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  1. 1. Healing Touch: Universalizing Access To Quality Primary Healthcare Team Details 1. Swami Yogesh 2. Phad Rohit 3. Bharti Sandip 4. Kharosekar Chaitanya 5. Chame Gajanan College: Govt College Of Engineering,Pune.
  2. 2. Current HealthCare Situation of India: • Lack of integration of sanitation,hygiene,nutrition and drinking water issues. • Govt’s pu li spending on health is 0.9% of GDP. • Hospitalized Indian spend on an average 57% of their annual expenditure • Only 10% Indians have some form of health insurance • Lack of coordination and integration in healthcare. • Over 40% of hospitalized Indians sell assets to cover expenses. • Over 25% of hospitalized Indians fall below poverty line because of hospital expenses. • Lack of efficiency,accountibility,effectiveness in Govt health schemes. Healthy citizens are the greatest asset any country can have.
  3. 3. 0 10 20 30 40 without Doctor Without lab technician without pharmasist Public Health Service In Rural Area(In PHCs)% 0 5 10 15 20 25 30 35 Infant Mortality Rate 80 19.6 Rich Poor Middle 0.4 Rich Poor Gap (In %) 0 200 400 600 800 1000 1200 Per Capita Expenditure On Health(In $)
  4. 4. Proposed Solution: Health Card Scheme IDEOLOGY • One scheme covering all citizens • Universalizing health data • Health card for easy access to healthcare • Inclusive participation of citizen BASIC FEATURES • Electronic health card assigned to every citizen • It will be read by barcode reader system • All his/her primary medical credentials and medical history would be associated with it • One Primary health center for each village in rural areas. And One Village Hospital for adjacent five health centers. • Process can be made online ,so that medical information related to patient can accessed anywhere in the country. • Strengthening capacities for data collection, assessment and review for evidence based planning, monitoring and supervision.
  5. 5. Primary Health Center 4 District Hospital Taluka Hospital Village Hospital One Medical Practitioner & One intern & Staff Medical Practitioners additional facilities & Equipments Medical Specialists & Advanced Equipments Primary Health Center 3 Primary Health Center 2 Primary Health Center 5 Primary Health Center 1 Doctor,Health Activist, ASHA Govt District hospital plus private allied hospitals,ICU Centers,Blood Banks X-ray,Sonography tests,CT scans Sugar,Blood testing,Beds for patients First aid,generic medicines,AntiVenom etc PROPOSED HEALTH CARE HIERARCHY
  6. 6. Mechanism Of Implementation HEALTH CARD SCHEME HEALTH INSURANCE • Families paying health insurance will get electronic health card. • Distribution of health card will be monitored by district collector. • Inclusion of Primary database eg blood group,HB,weight,height in health card. • Each time patient visits PHCs, his medical history will be updated accordingly. Eg prescription, disease etc. • Management of this huge health database will be online and managed by private software institute. • Govt will collect Rs 50 per family per month as health insurance. • Collected by grampanchayat and deposited to health ministry. • Free treatment and operation in any village, taluka or district hospital. • Patients who needs severe operations will be operated free of cost in Govt allied private hospitals. Govt will use collected health insurance money in these cases. Special Advantage • Prevention of child foeticide : Each time mother comes for check up about her pregnancy, doctors can monitor her monthly progress. And this can be continued until baby borns. • Monitoring of epidemiology : Some diseases are more common in certain geographic areas, among people with certain genetic or socioeconomic characteristics, or at different times of the year. So according to data available doctors can predict about disease, their causes and advice accordingly to maintain hygienic environment to concern areas.
  7. 7. Primary Health Center(PHC) • One Health Activist and ASHA(Accredited Social Health Activist) currently working under NRHM to help medical official. Medical Official in PHC :  Responsible for implementation of all Govt schemes under PHC.  All Primary healthcare and treatment in village.  Accountable to Grampanchayat &Answerable to higher authority  Submit health progress of village.  Will recommend cases under health insurance to specialised hospitals Health Activist:  Permanent employee of Government.  Should be Bachelor of science  Should be trained by Govt to provide primary treatment.  Can handle primary health issues in villages by himself and can provide first aid treatment for critical cases.(e.g. Wounds during minor accidents, minor diseases)  Regular health check-up of primary school students.  Should spread social awareness regarding sanitation, health consciousness etc.
  8. 8. Resources & Consumptions • Human resources required: Considering existing system only additional health activist will require in each PHCs. This will helpful for local employment. Expenditure on Infrastructure development: • Expenditure Share-> 70:30 Center:State • Total no of villages in India=6,38,000 that is 6,38,000 PHCs • Salary of Health activists : 5000*6.38lack =319 Crore • Technical Infrastructure(Computer,internet access,databse management): 1000 Crores • Considering existing infrastructure expenditure may reduce Financial Management : • Average families per village=400 • Total money collected per village =400*50=20,000 Rs • Total money collected in India per month = 1276 Crore Total money collected • This money will be used in Health Insurance.
  9. 9. Long Term Objectives Quantitative Qualitative • Maternal Mortality Rate 100 per 1,00,000 live births . • Infant Mortality Rate 30 per 1000 live births. • Total Fertility Rate 2.1 • GRAM SWACHHATA competitions at district level. • Expenditure on health development to 5% of GDP • Increase in HDI(Human Development Index). • Health consciousness through Primary education. • Total sanitation Programs. • To Make PHC’s a ounta le to pu li . • Provide more facilities to medical officials serving in rural areas. • Develop better transportation facilities to connect villages to nearest hospitals. • Formulation of transparent policies for deployment of Human Resources for health.
  10. 10. Impact Of Scheme Criteria To Measure Impact: • Maternal Mortality Rate • Infant Mortality Rate • Total Fertility Rate • Nutritional Balance Scalability: • Integration with other Govt schemes such as Midday Meal,NRHM,FSB. • Autonomy to local medical officials to improve scheme according to local conditions • Develop Technical infrastructure Sustainability: • Compulsory internship in rural areas • Increase confidence and awareness in citizens about Govt health schemes. • Coordination and integration in health care hierarchy. • Health officials will discuss health schemes in Gramsabha. Monitoring Mechanism: • Make PHCs accountable to committee under district collector and district health officer • Committee will submit monthly monitored report to health ministry. • Regular visits of specialist and expert medical officials to PHCs
  11. 11. Challenges: • Need of strong technical infrastructure • Active participation of villages • Transparency in insurance schemes • Technical Education to health activist • Inclusion of expertise of private multispecialty hospital • Efficiency in distribution of health card Concept Risks: • Corruption in management of insurance money • Malpractices in insurance scheme • Possibility of health activist to join private hospitals after being trained by Govt • Database loss Some Remedies: • Regular audits by independent committees • In lusion of NGO’s and College students to spread awareness • Social activities such as street plays, NSS camps in rural areas. • Permanent bonds for health activist.
  12. 12. References • NRHM(National Rural Health Mission) • • • • _rate.html • hplan/pdf/vol_3.pdf