1. TOPIC :Universalizing access to Primary healthcare
RESTRUCTURING THE HEALTH MESH : A PROPOSITION TO ALLEVIATE THE FLAWS IN THE PRESENT SYSTEM
TEAM : CHARAK PUNJ
TEAM MEMBERS : DENNY SAINI
KARTIK ANAND
AAKRITI KUNTAL
SAMIR ALI
KHUSHBOO MITTAL

2. Present Scenario
 India’s healthcare expenditure forms only 3.87% of GDP
 2 Major healthcare inititiatives in India.
1. National Rural Health Mission (NRHM)
2. Rashtriya Swasthya Bima Yojana (RSBY)
 Indians reportedly pay 60% of health costs out-of-pocket, and of this, the
majority are on drugs.
 India ranks 150 out of 214 countries in terms of infant mortality rates.
 India ranks 136 out of 187 countries with an HDI of 0.554
GDP
India's economy grew at an annual rate of 5.3 % in the quarter ended
March 2012, much lower than expectations of 6.1 %
The GDP numbers mean that the country’s growth slowed for eight
successive quarters through the three months ended December 2012.

3. India’s vital clinical statistics(approx.)
 Cancer : 3 Million
 Diabetes : 34 Million
 HIV : 8-10 million
 Epilepsy : 8 million
 Hypertension : 150 million
 Schizophrenia : 1 Million
 Asthma : 40 Million
 Alzheimer’s : 1.5 million
 Cardiac-Related
Deaths : 2 million
 Infant mortality rate (IMR) is the number of new-borns
dying under a year of age divided by the number of live
births during the year times 1000. It is the number of
deaths that occur in the first year of life for 1000 live
births.
Infant Mortality Rate

4. Cause of problem Reason of the cause solution
1 Lack of trust in government/free facilities. More attention in private hospitals Improved services, honest workers
2 Superstious beliefs and customs Ingrained in the culture due to lineage Target to change the lifestyle
3 No treatment of the disease at initial
stage.
Illusion of invincibility Facilitating easier access to
medicines and creating
Awareness
4 Allopathic treatment considered to be
harmful for health in later stages.
A mindset that considers natural or
‘desi’ methods therapeutic in the long
run.
Building trust in allopathic medicines
by citing examples and creating more
homeopathy centers
5 Doctor alienated from the society. They do not prefer to reside in
villages.
A medium to relay knowledge
between doctors and villages
6 Ayurveda has not yet established itself in
villages.
Knowledge is scattered . Consolidation of such knowledge
through concerted efforts and
creation of more
ayurvedic health centers
AN INSIGHT INTO THE RURAL MINDSET :FACTORS HAMPERING HEALTH PROMOTION

5. A DECENTRALIZED AUTONOMOUS BODY FOR MANAGEMENT AND
VIGILANCE MAY PROVIDE THE KEY TO RESCUING A COLLAPSING VISION.
Creation of a health management centre at block level. Each to be assigned responsibility
of villages lying in its proximity. Enrollment of local residents with minimal qualifications and
othe from medical background for job posts.
The HMC shall facilitate the purpose of a Helpline. For this it should maintain a dynamic database of all information regarding
health ,hygiene, sanitation including the doctors available, optimum treatment plans, hospitals, healthcare schemes, preventive
measures, first aid.
It shall conduct regular surveys ,maintain records of and deal with problems faced by nearby primary health centers, sub centers
etc. It can provide other supporting services for instance continuous supply and provision of ‘ayush’ kits and products which are
generally out of stock in PHCs etc
BLUEPRINT OF PROPOSED
STRUCTURE
COURSE OF ACTION
The HMC shall have employees that undertake regular surveys and interact with the village community that is assigned to
them. Preferably the employee should be a resident of the village. They would entertain various responsibilities as
 Imparting knowledge regarding health schemes, immediate health concerns.
 Take actions in resonance with a foresight to change the lifestyle.
 Assist the ANMs in their work.
 Ensure implementation of all NRHM schemes.

