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  1. 1. 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
  2. 2. 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
  3. 3. 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 LegalEducationalTechnological PoliticalEconomicalSocial Low Per Capita Income
  4. 4. 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.
  5. 5. 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)
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. 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/V aatsalya-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