Glossarium

Manthan Topic: Healing Touch

Team Glossarium

Hindu College – Delhi University

PROMOTING UNIVERSAL ACCESS TO PRIMARY HEALTHCARE

INTEGRATED MOBILE HEALTHCARE VEHICLE FOR RURAL INDIA

ACCESS TO UNIVERSAL PRIMARY HEALTHCARE SERVICES IS LIMITED IN RURAL AND REMOTE AREAS OF INDIA

700 Million Total Population

23,458 Primary Healthcare Centers (PHC)

1:35000 PHCs to Population Ratio

2,533 PHCs Without Doctors

0.6 Doctor per Thousand People

FACTORS LIMITING PRIMARY HEALTHCARE SERVICE IN RURAL INDIA:

I. INADEQUATE HEALTHCARE INFRASTRUCTURES

-Remote Locations and Limited

Connectivity

-Poor Power and Electricity Supply

II. LACK OF TRAINED HEALTHCARE PROVIDERS

-Limited to certain cities and centers

III. AFFORDABILITY OF HEALTHCARE SERVICES TO THE RURAL POPULATION

RURAL INDIA – A GLANCE

Hypothesis: Failure to establish universal primary healthcare happens due to lack of infrastructure and awareness in rural areas

PROPOSED SOLUTION: MOBILE HEALTHCARE VEHICLE

Mobile healthcare vehicle refers to a vehicle which

has been modified in order to simulate a

healthcare center and facilitate provision of healthcare service.

It is provided by the government to partnering healthcare centers in order to expand their operations

and reach remote area.

Vehicles are attended my medical officers from the

partnering centers and provides services such as

medical consultation, distribution of medicines,

etc.

• Healthcare services are integrated with existing government insurance schemes such as Rashtriya Swasthya Bima Yojana (RSBY).

• Cost of healthcare services shall be born by partnering centers and refunded by insurance agencies under such schemes

WHAT WHY WHO

HOW

PROVIDING PRIMARY HEALTHCARE SERVICE ON A MOBILE VEHICLE IS AN EFFECTIVE WAY IN REACHING THE RURAL POPULATION

STRENGTHS

MOBILE SERVICE REACHES LARGER NUMBER OF PEOPLE AND EXTENDS TO REMOTE AREAS

ALLOWS FOR THE INTEGRATION OF HEALTHCARE SERVICES AND AWARNESS BUILDING PROGRAMS

MOBILITY OF MEDICAL OFFICERS TRANSLATES TO FEWER REQUIREMENT OF MANPOWER

REDUCTION IN HEALTHCARE COSTS DUE TO INTEGRATION WITH GOVERNMENT HEALTHCARE

AND INSURANCE SCHEMES

LOW CAPITAL INVESTMENT AS COMPARED TO BUILDING PRIMARY HEALTHCARE CENTERS

PROBLEM-SOLUTION MATRIX

INFRASTRUCTURAL

INADEQUACY

MOBILE VEHICLE

HEALTHCARE SERVICE

LACK OF MANPOWER DISTRIBUTION OF MANPOWER

FROM STAFFED CENTERS TO

TRAVEL TO DIFFERENT SITES

FINANCING

HEALTHCARE SERVICE

INTERGRATION WITH

GOVERNMENT

INSURANCE PROGRAM

SUSTAINABILITY MULTI-PARTY INCENTIVE

AND THIRD-PARTY

MONITORING

Stakeholder Analysis

Central

Government

Role: Providing healthcare vehicle, monitoring performance of program

Incentive: Ensuring Universal Primary Healthcare to Citizens

Role: Planning operations, supplying medical officer, providing primary

healthcare service, maintaining healthcare vehicle

Incentive: Extension operations and source of revenue

Role: Administering and Operating funding through existing government

insurance schemes

Incentive: Expanding operations and source of revenue

Healthcare

Centers

Insurance

Agencies

Medical Officers Role: Carrying out healthcare services and awareness programs

Incentive: Employment with healthcare centers with adjusted pay grade

as per operations

Rural Citizens Role: Utilizing healthcare services, participating in insurance programs

