Healing Touch: Universalizing access to quality
primary healthcare
Algorithm to place health facilities in a district to m...
 At the time of Independence, the country's health care infrastructure was mainly urban and clinic based. Outreach of ser...
CURRENT SITUATION
Sub Centre: Most peripheral contact point between Primary Health Care System &
Community manned with one...
OBJECTIVE
• Currently, there is no procedure that is followed to locate lower saturated regions and place new health facil...
Geolocation
• Geolocation of health services ( PHC, CHC, SC ) by using Google Maps
PlottingVoronoi
Polygons
• PlottingVoro...
SNAPSHOT FOR GOA
 Geolocate the Health Facilities  Make voronoi polygons around the health
facilities using QGIS
• Here,...
IMPLEMENTATION OF THE SOLUTION
 Placing any public facility in an area must be closely scrutinized as there could be a lo...
IMPACT
 The impact of the idea proposed can be measured directly by the change in the saturation index ( S ) in the regio...
LIMITATIONS
 Facility location is also largely influenced by political interests, which the algorithm cannot take into
ac...
REFERENCES
 The map data has been sourced from Google Maps.
 The GIS software used to make voronoi polygons : QGIS
 Twe...
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Nirmaan

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Nirmaan

  1. 1. Healing Touch: Universalizing access to quality primary healthcare Algorithm to place health facilities in a district to maximize access to quality primary health care Team : Shreya Chandra | Shreyas G M | Chandrahas M |VenkataYaji | Gokul Krishna BITS Pilani KK Birla Goa Campus, Goa
  2. 2.  At the time of Independence, the country's health care infrastructure was mainly urban and clinic based. Outreach of services in the rural areas was very limited. From the First five-year Plan, Central and State Governments made efforts to build up primary, secondary and tertiary care institutions and to link them through appropriate referral systems Community Health Centre PHC SC SC SC SC SC SC PHC 6 x SCs PHC 6 x SCs PHC 6 x SCs INTRODUCTION The solution which we develop will help place the three tiers of health care institutions and thus increase the access to them Three-fourths of the country’s health budget goes into addressing PHC through the National Rural Health Mission (NRHM).The country spent close to Rs 21,000 crore in 2012-13 alone.The problem is not lack of funds.The problem is how to locate the PHCs. The three tier system in India that constitute health institutions: PHC – Primary Health Centre. SC – Sub Centre
  3. 3. CURRENT SITUATION Sub Centre: Most peripheral contact point between Primary Health Care System & Community manned with one HW(F)/ANM & one HW(M) Presently there are 148366 sub centres Avg. Radial Distance(kms):2.59 Avg. number of villages covered:4 Avg. population covered:5615 Target for the population to be covered:3000-5000 Primary Health Centre (PHC):A Referral Unit for 6 Sub Centres capacity of 4-6 beds manned with a Medical Officer Incharge and 14 subordinate paramedical staff Presently there are 24049 CHCs Avg. Radial Distance(kms):6.42 Avg. number of villages covered:27 Avg. population covered:34641 Target for the population to be covered:30000 Community Health Centre (CHC) Capacity of 30 beds per hospital/Referral Unit for 4 PHCs with Specialized services Presently there are 4833 CHCs Avg. Radial Distance(kms):14.33 Avg. number of villages covered:133 Avg. population covered:172375 Target for the population to be covered:120000 3530 to 18998 18999 to 27467 27468 to 34675 34676 to 83864 Rural Population covered by PHCs Target population to be covered by each PHC : 30,000 • It is evident from the statistics above that there is a long way to reach the norm of one PHC for 30,000 people in many states
  4. 4. OBJECTIVE • Currently, there is no procedure that is followed to locate lower saturated regions and place new health facilities • Access is defined as physical access - in terms of time taken to reach the facility, affordability of the service as well as the medicines, overcrowding and quality of doctors. • In our solution to the problem, we will try to address the problems of geographic accessibility, overcrowding. “ In August 2006, Goa's local newspapers carried a series of reports on the inadequacies of the state's primary health system. Patients testified to the loss of family members due to lack of access to health services in their vicinity. Kushawati Gaonkar, who lives in a village in Corla, Quepem, is 35 kms from the nearest health centre. Four years ago she lost her baby because she could not access its services in time. In another instance, Srikant Devidas of Sulcorna could not be saved when he collapsed while working in a Quepem field. The nearest health centre was 32 kms away ̋  To provide an outline of an algorithm to place health facilities in a district to maximize access to quality primary health care for the population of that district.
