The document proposes a solution called "Sarva Swasthya Chakra" to universalize access to primary healthcare in India. The key elements are: 1) Expanding the reach of primary health centers through public-private partnerships and collaborations with local organizations. 2) Improving the expertise at health centers by training rural health workers and enabling expert consultations through technology. 3) Creating a pull factor for health centers through gamification, community events and awareness campaigns. The goal is to make quality healthcare accessible to more rural Indians in a sustainable way. Challenges around implementation, resources and sustainability are also discussed.

1. Healing Touch: Universalizing
Access to Primary Healthcare
STUDENTS OF T. A. PAI MANAGEMENT INSTITUTE, MANIPAL
TEAM PATTHS
ASHWINI NAGARKATTI|HIMANSHU ARORA| PRATIK DUGAR | TUSHAR NAGALKAR | TRIPTA KAUR BATH

2. • Can a program address the identified theme in a
creative way?Creative/Innovative
• Will a program addressing the theme be feasible given
the resources at hand?
• Would the cost concerns outweigh the gains?
Feasible
• Can such a program be successfully scaled to other
target regions?Scalable
• Does the theme address the most important challenge
that the country faces in the present scenario or does it
address a generic problem?
Contextually
Appropriate
• How much time would be needed for executing a
program that addresses the theme?Time Factor
• Does the theme includes all groups or excludes some
segments of society?Socially Inclusive
• Is the theme politically viable? Could it face the
following challenges?Politically Immune
• Can a program addressing the theme be locally
governed?
• Would it lead to decentralization of power?
Locally Governed
• Will it be easy for such a program to get people’s
support?
People Participation
• Will it lead to a situation where people would become
self-dependent to such an extent that after some
period, the program would no longer be necessitated?
Futuristic
BASED ON
THEME SELECTION
The analogy of India’s current issues can be drawn to Sagar Manthan
from Vishnu Purana which gave 14 jewels (themes)
Although each Jewel (Issue) had immense value, some were more
important than the others
Healing Touch: Universalizing access to Primary Health Care

3. CURRENT SITUTATION
69% of India’s population inhabits rural areas, only 26% of doctors
practice there
Urban India’s physician density is 14 physicians per 10,000
population, on par with many developed countries
Rural India’s physician density is 2 physicians per 10,000
population
India faces 45% shortage of doctors in PHCs
India is called the TB and diabetes capital of the world
Funds allocation in India (1.04% of GDP)
Inconvenient / Number of PHC locations leading to accessibility
issues
In the 11th Five Year Plan, just 64% of the promised allocation of
1.4 lakh Crores was spent on health
There is a vast disparity between the availability of urban and rural healthcare workers in India
Increasing the Reach
Lack of Expertise
Creating a Pull Factor
Tacking the financial constraints
C
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4. Expanding the
reach of
Primary Health
care
Improving the
quality of
expertise in the
Health care
centres
Creating a Pull
factor for the
Primary Health
care centres
Improving the
overall hygiene
conditions
PROPOSED SOLUTION
“SARVA SWASTHYA CHAKRA”
-meaning All round Healthcare of every individual in India can be initiated.
Objectives of
the chakra

5. 1. Expanding Reach of the Primary Health Care
Centres
In the current situation, the healthcare service is prevalent in India
as an alliance, using the market governance model; or the
partnership model. We need to create a community ecosystem
where all the parties work together to achieve a common goal.
• Increasing the number of Public private partnerships with the private hospital chains, NGOs
• This would increase the number of health care centres and doctors in an area
• Eg. The current PPP with the Piramal group
Public Private
Partnership (PPP)
• Collaborate with IT centres present in village like cyber cafes, e-chaupals, sahaj centres etc to expand the reach
of PHCs
• Collaborate with kirana and medical stores to organize immunization camps near a locality. These stores can also
be used for spreading awareness by advertising weekly posters in the stores
Collaborate
• Have mobile vans which would visit to a locality once a week for regular check-ups
• Expand the scope of 24 x 7 helpline 104 to reach all the statesDoor-to-door service

6. 2. Improving Expertise in Primary
Healthcare
The PPPs with private hospital chains would bring in a lot of expertise of quality doctors and management team associated with them.
A qualified doctor from such hospitals can be shared between 3-5 PHCs
Rural health workers can be trained to provide the first line of care
Owing to collaboration with existing IT centres like e-chaupal and sahaj centres, the rural health care workers can connect with expert
doctors who can guide them via virtual mediums like skype etc.
Expert Medical Diagnosis systems can also be employed where computers can be used to solve problems that usually require human
expertise. It would help in identifying diseases and describing methods of treatment.
Retired doctors can be engaged to advise the general public about first line of care through the 24X7 helpline