Incentive: Affordable access to primary healthcare services and

awareness programs

Non-Government

Organizations

Role: Monitoring Implementation of the program

Incentive: Proper utilization of taxpayer’s funds and prevention of

corruption

WIDE RANGE OF PRIMARY SERVICES CAN BE PROVIDED ON A MOBILE HEALTHCARE VEHICLE

MEDICAL SERVICE Consultation with visiting

doctor over various medical symptoms and prevention of disease

LABORATORY SERVICE

Collection of sample for laboratory checking, with result intimated on next

visit or by post

SCHEME REGISTRATION

Promotion and registration of various government insurance

and healthcare schemes

AWARENESS BUILDING

Integrated awareness building program on

personal hygiene, healthy lifestyle, and prevention

of diseases

ONSITE PHARMACY Availability of vitamins ,

pills. and medicines , expanding to remote

areas

PREVENTION SERVICES

Services for disease prevention, such as immunization and

vaccination

PLANNING

INFRASTRUCTURAL MAPPING (Partnering Centers Selection)

Quality and Quantity of Manpower and

Equipment

Ratio of PHCs to Population

Radius Of Operation

Class A PHC

Class B PHC

Class C PHC

DISTRIBUTION AND OPRATIONAL MAPPING (Vehicle Distribution)

Class A PHC

Class B PHC

Class C PHC

Most Number of Vehicles

Medium Number of Vehicles

Least Number of Vehicles

Most Manpower and Target Sites

Medium Manpower and Target Sites

Least Manpower and Target Sites

PLANNING IMPLEMENTATION

FINANCES

1. Vehicle funding under the National Health Mission, with approximate cost of Rs5 Lakh per vehicle 2. Payment of Healthcare services, travel, and medical officer remuneration to be integrated with existing government insurance schemes 3. Treatment package and payment method shall follow same procedure applied in case where patient visits center directly

MANPOWER

1. Medical Officers shall be outsourced from partner medical centers, whether private or public 2. Remuneration for medical officers shall be included in insurance schemes. 3. Drivers/clerks to be employed by partnering medical centers, with remuneration package integrated under existing insurance schemes

SERVICES

1. Vehicle shall travel from one panchayat to another every working day, with planning coordinated with district government. 2. Services shall be integrated with partnering healthcare centers, including in cases of hospitalization or need of secondary and tertiary services.

PLANNING IMPLEMENTATION MONITORING

• Implementation shall be supervised by the national and state department of health and family welfare through regular checks on operation sites and reports by partner healthcare centers

Government Supervision

• Hotline for complain regarding the program shall be printed on each vehicle. It shall be forwarded to the District Health and Family Department.

Healthcare vehicle Complain Hotline

• Non-Government Organization operating in the same field or region shall be integrated as partners of the program. In supervising operations.

Third-Party Supervision

Implementation Challenges

Multi-Party Coordination Coordination between stakeholders on implementation of the program

SOLUTION: Stakeholders must engage in coordinated dialogue to create a clear understanding regarding

respective responsibilities before implementation of the program. Regular discussions should be held upon implementation to monitor progress and solve any existing issues.

Payment of Healthcare Integrating Insurance Schemes and

Provision of Healthcare

SOLUTION: Insurance agencies running government insurance schemes must

ensure prompt payment towards services provider. Any disputes regarding

reimbursement and healthcare services must be addressed without disrupting

operations.

Effective Monitoring Ensuring Proper Utilization of Funds and

Mitigating Corruption

SOLUTION: Third-party reports and evaluation must be accounted in regular checks and given considerable attention

in determining authority and distribution of funds

References

• Reddy et.al, “A Critical Assessment of the Existing Health Insurance Model in India,” (Delhi: Planning Commission of India,2011).

• Mckinsey&Company, “India Healthcare: Inspiring Opportunities, Challenging Journeys,” December 2012.

• R.Srinivasan, “Healthcare in India: Vision 2020,” <http://planningcommission.nic.in/reports/genrep/bkpap2020/26_bg2020.pdf>.