With compatibility for 23 different probes, the system offers dynamic organ scanning.

Wipro GE Healthcare has been pioneering ‘Make in India – for India and the world’ for decades. Other Made in India products from the company’s PLI factory include the Revolution Aspire CT system and Optima IGS320 AI-enabled Cath Lab, among others. Earlier this year, Wipro GE Healthcare also announced an investment of over Rs 8000 crores in manufacturing output & local R&D over the next 5 years.

REGD.WITH RNI NO.MAHENG/2007/22045,POSTAL REGD.NO.MCS/162/2025 – 27,PUBLISHED ON 8TH EVERY MONTH, POSTED ON 14TH,15TH,16TH EVERY MONTH,POSTED AT MUMBAI PATRIKA CHANNEL SORTING OFFICE,MUMBAI – 400001

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