This document proposes reforms to address practical loopholes in India's healthcare system. It identifies issues such as insufficient infrastructure and doctors, ignorance of hygienic conditions, insecurity of doctors working in rural areas, inadequate maternal care and training, lack of medical research and development, poor conditions of Ayurvedic treatment, lack of training for frontline health workers, and lack of information and connectivity between facilities. It proposes establishing a Healthcare Management Council (HMCI) at central and state levels to oversee the system. HMCI would include doctors, retired judges/officers, media and community representatives. An administrative wing of army personnel would be deployed to hospitals and primary health centers to improve administration, infrastructure,

1. “SANJEEVANI”
Taking Health Care, From Dusk To Dawn

2. India provides health care access to its citizens through 23109 PHCs and a lot of Govt.
and private hospitals. But despite of having such a chain of medical institutions, the
dismal condition of health care in India is the matter to reevaluate the system.75% of
health care infrastructure in India caters to only 27% of the population. Why? The
question still unanswered.
Practical Loopholes In Health Care System
1. Insufficiency
a. Lack of doctors in Govt. Hospitals. Generally PHCs are guided by only one
doctor(far less than required). Overload of patients on doctors.
b. Lack of required no. of hospitals and medical colleges according to the
population.
c. Lack of appropriate infrastructure of PHCs and Govt. hospitals.
2. Ignorance
a. Replacement of defective equipments and supply of needs in PHCs and Govt.
Hospitals takes a lot of time, thus diverting the channel of patients to apex Govt. or
Private Hospitals.
b. Most of PHCs and Govt. hospitals are in unhygienic condition (major cause of
infant mortality -neonatal causes (52%) & pneumonia (13%) which results from
unhygienic condition).
3. Insecurity
Doctors unwilling to take rural (PHCs) posting because:
a. Unavailability of proper facilities in rural areas.
b. Low salary of doctors (only Rs. 30000). They can earn much more in urban areas.
c. Capable doctors don’t take complicated cases (in PHCs).In case of unsuccessful
treatment village mob will try to cause harm (it happens).Doctors are insecure ,thus
they refer channel of patients, increasing the load of apex Govt. hospitals.

3. 4. Inane Mothers
Maternal deaths, the only reason behind is bleeding during delivery. Delivery in
hospitals can stop bleeding by clotting medicines. Absence of 5 C’s and neither
trained nor educated Dai’s system of rural India are reckoning causes of maternal
deaths. And this is just the lack of knowledge
5. Inadequate R&D
a. Dignified posts of apex Govt. hospitals and Medical colleges under political
influences are dominated by some doctors who are busy in making money and
patients’ treatments. Though they are updated with latest technology but seldom
contribute anything to R&D.
b. Central Govt. have no scheme to fund the R&D works of medical students.
6. Inarticulate Ayurveda
a. Dismal conditions of ayurvedic treatment.
b. No R&D works in Ayurveda.
c. Now , Ayurveda itself needs “Sanjeevani” to stand tall in front of chemicals.
7. Incapable ANM & ASHA
Lack of regular training sessions for ANMs and ASHAs.
8. Information & Connectivity – ‘Unplugged’
a. Lack of proper information sources for patients.
b. Lack of Connectivity of PHCs to the higher hospitals and appropriate referral
system.

4. 1. Towards Sufficiency
a. Increasing the no. of seats in medical colleges
b. Increasing the no. of Medical colleges and Hospitals in different geographic regions
based on the population of that region.
c. Special emphasis should be given on the increase of PG seats because a good doctor
can only be produced after doing the PG (seats should be increased by three fold).
d. All the doctors after PG should be given a mandatory 2 years of rural posting and the
salary equivalent to the one specified for the doctors.
e. Enhancing the infrastructure of PHCs and Govt. hospitals. Roughly, each PHC caters to
the population of around 50000. But the no. of beds available in most PHCs are around 6-8
which should be increased to 25-30 to serve in efficient manner.24 hour electricity should
also be provided (by generators).
2. Secured Doctors
a. Increasing the salary of the doctors especially who are posted in rural areas will be a
kind of motivation will be a kind of motivation for them.
b. Every PHC in rural areas should have 3-4 doctors’ quarter.
3. Articulate Ayurveda
a. Existing Colleges and Hospitals should be rejuvenated.
b. R&D should be promoted in Ayurveda.
c. The great treatment of Ayurveda (which can even cure paralysis and many more ) which
are pin point at few locations should be scattered across the country through proper
promotion by some brand ambassador.
d. Medicinal parks should be opened and grown all across the country.

