- The document proposes a 3-tier healthcare system to improve primary healthcare in rural India. It involves dividing rural populations into communities of 500 people each, with 4-5 volunteers from each community providing basic healthcare. Volunteers undergo training and are supported by physical repositories stocked with medicines. The system aims to increase access, spread awareness, and utilize community networks and existing resources to improve rural health outcomes. Record keeping via health informatics will help evaluate the system's impact.

1. Healing Touch:
Universalizing access to quality primary health care
SASHAKT
Samudayik swasthya, ab aapke haath
TEAM MEMBERS :
Megha Arora
Pawas Chhokra
Sanchit Saini
Swati Gautam
Utkarsha Bhardwaj
Institute : IIIT-Delhi, New Delhi, India

2. India : Health Statistics
Demographics
Total population (000) 1,241,492
Total under-live population (000) 128,589
Births (000) 27,098
Birth registration (%) 41
Total under five deaths (000) 1,655
Neonatal deaths: %of all under 5 deaths 53
Neonatal mortality rate (per 1000 live births) 32
Infant mortality rate (per 1000 live births) 47
Stillbirth rate (per 1000 total births) 22
Total maternal deaths 56,000
Lifetime risk of maternal death (1 in N) 170
Adolescent birth rate per 1000 women) 39
52
0
10
20
30
40
50
60
1992-1993
NFHS
1998-1999
NFHS
2000 MICS 2005-2006
NFHS
Other NS
Percent
Skilled Attendant at delivery
percent live births attended by skilled health personnel
Resource : India Accountability Profile 2013

3. Problem Statement
• Immunization coverage varies in urban areas (58%) and rural areas (39%),
• Physical access to both preventive and curative health services is a major barrier for India’s large rural population
(>70%).
• 80% of health infrastructure, medical manpower and other health resources are concentrated in urban areas where
only 31% of the population resides.
• The number of government hospital beds in urban areas is more than twice the number in rural areas.
Scope of the broad problem
Causes of the problem
Reasons for selecting a specific cause
• There are massive delays in the access to primary health care facilities.
• Owing to the disparity in infrastructure between urban and rural health care facilities, the facilities in urban settings
function under humungous stress.
• There is a general lack of awareness about the basic immunization, medical policies and other such government
schemes and plans, hindering their impact.
• Lack of skilled manpower to cater to the demands in rural settings.
• Lack of awareness about basic preventive measures.
• Poor implementation of government schemes.
• Inadequate government spending on health care.
• Limited or no access to primary healthcare facilities.

4. Nearest Community Hospital
Nearest City Hospital
SAHAYOGIS
• Dividing rural population into communities of around 500
people each
• Volunteers (both men and women) from each
community to provide primary healthcare
• A physical repository (for every 100 communities) to fulfill
the resource requirement of every community
• A health informatics system that keeps track of patients,
diagnosis, number of cases of a particular disease etc.
• Deals with cases directed by Sahayogis that require high
levels of treatment
• Handles cases requiring advanced level of treatments
• Equipped with proper infrastructure
Our Proposal: A 3 tier system

5. Proposal Description
• Our proposal focuses on
improving the primary health
care situation in rural areas.
• We work by dividing the
rural population of 83.3
crores into 16,66,000
communities of around 500
people each, covering over
6,40,867 villages in India.
• 4-5 volunteers including
both men and women, along
with the existing doctors,
from each community to
provide quality healthcare
at community level.
The entire focus is
on utilizing the
community bond
that exists in a
village. The personal
healing touch would
go a long way in
achieving the
objective of
ensuring proper
healthcare for
everyone.
This also rules out
the need for
appointments and
provides a
personal level of
interaction.
Volunteers are
people who
belong to the
same community
to ensure a sense
of belongingness
and in order to
instill a comfort
level, especially
targeted at
women.
Personal healing touch

6. Volunteers
• Secondary source of
livelihood.
• Job stability and
stability.
• Basic knowledge of
health care.
• Stipend during training
phase.
• Additional incentives
when a volunteer
becomes a sahayogi to
ensure performance.
Eligibility criteria
• Secondary education
• Undergo rigorous
training (time duration:
Around three months to
one year) by the best
available doctors.
Training includes:
• Knowledge of
elementary diseases,
medicines, basic
treatment for wounds and
fractures, childbirth,
vaccinations, etc.
• Basic know how of
record keeping using
health informatics.
• Awareness related to
sanitation, hygiene,
disease prevention, etc.
and related govt. schemes
and plans
Motivation for volunteers
•Pass a test to be able to
become a sahayogi.

7. • Physical repository for every 100
communities.
• Provides generic medicines to
sahayogis.
• Fulfills resource requirements of
communities
• Government funded
• Use of health informatics for record
keeping purposes
• Volunteers maintain a database to track
disease patterns
• Will update medicinal requirements
through these repositories
• A system of checks and balances to
monitor the working of the system.
• Personal communication with patients
within the community
• Spreading awareness of basic health-care,
sanitation and personal hygiene among
the communities
• Acting as points of contact between the
government and the community
• Directing patients to higher levels in the
system, incase the treatment is not
possible at sahayogis level
• Record keeping of the
cases they deal with on an individual
basis
• Procurement of medicines from the
repository and their distribution.
Repositories Role of volunteers

8. Merits of our solution
• Our solution addresses the problem of delays in primary health care by involving people
(sahayogis) belonging to the community itself.
• It is targeted towards spreading awareness on the preventive aspect of healthcare as well as
building a disease prevention mechanism.
• We are suggesting a mechanism that utilizes the existing resources and takes into consideration
the unique demographics of the community and the problems that can be solved in a novel
manner.
• Furthermore, the proposed solution seeks to ensure proper dissemination of information and
knowledge about the various government schemes.
• There is a proper record system to understand the previously unaccounted for data that would
facilitate the policy makers to analyze the prevalent situation and trends.
Limitation of our solution
• While we increase the access to quality primary health care for communities that lacked them
earlier and take into account the unique demographics of the community by involving members
from the community itself, our solution doesn’t directly ensure access to primary health care for
the marginalized members within the community itself.

9. Impact
• The use of health informatics for record keeping
purposes can serve as a parameter to judge the
impact of our solution. Things like number of
patients recorded with a particular symptom,
number of cases of a particular disease, etc. would
work as a strong indicator of the success of this
scheme.
• Analysis on the data collected from various
communities can be easily collated, thereby, helping
policy makers in the identification of trends in
disease prevention, epidemics, hence, working as a
parameter to analyze the impact of government
schemes and plans for disease prevention and cure,
etc.
Parameters to gauge the success of our solution
Scalability and sustainability of our solution
• Since our solution works by providing access to quality primary health care by involving people
from the grassroots level and utilizes pre-existing resources, it is very much scalable and
sustainable.

10. • Census 2011:
http://censusindia.gov.in/2011-prov-
results/paper2/data_files/india/Rural_Urban_2011.pdf
•India Accountability Report 2013:
http://www.countdown2015mnch.org/reports-and-articles/2013-report
•National Rural Health Mission Report : http://nrhm.gov.in/
•http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093249/
•http://www.who.int/bulletin/volumes/86/12/08-021208/en/index.html
References