7. 3. Create Pull factor for Primary Health Care
GAMIFICATION - which would use
game mechanics in a non-game
context to increase user-
engagement at PHCs. This can be
done by
• Organizing fair (mela) and plays (nukkad
natak) near the PHCs with a health related
theme
• Attaching a badge value to getting a health
check up done, like “I did a checkup today”
badges or stamps
Organizing movie screenings to
spread awareness about health care
Distributing pamphlets and taking
up slots on radio
To create a pull factor, we can use
An Illustration of gamification using a simple game Bingo:
Sensitize the community on the benefits of regular health checkups and primary care
Provide villagers with bingo cards
Ask questions pertaining to preventive measures of healthcare
The Bingo cards would be containing answers to the questions instead of cardinal numbers
Several declared winners would be required to go to the PHC for collecting goodies
Impact
A Pull factor is created at the PHC, and the villagers can be attracted for a health check up, thereby providing preventive care

8. 4. Improve Hygiene Conditions
The collaborations with Kirana and Medical stores can be used to advertise about improving hygiene and its positive implications
Tie up with schools and colleges to organize programmes and introduce health awareness related subjects.
The corporates can also be engaged for performing their CSR activities with the Sarva Swasthya Chakra campaign
The melas and Nukkad Nataks organized can also be used for spreading awareness by having health based themes
Water purifying medicines must be provided for free or at very cheap rates in areas where there is a threat of water borne
diseases
Install dustbins at various places in villages to reduce garbage spillage in the area
Pest control at regular intervals at key places like marketplace, panchayat chowks etc.
Providing cash awards/recognition to the cleanest locality/house in the area

9. FINANCIAL ESTIMATIONS
 The proposed project is expected to be a PPP. The bulk of the financing would be done by the Govt. and the remaining by the
Private player
 Additional funding can also be generated from NGO’s, Individual donations through online or Govt. offices
 To attract donations, famous personalities like Filmstars, cricketers, politicians etc. can be invited for various events like fair,
marathons etc.
Cost
Pre - operating
cost
Operating Cost
1. Project Coordinator (1/5 time Physician) : Rs. 2,00,000
2. Paramedic/Computer Operator : Rs. 1,75,000
3. Nurse/medical assistant : Rs. 1,50,000
4. Lab Technician : Rs. 1,00,000
5. Transportation : Rs. 50,000
6. Consumables : Rs. 45,000
7. Miscellaneous (promotional and others) : Rs. 5,00,000
Total operating cost per annum per PHC : Rs. 12,20,000
1. Improvements on PHC’s : Rs. 4,00,000
2. Solar Panels and batteries : Rs. 3,00,000
3. Computers and Printers : Rs. 75,000
4. Testing Equipments : Rs. 2,00,000
5. Medical Supplies, Stationery etc. : Rs. 75,000
6. Furniture and Fixtures : Rs. 50,000
Total per PHC : Rs. 11,00,000

10. IMPACT AND REACH
Potential to cater the
needs of 800 Million
Indians in rural India
Reduction in Death Rate to
6 deaths / 1000 population
(estimation)
Addition of trained
medical staff and doctors
at PHC
Technical competence of
the volunteers to do basic
diagnosis
Ancillary Impact: Increased
Employment due to
professionals required at
PHC’s
Improvement in hygiene
conditions: reducing
diseases and pressure on
hospitals
Net Reduction in
Government spending
Step forward towards the
dream of HEALTH FOR ALL

11. CHALLENGES AND MITIGATION
IMPLEMENTATION RISK
• Project not accepted by the Govt.
• Lack of technical Expertise
• Lack of capital for the project
SUSTAINABILITY RISK
• Project unable to meet its objectives
• PPP not feasible
CHALLENGES
• Project should be attractive for the
private players and the Govt.
• Adequate training and Development
for staff
• Inadequate availability of resources
( both capital and human resources)
MITIGATION
• To develop a self generating model wherein
certain minimal amount of money is taken as
“fees”. Collaboration of Central & State Govt. with
private players can also play a key role.
• Outsourcing IT Infrastructure, training &
development programme to 3rd party vendors.
• Creating awareness and participation at school &
college level through summer camps, social
service programmes etc.

12. REFERENCES
 http://www.giveindia.org/c-56-health.aspx?gclid=CMzkk7Ths7kCFQkF4godBF0ACQ
 http://www.hmri.in/where-we-work/maharashtra.html
 Document relating to PHC proposal submitted by The George Foundation, written by Abraham
George and Rajan Gupta
 http://www.healthissuesindia.com/2013/07/01/interview-of-professor-jacob-john/
 “PRIMARY HEALTH CARE IN INDIA” by Mr. Somnath Roy, Director, National Institute of Health
and Family Welfare, New Mehrauli Road, New Delhi
 http://www.it.bton.ac.uk/staff/lp22/cs237/cs237medicalxsys.html
 http://archive.ispub.com/journal/the-internet-journal-of-medical-informatics/volume-5-
number-2/developing-an-automatic-diagnostic-system-driven-by-consumer-generated-health-
care-data.html#sthash.ffCl7gFq.dpbs
 http://www.isical.ac.in/~sushmita/paper/fexpsys.pdf
 http://www.who.int/bulletin/volumes/86/1/08-010108/en/index.html