This document presents a case study on developing a long-term strategy to combat health care problems among underprivileged people in India. It identifies key problems such as a focus on curative rather than preventive care, illiteracy, poor nutrition, children's workloads, and a lack of involvement from schools. Immediate responses proposed include using mobile health applications, organizing health camps, and encouraging collaborative efforts between different actors. The long-term strategy focuses on preventive health services, improving infrastructure and services through increased resources and public-private partnerships, empowering local governments, implementing community-based health insurance, and generating resources through targeted philanthropy programs. Roadblocks to implementation are also addressed.

1. Parishram Case Study 1 : Develop the long term strategy to combat the
health care problems of underprivileged people
Presented By:
Team: Active Y
Shanu Singh
Vijay Grover
NITIE, Mumbai

2. PROBLEM IDENTIFICATION

3.  Curative Care Vs Preventive Care
 Focus on the root cause of health problems is not there
 Prevention is considered as the only measure for health problems
 Ignorance
 Illiteracy ratio is 59.40% in rural areas compared to 80.30% in urban areas
 Eating Habits
 Low nutrition value

4.  Children’s workload
 Work is the primary occupation of 9.4% of girls and 4.2% of boys aged 5 to 14.
 Almost all girls(84.6%) do household work. Boys activities are much more diversified but
household work being relatively frequent(24.6%)
 Uninvolved School
 Unable to keep track of school children
Source: National Council of Applied Economic Research Report

5. Economic Factors
 Concentration Of Resources
 Urban areas constitute major chunk of resources
 Government Health Facilities
 Primary health care centre has been developed as a three tier system
 Inadequate presence of government health facilities in rural regions
Source: Ministry of Health and Family Welfare, Mar 2008 Report

6. Economic Factors Contd..
 Untrained Health Workers
 Trained manpower is the important prerequisite for health care
Source: Ministry of Health and Family Welfare, Mar 2008 Report

7. Financial Factors
 Few Public-Private –NGOs Collaboration
 Absence of public private collaboration leads to the people in rural areas either opting
for inefficient and inadequate health facilities of government or expensive but adequate
health facilities of private institutions
 No Community Health Insurance
 No ready access to money at the time of need
 Manipulation by money lenders in rural areas
 Unaffordable Health Care
 Low income of people in rural areas
 Commercialization of private medical practice

8. IMMEDIATE RESPONSE SYSTEM TO ADDRESS PROBLEMS

9. mHEALTH – HEALTHCARE THROUGH MOBILE
 Uses of mHealth applications
 Collecting community and clinical health data
 Delivery of healthcare information to practitioners and patients
 Motivations behind using mHealth
 Large mass, high burden disease prevalence and low health care workforce
 Lowering information and transaction costs
mHealth Framework
Source: United Nations Foundation and Vodafone Foundation Technology Partnership Report On mHealth

10. mHealth Value Chain
 Value Chain Participants
 Forge strong partnerships across sectors (for-profit, non-profit and public sector).
 Understanding of the needs and interests of multiple players is required in order to
marshal their energy and resources

11. Health Camp
 Challenges
 Limited resources like medical equipments, practitioners
 Immediate damage control
SOLUTION PROPOSED
 Centralized high density location such as  Child (Age 5-15) centric diagnostic
Melas/Haat should be leveraged to launch and preventive camps should be
health camp facility organized at the local School Level
 Night Time Camp: Highlight the  Cover each and every child
importance of preventive methodology  Empower faculty to understand
through specially designed videos. different medical condition
 Day Time Camp: NGO can invite guest symptoms.
medical practitioners from nearby cities  Disperse knowledge about good
to provide free consultation along with and cheap eating habits e.g.:
free distribution of medicine like folic cheap source of natural vitamins,
acid and vitamins to the villager minerals and protein.

12. Collaborative Efforts
 Challenges
 Actors involved currently works independently leading to duplication
 1st Level – Panchayat/village level practitioner eg – ayurvedic vedh
 2nd Level – Separate Govt. healthcare campaign
 3rd Level – Similar cause NGO and community based organization
SOLUTION PROPOSED
 Collaboration Level A (Short Term)  Collaboration Level B (Long Term)
 1st Level – Centralized location  Prevent any duplication of efforts
under single gram panchayat and bring in quality service
 2nd Level – Different government  NGO can go for adoption of
agencies and campaign should pool in village/gram panchayat.
common resources  Responsibility of end-to-end
 3rd Level – Specialized NGOs such health care facility
as eye care, maternal and child care  Budget approved and financed
should setup common facilities like by government (7th plan)
medical van to increase the span of  Bring in quality and efficiency.
coverage.

13. Long Term Strategy to Combat Healthcare
Problems

14. Preventive Health Services
 Awareness Campaign – Emphasize on the need of easily available source
of various nutrients, vitamins.
 Free distribution of medicines like folic acid, vitamins and calcium
especially for children and pregnant ladies.
 Cost effectiveness ratio

15. Improvement in Infrastructure And Services
 Increase In Resources
 Equity In Distribution Of Resources
 Partnership In Quality Health Services
 PPP Framework
 Capitalization Of Resources
 Private Sector Efficiencies
Source: MGI India Consumer Model

16. Empowerment Of Panchayati Raj Institutions
 Ownership of public delivery system
 Village Health Committee should be given certified vocational training
 Develop and deliver village health plan
Outcome of one of such field based study in Gujarat
 Ensured better attendance of health care functionaries at the local level.
 Exerted moral pressure on health staff not to shirk from work.
 Contributed in improving the supplies of drug and equipment

17. Community Based Health Insurance
 The coverage by community health insurance scheme by community
organizations is limited to 30 million.
 Imperative need to involve NGOs and community based organizations as
insurance providers and as a third party administrators.
 Challenges – Propositions
 Premium Payment - Premium payment should be aligned with the agricultural
production season
 Healthcare Service Access – Insurance company can provide medical van facility in
coordination with regional NGO
 Preventive Model – Insurance companies can concentrate on preventive methodology
to reduce premiums in long run

18. Resource Generation Through Philanthropy
 Current philanthropic activity framework
 Donors: Individuals, corporations and governments.
 Supporting Networks: Philanthropic venture, Red Cross, dedicated funds like the
Prime Minister’s National Relief Fund
 Grass Root NGO: These NGO disburses donations as part of their healthcare
activities.

19. Model for Philanthropy

20. Road Blocks – Proposed Strategy
 Lower Income Group
 Involve regional people to increase program penetration
 The community leader or the Sarpanch can be core committee member of the NGO.
 Share the success stories of any program undertaken by the NGO
 Middle Income (400 million people )
 Lack of trust in NGO – Highlight the major achievements and initiatives
 Politically motivated NGO – Promote apolitical image, associate with social figure
 Lack of transparency - Annual general meeting with open Q&A sessions
 High net worth individual
 long term association even without any financial gain will be strategic
 Corporate
 Corporate leaders can be represented in the advisory board of NGO
 NGO can collaborate in the CSR activities of the organizations.
 Corporate executive can be encouraged to form executive giving circles e.g. – Melinda
gates foundation AIDS and Malaria initiatives

21. Thanks