The document outlines a proposed network of nurses and auxiliary nurse midwives (ANMs) managed by a public health information system (PHIS) to provide primary healthcare services to rural India's population. The model proposes a 4-tier structure with nurses and ANMs at the grassroots level, supported by doctors at the district level and overseen at state and central levels through PHIS. The summary also provides details of implementation, requirements, impacts, and challenges of the proposed primary healthcare network.

1. TEAM DETAILS
Team Coordinator- Karan Gujral Team Name- GENESIS
OTHER TEAM MEMBERS
Mridul Bhattacharyya Vishal Budhiraja
Govind Singh Vivek Agarwal

2. CURRENT SITUATION OF PRIMARY HEALTHCARE IN INDIA
800 million people
live in 6,36,000
Indian Villages
66% of rural Indians do not
have access to the critical
medicines
31% of the population
travels more than 30 kms to
seek healthcare in rural India
8% primary health
centers do not have
Doctors
39% PHCs do not have
lab technicians
18% PHCs do not
have a pharmacist
India spends less than
0.1% in publicly
funded medicines
60% of all health
care expenditure is
out of pocket
75% of India’s health care
infrastructure caters to only
27% of the population
Indian healthcare
expenditure forms
3.87% of GDP
compared to 7.2% of
rest of the BRICS
countries
India ranks 150 out of 214
countries in terms of infant
mortality rates (per 1000
births)
India had a shortfall of
9,148 primary health
centers

3. A network of Nurses/ANMs managed by Information System to
provide primary healthcare to all in rural India
 4 LEVELS – Grass Root, District, State
and Centre
 Panchayat Jurisdiction is the grass
root level
 Nurses/ANMs At Grass Root Level
 A panel of 10 doctors at the district
level
 Public Health information System
(PHIS) – a computerized health care
data communication system
 PHIS handled by Government
School Teachers
 Centralized control while
decentralized operations
 Primary Health care access to all
 The problem of shortage of
DOCTORS in India is resolved to a
great extent
 Low set up and maintenance cost
 Easy implementation
 Inbuilt control mechanism
 Proper utilization of government
infrastructure and available
human resource

5. Model for implementing the mechanism
 Administrative body
 PHIS handled by
professionals
 Administrative body
 PHIS handled by professionals
 Panel of 10 Doctors to guide the Nurses
/ANMs
 Additional doctors from public and private
healthcare centers on nominal fee
 PHIS handled by professionals
 2 Nurses/ANMs for treatment of general diseases,
stitches, dressing
 Medicine storage at Panchayat Aawas
 PHIS handled by School Teachers
 Awareness programs by NGOs with active participation of
school children (especially classes 11th and 12th)
CENTRAL
LEVEL
STATE LEVEL
DISTRICT
LEVEL
GRASS ROOT
LEVEL

6. Implementation of the model
GRASS ROOT LEVEL
Nurses/ ANMs will treat general diseases, put stitches and do dressing
Nurses/ANMs will take out medicines from the stock and write down the
quantity taken out on the quantity sheet
One Government Primary School Teacher will compile the quantity sheet
once a week and send the stock information to the district level through
PHIS
In case the Nurses/ANMs need help, the Panel of doctors would be
informed immediately through PHIS

7. DISTRICT LEVEL
STATE LEVEL
CENTRAL LEVEL
Doctors will be sent to grass root level in case of requirement either from the
panel or from public and private health care centers
Stock reports for medicines required in high quantity will be sent to state level
through PHIS
Small and emergency purchases to be done at district level itself
Bulk medicine purchases to be done at the state level
Monthly reports to be send to the central level through PHIS
Performance analysis
Centralized control

8. Requirements for the mechanism
HUMAN/ PHYSICAL RESOURCE
• Nurses/ANMs
2,60,000
• Doctors
6,710
• School Teachers
1,30,000
• Other Staff
3,355
• Computer Systems
1,31,400
• Technology and Maintenance
FINANCIAL RESOURCE
• Rs 3,120 cr pa
• Rs 402.6 cr pa
• Nil
• Rs 40.26 cr pa
• Rs 197.1 cr pa
• Rs 78.84 cr pa
TOTAL = 3,838.8cr
The programme can be funded by the government which has a budgetary allocation of Rs 3,00,018 cr
for health care from 2012-2017 (12th 5 year plan).

9. IMPACT AND REACH
BENEFICIARIES AWARENESS
DEMOGRAPHIC
DIVIDEND
Over 800 million
Indians living in rural
areas will get access
to quality primary
health care
By 2026 India will have
the largest youth
population. This
programme would
make the entire youth
population healthy
resulting in better
productivity, efficiency
and effectiveness.
Thus, making India a
super power.
The active
participation of
school children
would make them as
well as the society
aware of various
health related issues

10. • Weekly updated financial and operational reports through PHIS
Corruption
• Procurement of cost-effective Generic medicines
Supply of medicines
• Job enlargement to include PHIS
Convincing school authority
• Awareness programmes with the help of NGOs gram panchayat.
Securing cooperation of village heads
• MITIGATIONS
CHALLENGES

11. APPENDIX
References
• www.changemakers.com/healthbiz/entries/new-entry-41
• www.tradingeconomics.com/india/rural-population-growth-annual-
percent-wb-data.html
• en.wikipedia.org/Primary_health_centre
• 12th Five Year Plan (2012-2017), by The Planning Commission of
India
• Forbes India Article on Healthcare and Sanitation in Rural India