6. SALIENT FEATURES :
Ignorance about NRHM schemes still blooming, people at disadvantage due to lack of knowledge regarding
their rights.
Integration of Upstream, downstream and midstream efforts. Midstream efforts crucial; increasing
involvement of college students , job seeking rural youth ,panchayats, rural schools ,prominent local figures
through suitable incentives.
Campaigns should invariably adopt behavioral change as a goal.
Goals should be clear about target population, objectives should be measurable.
Communication strategy : nukkad nataks,posters
Message content : Emphasis on information new to target group and essential for behavioral change, Lucid
,comprehensible and concise.
The HMC shall promote campaigning as a necessary measure to tackle
abject ignorance prevalent.

7. Inspite of the various programmes, one of the
reason behind failure is insufficient advertising
mediums. TV advertisements are usually out of
the reach for typical rural areas. Because most of
the villages are deprived of the electricity,
televisions, literacy and most importantly
awareness. So there is a need to make our
advertising methods more effective so that it
reaches everyone. The best possible way is to
come in direct contact with the general people .

8. HEALTH PROMOTIONGUIDING PRINCIPLE
 Health promotion is acceptance that health and social wellbeing are determined by many factors outside the health system
which include socioeconomic conditions, patterns of consumption , demographic patterns, learning environments, family
patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization and
trade and global environmental change.
 Health promotion component needs to be strengthened with
simple, cost-effective, innovative, culturally and geographically
appropriate models, combining the issue-based and settings-
based designs and ensuring community participation.
 For effective implementation of health promotion we need to
engage sectors beyond health and adopt an approach of health
in all policies rather than just the health policy.

9. Ing
• Funds collected from
panchayats.
•From the funds under the
ministries working for rural
development.
•The existing govt. buildings which
are redundant can be utilized or
new buildings need to be
constructed.
•The heads of such HMCs should be
retired military persons or government
officials .
•The customer care personnel can be
local residents with minimal
qualifications and proficiency in local
languages.
•Certain Persons with medical education
are mandatory for posts.
KEY FEATURES OF IMPLEMENTATION
PROPOSED SOURCES OF
FUNDING INFRASTRUCTURE WORKFORCE

10. CHALLENGES
 The autonomous body should work independently to avoid possible corruption which
could arise from affiliation with NRHM’s or other concerned employees.
 The Panchayat and the villagers may not easily accept an HMC employee as a part of
administration which could result in various problems for the new comer.
 Recruiting desired retired military persons ,Govt. officials in such a large number.
 The new system shall tackle the claws of corruption etched in the present system through
surveys and checks.
 It will pave the way for reinforced efficacy as per original vision.
 It will focus on the vices of ignorance and inefficient management that are key factors in
the failure of present system.
MERITS

11. Impact of Solution
 As the plan is related to management so the work done by the dept. can be directly evaluated by
the state government without interrupting other departments.
 The plan is bound to provide better job opportunities for the youth that consist of India’s 50% of
the population
Sustainability of the solution
The plan provides a better and more reliable management system if executed as per the plan. It
posses enough flexibility for the changes that can be applied any time whenever they are
required.
Scalability of the plan
The plan aims at changing the lifestyle of the village and provide an opportunity to avail the
services that have yet not reached the villages. To connect it with the rest of developing country
and make it a part of development to create a healthier and disease free India.

12. Appendix
References
 http://censusindia.gov.in/Census_Data_2001/Census_data_finder/A_Series/Number_of_
Village.htm
 http://www.ncbi.nlm.nih.gov/
 http://people.oregonstate.edu
 http://www.issuesinmedicalethics.org
 Computerization of Panchayat Raj Institutions(PRIs) under the e-Panchayat Mission Mode
Project in Andhra Pradesh under BTOM (Build, Transfer ,Operate & Maintain )Model July
2013
 Preparation of Gram Panchayat Level Plan published by A.M.M. Zakir