Case solution to Parishram (saamanjasya2.0)


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Case Study Solution for the case uploaded in name of 'Parishram'. This competition was won at VGSOM, IIT Kharagpur.

Sector: NGO/HealthCare

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Case solution to Parishram (saamanjasya2.0)

  1. 1. ActiveY Parishram 1
  2. 2. ActiveY ParishramExecutive SummaryAffordable and quality health care facilities are still dream for majority in rural India; problemhas been further escalated by ignorance and unawareness regarding healthy living. In thisdemanding situation, collaboration of all the stakeholders including panchayat, NGOs andGovernment is imperative to overhaul the rural health care scenario. NGOs and Governmentshould now direct more energy towards curative care rather than preventive care. Also transfer ofresponsibility and accountability from government institutions to NGOs and panchayat will helpin increasing awareness, eradicating ignorance and bringing in quality health care facilities to themasses. 2
  3. 3. ActiveY ParishramIntroductionIn recent times Indian economy has been growing at tremendous rate and has gained rank inorder of top 10 economies of world. But on the side of human development and health index weare still positioned in lower half of the ranking. This striking contrast gives us a cue that theproblem is deep rooted not just in policies but also in our socio-economic fabric. In order to findthe cause of this multi-facet problem, identification and analysis is done at social, economic,financial and political platform.Problem Identification •FOCUS ON CURATIVE CARE •CONCENTRATION OF RESOURCES IN URBAN •IGNORANCE ON PART OF AREAS PARENTS •INADEQUATE GOVERNMENT •LACK OF AWARENESS HEALTH FACIILITES •UNHEALTHY EATING HABITS •UNAVAILABILITY OF •WORKLOAD ON CHILDREN TRAINED HEALTH WORKERS •LACK OF SCHOOL • LACK OF QUALITY INVOLVEMENT IN CHILDREN • HEALTH SERVICES HEALTH •n SOCIAL ECONOMIC FINANCE POLITICS •FEW PUBLIC-PRIVATE -NGOs •NO TIME BOUND GOAL COLLABORATION •NO INVOLVEMENT OF •NO COMMUNITY BASED PANCHAYAT OR HEALTH INSURANCE COMMUNITY •UNAFFORDABLE HEALTH •COMPETING PRIORITIES SERVICES 3
  4. 4. ActiveY ParishramSocial FactorsTraditionally we have been oriented towards seeking a cure for an existent medical condition.But to tackle the increasing health challenges which we face because of unhealthy eating habitsand living condition, we need to focus on preventive care. Curative care differs from preventivecare as it aims at prevention of the diseases through the adoption of proper life styles,immunization, etc. NUTRITIONAL STATUS OF INDIAN CHILDREN, 2005-06 (IN PER CENT) SOURCE:NATIONAL FAMILY HEALTH SURVEY-3 (2005-06) CHILDREN UNDER THREE URBAN RURAL ALL-INDIA WHO ARE STUNTED 37 47 45 WASTED 19 24 23 UNDERWEIGHT 30 44 40 Fig2. Nutritional status of children in IndiaMajority of the population at the bottom of pyramid is uneducated and unconnected with themain stream of development initiatives. This has led to: 1. Inability to understand the importance of health in initial years of child mental/physical development. This lead to overloading child with home tasks. 2. Lack the awareness required to address the child health problem on the basis of early symptoms. 3. Inability of schools to keep track of child health.Economic FactorsIndia faces a huge need gap in terms of availability of number of hospital beds per 1000population. With a world average of 3.96 hospital beds per 1000 population India stands just a 4
  5. 5. ActiveY Parishramlittle over 0.7 hospital beds per 1000 population. Moreover urban-rural divide is very explicit.There are only 0.2 hospitals beds as compared to 3 in urban areas. Moreover the publicexpenditure per 1000 population in rural areas is only Rs. 80,000 as compared to Rs. 560,000 inurban areas. Unavailability and competency of trained health workers is also a point of concern. RURAL URBAN AREAS (PER 1000 POPULATION) (PER 1000 POPULATION) HOSPITAL BEDS 0.2 3.0 DOCTORS 0.6 3.4 PUBLIC EXPENDITURE Rs. 80,000 Rs. 560,000 OUT OF POCKET Rs. 750,000 Rs. 1,150,000Political FactorsLarge number of well intentioned polices are designed by government but only few of them ableto show the intended results. It is mainly because goals are generally not time bound hence itbrings in corruptions and inefficiency. Moreover panchayat is generally not involved in rollouthence they fail to bring in the required participation in the health program.Moreover, there are several parallel health programs going on with each having its own focusarea therefore it sometimes lead to conflict of interest between different agencies which leads toduplication of efforts and thereby wastage of scarce resources.Financial FactorsInadequacy of affordable health care has lead people in rural areas to either opt for inadequategovernment health facilities or expensive facilities of private institutions. Though some NGOsprovide medical services through hospitals and mobile vans but these are too few in number to 5
  6. 6. ActiveY Parishrambring in the necessary affordability and accessibility to health services. Also absence ofcommunity based health insurance has deprived needy people of the ready access to money andefficient health care services. 6
