1. Manthan Theme: Healing Touch
Towards guaranteeing a better living –
Fixing India’s ailing health system
Team Name: AshaKiran
Yeshwanth Reddy
Vishranth Suresh
Keerthana Chilukuri
Chaitra Yarlagadda
Arun Sudarsan

2. India’s Health Status
Life Expectancy
65.48
MMR
200
CMR
61
AMR
247 – Male; 159
- Female
1:1953
Rural
1:5500
Urban
1:750
Doctor: Population Ratio
8.9
6.2
3.9
6.2
8.5
0
1
2
3
4
5
6
7
8
9
10
Brazil Russia India China South Africa
India spends less on health than
most developing countries
Health Expenditure as a % of GDP
(2011)
?
Health, along with Education, is one of the
most important factors that contribute to
upward social mobility. More than 60% of
our population is in the rural
areas, inadequately served by the existing
infrastructure. India’s health is improving
slower than it ought to. We conceptualize
solutions for creating lasting impact.

3. 23,887
PRIMARY HEALTH CENTRE
Radial Distance: 6.42 km
4,809
COMMUNITY HEALTH CENTRE
Radial Distance: 14.33 km
“Nearly 92% of deaths from communicable diseases occur among the poorest 20%”
With the State funding only 3.9% of its GDP on
healthcare, the out-of-pocket expenditure has
skyrocketed in the country. As per World Bank
data, in 2011, the average OOP expenditure in
health was a staggering 86%. Brazilians, and
South Africans, for instance, spends only 57.8%
and 13.8% respectively. A significant illness
therefore, will drive Indians to poverty.
OUTOFPOCKETEXPENDITURE
There are only 45,629 MBBS and 22,625 PG
seats in the country. The total number of doctors
is roughly 6,14,439 across India. Rural India is
the least served, with a doctor: population ratio of
1:5500. RURAL–URBAN
DIVIDE
Access to affordable, quality primary healthcare is
a fundamental right of every citizen. The focus
therefore should be on building the necessary
infrastructure, and supporting it with the adequate
human capital.
GOAL

4. RURAL MEDICAL PRACTICIONERS
CATCH THEM EARLY
• 50 students selected from each district after class
10 to undergo a 2+3 RMP Diploma Course.
• The Course is fully funded and supported by the
Government.
• The RMPs, once they finish the diploma are
required to work in sub-centres and PHCs for a
minimum period of 5 years
• RMPs are then given an option to continue
studies for further 3 years to earn MBBS degree
2
PARADIGMATIC SHIFT – EQUIPPING
STUDENTS TO HEAL THEMSELVES
• Introduce a paradigmatic shift in healing
• Students from standard 8 onward are given basic
training on identifying symptoms, and
prescribing basic treatment procedures
• This is intended to serve the dual purpose of
creating awareness among students , and also to
motivate a few of them to take up RMP diploma
course (next part) after class 10
• Self-healing should be the new mantra
1
CONVERTING SCHOOLS:
RED CROSS ON SCHOOL GATES
• There are 1,48,424 sub-centres in India. The
average radial distance is 2.59 kilometers.
• With the RTE mandating the presence of a
school within 1 km.sq, it is possible to convert
1-2 rooms from selected schools to sub-centres
or PHCs.
• Some of the bigger schools’ classrooms will be
converted to PHCs, to reduce the number of
sub-centres affiliated to each PHC
3 WHEREVER YOU ARE, THE HOSPITAL
COMES TO YOU
• A mobile ambulance cum sub-centre to be on the
wheels with RMPs and a few equipment like
ECG, X-ray, eye-testing, etc.
• This van will visit 2-3 villages a day, providing
services for free to BPL families, and for a
concessionary fee for APL families.
4
AWARENESS
MANPOWER
PLATFORM
ONTHEMOVE

5. JANUARY FEBRUARY MARCH
APRIL MAY JUNE
JULY AUGUST SEPTEMBER
OCTOBER NOVEMBER DECEMBER
(1) PREPARE CURRICULUM FOR SCHOOL AWARENESS TRAINING
(2) RMP CURRICULUM – PREPARATION & APPROVAL
(3) BUYING, MODIFYING, AND FINALIZING 1000 MOBILE VANS
(1) TRAINING FOR BIOLOGY TEACHERS FOR AWARENESS PROGRAM
(2) PUBLICITY CAMPAIGN TO ANNOUNCE START OF RMP IN 2015
(3) ROLL OUT OF 1000 MOBILE VANS IN NORTH-EAST & WEST OF INDIA
(2) RESOURCE UPGRADATION IN DISTRICT MEDICAL COLLEGES
(1) FINAL TRAINING FOR BIOLOGY TEACHERS FOR AWARENESS PROGRAM
TIMELINEOF
ACTIVITIES(2014-15)

