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    Glossarium Glossarium Presentation Transcript

    • 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 MillionTotal Population 23,458Primary Healthcare Centers (PHC) 1:35000PHCs 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_bg2 020.pdf>.