  7. 7. ActiveY ParishramThe Immediate ResponseImmediate responses are designed to be highly focused and oriented towards masses that are indire need of health services. 1. Bringing in medical facility to each and every village would be bit difficult initially therefore Melas/Haat should be used to launch the concept of a HEALTH CAMP. Since resources are limited therefore to maximize their utilization we can use same platform for multiple purpose: a. Evening/Night time at camp: NGO and government agencies can show especially designed projected videos showcasing the symptoms of health related issues covering fields like anemia, TB etc. Also they can highlight the importance of both preventive and curative methodology. b. Day time at camp: NGO can invite guest medical practitioners from nearby cities to provide free consultation along with free distribution of medicine like folic acid and vitamins to the villagers. 2. NGOs can design special program where they can bring in educated and trained volunteer from the cities to publicize healthy eating habits in villages. Also volunteer must ensure with the help of panchayat that they could prevent household chores and manual work for children below 15 years. 3. NGOs along with district health and education office should actively involve schools in ensuring the health of children. Regular health camps can be arranged at rural schools to keep track of various symptoms of disease in children. 4. Village leadership should be convinced to provide subsidized transport to the children coming from poor background. It will help already malnourished children to maintain energy level. 5. NGO can make use of mHealth, a practice of medical and public health, supported by mobile devices. mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery of healthcare information to practitioners and patients. 7
  8. 8. ActiveY Parishram Motivations behind using mHealth service arise from 2 factors: a. Large mass of rural inhabitants, high burden of disease prevalence and low health care workforce. b. Potential of lowering information and transaction costs in order to deliver improved healthcare. 8
  9. 9. ActiveY ParishramLong term strategy focus area LONG TERM STRATEGY TO COMBAT HEALTH CARE PROBLEMS OF UNDERPRIVILEGED PEOPLE Fig. 4 Long term plan outcome Preventive Health Practices Till now emphasis on preventive care had been on a lower priority because of the burden of communicable diseases like TB, Vector borne diseases etc. Improvement in health status necessitates expanding our energies with equal emphasis on preventive care particularly in the case of HIV/AIDS, child health, and polio. This can be done by awareness campaigns emphasizing the need of easily available source of various nutrients, vitamins etc. Also vitamin and folic acid capsule should be freely distributed especially for children and pregnant ladies. 9
  10. 10. ActiveY Parishram On economic front cost effective ratio shows the saving for preventive measure rather than treatment for existing health problems.Improvement in Rural Health Care Infrastructure and ServicesRural areas have been neglected historically since the main inputs have been limited to familyplanning and more recently immunization services. The only way to remedy this gross disparityis more resources for the health sector at one level and greater equity in distribution of resourcesbetween rural and urban areas at another level. 10
  11. 11. ActiveY ParishramPartnership with not-for-profit NGOs has also gradually evolved from that of advocacy to actualpartnership in quality service delivery and monitoring since Seventh Five-Year Plan. Thegovernment has shown willingness to hand over the government infrastructure to NGOs or otherforms of peoples groups for providing health care to the masses within the assigned budgetaryprovision. This option can be tried in selected blocks as a pilot project.A desired PPP framework under ambit of NRHM would enable capitalization of governmentalresources while ensuring private sector efficiencies in delivery.Empowerment of Panchayati Raj InstitutionsIn order to make health reform touch each and every nook-corner of rural India it is imperative toempower the community. The Panchayati Raj Institutions (PRI), right from the village level todistrict level, would have to be given an ownership of the public health delivery system in theirrespective jurisdiction. Village Health Committee should be given certified vocational trainingby NGOs and district level health office for capability development so that in near future theyshould be able to develop and deliver health plan for each village. 11
  12. 12. ActiveY ParishramOutcome of one of such field based study in Gujarat: a. Improvement in the quality of health care services, especially through ensuring better attendance of health care functionaries at the local level, as well as exerting moral pressure on health staff not to shirk from work. b. Watchful participation of local communities has contributed in some measure in improving the supplies of drug and equipment by assisting health staff by bringing the deficiencies in the supplies to the attention of higher authorities.Community based health insurance by NGOsIn a country of over a billion people, barely 30 million are covered under community healthinsurance scheme by NGOs and other community organizations. In order to reduce the distressof poor household, there is therefore an imperative need to involve NGOs and community basedorganizations as insurance providers and as a third party administrators. Innovative and flexibleinsurance products need to be developed and marketed. The ultimate aim should be to providehealth security to the poor by be ensuring accessible, affordable, accountable and good qualityhospital care.Fund Generation through PhilanthropyPhilanthropic activity framework in India can be understood with the help of followingconstituents. 1. Donors: Individuals, corporations and governments. 2. Supporting Networks: Philanthropic venture, Red Cross, dedicated funds like the Prime Minister’s National Relief Fund. 3. Grass Root NGO: These NGO disburses donations as part of their healthcare activities. 12
  13. 13. ActiveY ParishramIn India individual and corporate donations make up only 10 percent of charitable giving. Whileby comparison, nearly three-fourths of all philanthropy in the US is undertaken by individuals.Hence there lies a huge potential in tapping charity from high- net-worth individual. 13