Healing Touch Universalizing access to quality

primary healthcare.

SIBM,Bengaluru 1.Khush Agarwal

2. Neesha Munshi

3. Pallav Prasad

4. Pooja Kanjani

5. Ragvendra Muttagi

India accounts for 21% of the world’s global burden of disease.

WHO says 3.2% Indians will fall bellow the poverty line will because of high of high medical bills.

39 million Indians are

pushed to poverty because of ill health every year.

Around 30% in rural India didn’t

go for any treatment for financial constrains.

SCOPE OF PROBLEM

High

Population

GDP spent on

healthcare - low

Lack of health

Awareness

Environmental

degradation

Low budget due to

developing economy

Lack of skill

and knowledge

Coalition

Government

State Govt.

Partnership

No Financial

Feasibility

Lack of IT

penetration

Brain Drain

Expensive

medical education

Lack of

awareness

Laws not implemented

properly

Lack of quality

On job skill

Cause And Effect Diagram

Lack of Primary quality health

Political

Instability

High Litigation

expense

Legal Educational Technological

Political Economical Social

Low Per Capita

Income

Reasons for selecting the cause

Health care is the backbone of any economy

. A healthy nation is progressive and leads to optimum utilization of

people resources.

This is one issue which is not given due importance

despite of high level of materiality attached to it. It pertains to almost 75% of the Indian population

and hence has an immense scope

This is one issue where there is need (demand)

and some money (supply) , but both remains unmet . It calls for introspection

as to where things are going wrong . The

suspicions revolves around intermediaries,

delivery mechanism, lack of intent and henceforth

has a huge scope of innovation.

Proposed Solution

2. Setting up a retail chain of generic drug store along with mandate usage of generic medicines, if possible, in government hospitals at least. Using government dispensaries and hospitals for maintaining inventory for the drugs and distribution thereof. Creating awareness as to usage of generic drugs by the government and private players. The entire distribution channel could be outsourced to a private player pioneer in distribution network.

3. Implementation of technology at each step in the form of Hub and Spoke model on EDI(Electronic data Interchange) where a central monitory system would be taking care of all the movements of the generic drug and will account for all the services delivered.

1. Opening up of new 5000 Primary Health Centers in rural India. Selection of location for pilot project based upon the percentage of rural population in that particular state, intention of the state government and its participation level.(We have selected Bihar ,intention of state government to implement healthcare measures(highest allocation in terms of growth on healthcare as a percentage of GDP)

AFFORDABILITY

ACCESSABILITY

HEALTH

OPENING OF HOSPITALS

GENERIC DRUGSTORES

TECHNOLOGICAL UPGRADATION

TELESERVICES

STRUCTURED CUSTOMER DATABASE

SANITATION

EMERGENCY AMBULANCE

AADHAR CARD

CORE PRODUCT

ACTUAL PRODUCT

AUGMENTED PRODUCT

PRODUCT CONCEPT

Usage of AADHAR card as the means for identification and delivery of services.

Using EDI to maintain , sustain the overall delivery and monitaring mechanism.

Improvement of ASHA workers mechanism on following grounds

a. Decreasing attrition by compensation benefits, motivation and recognition in the society.

b. Job allocation and clear identification of roles in terms of administrative and service provider.

c. On job training to save time and improving on the job skills overall. d. Careful , clear and transparent selection mechanism for the ASHA

workers and clear hierarchy to be identified and transmitted.

To penetrate to the desired level it is necessary to have a trio partnership of NGO s

, private and government.

Value Additions

Hospitals

Secondary Health Care Centre

Dispensaries

Aasha Employee

Every Individual

Implementation Of The Solution

CSR by Hospitals

CSR In

Hospitals

Up gradation Of Hospitals

Vaccination Awareness

Screening Centres

Preventive Measures

Upgradation of already existing ones

Trained Nurses

Emergency Help 24 X 7

Generic

Medicines

Criteria to measure the impact of the solution

There are 123109 PHC to cater to 50% of villagers , an increase in 5000 PHC efficiently can cater to another 20% along with improving the current

PHC available to work more efficiently.

36% of the unspent fund could be spend on opening hospitals and the generic medicine

distribution system.

Improving the current Hospital Beds to people ratio from 9:10000 to 900:10000 by new and

optimum utilization

Scalability of the solution

To test market it couple of districts of a state and then replicating the successful model in a planned

way in 3 phases on the basis of investment amount required in particular project.

Phase 1 (Investment of less than 25 lacs)Phase 2 (25 lacs upto 1 Crore)Phase 3 (1 crore and above)

The phase might not be sequential it would be more "need based "and depend on location to

location.

Impact of the solution

Sustainability of the solution

Random Audit along with compulsory audit at the viable location hierarchy of distribution

and health services to curb the corruption and unwanted bottlenecks.

Setting up a highly flexible department to take quick decisions regarding the day to day

operations .

Appropriate

Monitoring mechanisms

As mentioned before, AADHAR card would be the primary source of database creation and management along with the existing ASHA database . Any service provided or generic

medicine sold would go through the database and recorded for accountability and

monitoring purpose.

With a central EDI system in place it would be easy to analyze the efficacy of the

implemented solution and replicate it in the other regions with required modifications.

Impact of the solution

Challenges

The first major problem would be fund generation and regular infusion of capital.

The proposed solution assumes mandatory CSR@2% by private hospitals and Cess @0.5% on all direct and indirect taxes which might not be well taken by

the society and taxpayers.

Opening up of 5000 efficient PHC is itself a

challenge and a humungous task.

Financial viability of technological advancement in the deepest parts

of India in absence of internet penetration and skill shortage.

Such high spending by government and increase in participation by private players would lead to skepticism from political and

social aspects .

Mitigating factors

Phased implementation of compulsory CSR on the basis of turnover by hospitals

No Cess on necessities , balance it out with luxuries. The funds need to be earmarked for

the purpose asked for

Government infrastructure company along with private partnership would implement on the

basis of transparent tender process and fast track completion goal

It is very important to propose a Time Bound Feasible Solution in front of

parliament as well as Public

AAKASH tablets could be used with temporary and then later on permanent ISP help for setting

up networks, Help

from BSNL

Skill development through basic training

Computerization at major junctions rather than at every place

1.http://www.who.int/gho/countries/ind.pdf 2. http://www.who.int/gho/countries/ind.pdf 3. A critical review of National Rural Health Mission in India – ISPUB 4. http://www.who.int/gho/countries/ind.pdf 5. http://www.livemint.com/Companies/vaAHnd8ULMWgGoXuT4sS1L/Vaatsalya-Healthcare--The-hinterlands-doctor.html 6. http://healthcare.financialexpress.com/201012/market08.shtml 7. NRHM,2005 A transmogrification or façade, Research Paper. 8.World health organization data 9.NRHM health statistics information portal

Appendix