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Awaaz
1. Healing Touch:
Universalizing access
to quality primary
healthcare
Ezaz
Gopika Jhunjhunwala
Kartik Dhiman
Samkit Rampuria
Utkarsh Kumar
BIRLA INSTITUTE OF
TECHNOLOGY, RANCHI
2. Problem Statement
India has a cumulative short fall of almost 17,000 Public
Healthcare Centers (PHCs)
A concomitant shortage of 8500 Doctors across these centers
41% of existing PHCs lack healthcare personnel
Shortage of 2.6 million health workers
Inadequate funding for primary healthcare. The Union
government has allocated only 1.04% of GDP towards
improving health in their 12th plan. This is among the lowest
budgetary allocations in the world
Lack of modern facilities and awareness
Inefficient implementation of government policies
3. SOLUTIONS
Development of
efficient healthcare
workforce
Making sure that the
people know what is
available, how to access it,
and how different parts of
the system work together
Procurement of
modern facilities
Development of a
hierarchical system
starting from the grass
root level
1.
2. 3.
4.
4. Development of a hierarchical system starting from the grass
root level
Sub Centers PHCs CHCs
• Establish a single sub centers for
every two villages consisting of one
male and one female health worker.
• Recognize eligible individuals
from the village itself and provide
them with incentives.
• Proper communication and
transportation channel among the
sub centers, PHCs and CHCs.
•A referral unit for 6 sub centers.
•Monitoring of the functioning
and coordination with sub
centers.
•4-6 bedded, with basic facilities.
•One medical officer In charge
and 15 paramedical staff.
•A referral unit for 4 PHCs.
•Monitoring of the functioning
and coordinating with PHCs.
•30 bedded hospital.
•Specialized in modern services.
•Equipped with Life support
system.
5. Development of efficient healthcare workforce
• Assuming the worst case scenario that only 25% of the Indian Rural population has access to health facilities.
75% of 6,38,000 villages = 4,78,500 villages.
•For every two village we intend to setup one sub centre. So for these 4,78,500 villages we need 2,39,250 sub centers.
•For every 6 sub centers we intend to setup one Public Healthcare Centre (PHC). So the number of PHCs required = 39,875.
•For every 4 PHCs we intend to setup one Community Healthcare Centre (CHC). So the number of CHCs required = 10,000
approx.
•Spread awareness and raise incentives to attract people for their own welfare.
•Develop barefoot doctors and paramedic teams.
•Make internships compulsory for MBBS graduates for at least 1 year in underserved areas and providing them with job and
social security.
•Postgraduate courses should be sponsored by the government to improve the quality of workforce.
6. Development of efficient healthcare workforce
•Collaboration of Public and Private Sector for intensive training of paramedics, nurses and barefoot doctors.
•Appointment of Central Monitoring Team at district and state level.
•Monitoring Teams shall comprise of local representatives as well as government officials so that they have indigenous as well
as technical expertise.
•Monitoring Teams shall be rotated every one year and its members must be chosen in agreement with the beneficiaries of
the plan.
•Regular survey for satisfactory functioning of the plans suggested.
•Immediate and strict action against malpractice. Stringent rules to govern the working of the workforce.
7. Procurement of Modern Facilities
•Linking of the health records of all individuals with AADHAR cards so that data can be accessed remotely.
•Issuing of school health cards for children to keep track of medical history.
•Installation of modern communication services with internet facilities at all sub levels.
•Proper transport system shall be placed for each sub center, PHC, and CHC for improved efficiency in traversal of the
patients from peripheral centers to tertiary hospitals.
Making sure that the people know what is available, how to access it,
and how different parts of the system work together
•It can be particularly difficult for patients moving from one part of the health system to another. For example, when they
are discharged from hospital, or when they need a range of health providers, such as a psychologist, dietician or
physiotherapist.
•Currently, no one is responsible for ensuring that each local community has the right mix of services to meet its health
needs and it is difficult for patients to know whether things are working and, if not, who should fix them.
8. Funding- Successful Models
• The Australian Government introduced the Medicare
system in 1984. All Australian Government funding for
health services comes from taxation through its general
revenue. A Medicare Levy is set at 1.5% of taxable
earnings (for all but low income earners). A surcharge of
an additional 1% is levied on high income earners who
do not have private health insurance
• The UK health system, the National Health Service (NHS)
is funded through taxation to provide free primary health
care services to all UK permanent residents.
Expenses
2,39,250
sub
centers
39,875
PHCs
10,000
CHCs
239.25
crores
4000
crores
500
crores
1820
crores
6559.25
crores
Mass Coverage and Manpower Requirement
Training cost
of 1.82
million
paramedics
•62.436 billion people will be covered by workforce of 1.82
million paramedics, nurses and doctors.
9. Risks Involved
•Amount of time taken to implement any plan in India has been seen to be devastating.
•Conflicts between the governments at the state and central level.
•Inefficient Management of Manpower.
•The current situation of the economy does not permit the allocation of more resource considering the CAD and fiscal
deficit.
•The AADHAR card system has not been implemented nationwide.
•Corruption.
•People in rural areas still stick to superstitious practices instead of availing the resources present.