6. RMP PROGRAM
The first batch of RMPs will now enter the
3rd year of their course.
They will be put in the district medical
college where they will be trained full time
for the next 3 years by retired medical
professionals
RED CROSS ON SCHOOLS
• Identify the areas where there are no sub-
centres in the vicinity
• Modification/extension of the existing
government buildings (schools/panchayat
offices) in such areas
• Development of this infrastructure will
begin in South India where the man-
power shortage is not as much as in
North.
2017-18
Healing thyself
Roll out of school awareness program
in 8th standard.
Once in a month practical labs in
District Colleges
RMP DIPLOMA
RMP program commences in all the
districts (at class 11)
Weekly classes by retired professionals
in all districts
MOBILE VANS
Impact evaluation of first 1000 mobile
hospitals
Scaling up to 2000
2015-17

7. Achieving universal coverage in health care : to ensure all people have access to
affordable, preventative, curative and rehabilitative health services
1) Full fledged awareness & self-healing programs
2) Rural Medical Practitioners
The first batch of RMPs, 32 thousand in number, will be ready to be deployed in
rural healthcare centres.
3) More hospitals
Enough number of hospitals would have be constructed by now such that there is
at least one sub-centre at a radial distance of 1.5km
These sub-centres will be manned with the RMPs.
4) Mobile hospitals
By now we will have 5000 mobile hospitals across India that take health care
services to the doorstep
2020 – 5 years after launch
The success of this plan would ensure two things– first, quality health care services to doorsteps of
the needy and second, healthcare awareness and contemporary health care services seeking
behaviour among the underprivileged.

8. Three phased course structure
Implementation:
1) Aimed to prepare medical assistants at
the primary level, students can enrol in this
5 (2+3) year course on completion of the
10th standard.
2)First 2 years to be pursued at the school
level, with weekly classes on health
awareness and basic principles of diagnosis
and the next 3 years to be pursued at the
district medical colleges.
3)Students will be trained by retired
doctors.
4)Upon completion, the RMPs will be
salaried employees who can be promoted
as per government norms and permitted to
work in Public Health Centres.
Sustainability:
A modest fee can be collected from the
middle and upper middle class students
who can afford the RMP education to
make the model self-sufficient or less loss
incurring
Rural Medical Practitioners
(RMPs )
Specialized training to prevent basic
health issues
Study of patient history and basic
clinical examination
Diagnosis of common ailments
( Malaria / Anaemia / Hookworm /
Diarrhoea )

9. Primary Services
Concept and Implementation:
1) Mobile hospitals to address the present
problems of mobility and accessibility to
primary health care
2)Focus on access to villages which are
cut off from regular health services
3)Extensive focus on children and
women
4) Each mobile healthcare unit to visit 2-
3 villages a day on a regular basis
To avail specialised services, a meagre
fee can be charged only to the people
who come under a high income bracket.
However, people from slums and
backward tribal areas should be
provided absolute free of cost health
care.
Mobile Hospitals
X-Ray/ ECG / First Aid
BP Examination
Minor Surgeries
Immunization
Ante-natal / Pre-natal services

10. Cost Estimates

11. Implementation risks:
• MBBS doctors might object to the introduction
of a new RMP course
• Students might opt not to pursue
• RMP vis-a-vis the MBBS degree
• Funds for setup and maintenance of mobile
hospital vans
• As a short-term challenge, infrastructure for the
first few batches of RMPs might crop up
• Funds for setup and maintenance of mobile
hospital vans
• The manpower required to run the mobile
hospitals have to be be identified.
Mitigation factors:
• Differentiating RMPs from doctors by
giving them RMPs an “RMP” suffix
• Spreading awareness of the importance of
health care and the need for medical
assistants among the youth
• Implementing in Public Private Partnership
mode, mostly funded out of Corporate
Social Responsibility funds available with
India’s corporate houses
Monitoring criteria:
• Life expectancy
• Maternal mortality rate
• Infant mortality rate
• Decline in the advent and propagation of communicable diseases
• Diagnosis and recognition of diseases in an earlier stage

12. References
• NRHM health statistics information portal- https://nrhm-mis.nic.in/
• World Health Organization data
• http://www.censusindia.gov.in/2011-common/census_data_2001.html
• http://blogs.lse.ac.uk/indiaatlse/2012/11/26/maternal-healthcare-expenditure/
• http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS
• Gearing up for health care, McKinsey report
• http://www.mobilehealthclinicsnetwork.org/vehicles_medical.html
• FOGSI.org-
http://www.fogsi.org/index.php?option=com_content&view=article&id=278&Ite
mid=232
• http://www.wbhealth.gov.in/notice/let_to_aso.pdf
• http://articles.timesofindia.indiatimes.com/2010-09-01/india/28218508_1_mbbs-
student-rural-areas-rural-health-care
• http://www.pwc.in/en_IN/in/assets/.../healthcare_financing_report_print.pdf