  5. 5. Geolocation • Geolocation of health services ( PHC, CHC, SC ) by using Google Maps PlottingVoronoi Polygons • PlottingVoronoi* polygons. Each of the polygon will have only one of the health service and all the points in the polygon will be closest to the same health service Introduce road networks • Simple voronoi polygons will only determine distace from health centre in Euclidian sense • We inroduce road networks and skew the polygons based on the parameter - “time required by a person to reach a health service” Population per polygon • Look for the number of settlements in a polygon and find the population that is covered by a polygon.Approximation :A settlement is concentrated at the centroid Saturation Index • Compute Saturation index ( S ) = 𝑊1 𝑃 𝑃𝑜 + 𝑊2 𝐶 𝐶 𝑜 • P=Population corresponding to the voronoi polygon ; Po=Population norm per health facility ; C=Capacity of health facility ; Co=Base capacity;W1 and W2 are weights M E T H O D O L O G Y *Voronoi polygon – “A polygon whose interior consists of all points in the plane which are closer to a particular lattice point than to any other. ” (Wolfram MathWorld)
  6. 6. SNAPSHOT FOR GOA  Geolocate the Health Facilities  Make voronoi polygons around the health facilities using QGIS • Here, the particular lattice point is a Primary health centre.The same technique could be used for Community health centres and cub centres. • We have illustrated only the first two steps of the solution in this presentation by taking Goa as the sample region. - PHC
  7. 7. IMPLEMENTATION OF THE SOLUTION  Placing any public facility in an area must be closely scrutinized as there could be a lot of local and subjective factors which must be taken into consideration.  Hence, an algorithm that adequately captures every nuance involved would be too complicated to be helpful.  The algorithm provided in our solution points at those polygons which seem to be undersaturated. The actual placement of the facility in the polygon is left to the person responsible.  Considering that there has to be a balance between the subjective nature of the problem and the objective of the problem which is to maximize access, we believe that the algorithm is best used at the district level as a tool to indicate undersaturated areas in the district.
  8. 8. IMPACT  The impact of the idea proposed can be measured directly by the change in the saturation index ( S ) in the region.  The algorithm can be used as an indicative tool in any region to place health facilities.  The performance of the algorithm can also be measured by the improvements in the major health indicators such as infant mortality, maternal mortality and life expectancy
  9. 9. LIMITATIONS  Facility location is also largely influenced by political interests, which the algorithm cannot take into account.  Google Maps does not have data of all Primary Health Centres  For example, in Goa, out of the 19 Primary Health Centres, only 11 are listed on Google Maps  However, geolocating Health Facilites manually (i.e. without data from maps) is strenuous  There will be difficulties in implementing the solution in completely disconnected bodies. Example : Islands
  10. 10. REFERENCES  The map data has been sourced from Google Maps.  The GIS software used to make voronoi polygons : QGIS  Twelfth Five Year Plan - Planning Commission, Government of India  Rural Health Statistics in India 2012, Statistics Division, Ministry of Health and Family Welfare, Government of India  Indian Public Health Standards (IPHS) : Guidelines for Primary Health Centres Revised 2012 - Directorate General of Health Services, Ministry of Health & Family Welfare,Government of India  Forbes India : India's Primary Health Care Needs Quick Reform by by Seema Singh, Nilofer D'Souza | Mar 19, 2013  India together : Goa's health care challenges

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