5. Benefits- i. Ecofriendly India
ii. Help in growing rare medicinal plants and therefore
increasing the scope of R&D
iii. Access of common people to the medicinal plants (with
proper guidance available in medicinal parks) will help them to cure some
diseases at their level itself. This will really help not only below poverty line
people but also everyone in giving a proper Ayurveda based first aid to the
sufferer.
e. As Ayurveda seldom includes surgery , so introducing Distance
Learning in Ayuvedic curricula with certain lecture sessions every month
through out the year will help increase innovation ( # Medicinal parks will be
available as laboratory across the country).
4. From Ignorance to Unplugged –“ All Will Be Replugged ”
Jittery health care system is the ramification of poor administration and
ineffective implementation of rules and regulation.
There is an institute to keep check on the various happenings of the
medical field . But our team proposes an alternative to existent Council
to get rid of improper functioning with some innovative changes.

6. Structure
HMCI, an independent institute at the Central as well as State level which can make
decision making procedure to improve health care services and system in India.
Members of HMCI can be categorized into two wings:
1. Decision Making Wing:
Its members includes-
a. Doctors -To oversee the medical affairs (only those doctors who has at
least one research paper in that year).
b. Ex-Chief Justice or Retired Generals/Majors or select IAS and CBI officers –
To watch on the administration of the HMCI and eliminate unethical and corrupt
practices in the health care system and take harsh action against the guilty (only those
who have clean records).
c. Media Representatives – Select media persons any unethical things or
practice public and maintain transparency in the working of HMCI.
d. Community representative - This will Provoke community participation and
acts as a whistle blower for the change.
Media and Community Representative should be given proper security The tenure for
the members will be three years . No member could become the member in the same
state again. One can become the member for State HMCI only three times. Selection
Procedure of State HMCI will be made by Central HMCI . For Central HMCI , selection
will be made by different State HMCI’s through internal voting.
2. Administrative Wing:
It should consist Army men especially hired under health wing in NDA(a new plan
which also involves defense) to improve administration and ensure rules and
regulation in PHCSs and Govt. Hospitals.
No. of Army men deployed , for PHCs, it should be 3-4 and for hospitals, 15-20 ,
more or less according to the need. The duty centers of A.W must be changed
every six month.

7. 1. State HMCI will register all medical practitioners and private hospitals with itself,
making the list online and stating their accessibility.
2. The HMCI will provide Doctors Smart Card (DSC) to the registered doctors and
Staff Smart Card (SSC)to nurses and ward boys of a Govt. hospitals . It will also set
attendance record gadget which will be connected to the online system, where
they will swipe to check in and out. Swipe can be done only twice a day. This will
boost punctuality.
3. The A.W will ensure and make reports on services , quality ,hygiene and necessity
of a PHC or Govt. Hospital and send it weekly to the State HMCI. Information of
Defective equipments or requirements if any will be sent the same day and it must
be solved by State HMCI in two working days (max).
4. The A.W will ensure security of Doctors (against the mob) and safety of patients ,
so that no patient is denied of the quality care. It will ensure one attendant per
patient and focus on hygiene.
5. Through weekly reports of A.W and by surprise checking, HMCI will do Health
Survey, the patient based outcome research , to give the patients and practitioners
on the most effective medical option.
6. It will take the motivational step of rewarding top ten PHCs , top five hospitals and
top five doctors in terms of quality care.
7. It will conduct exam for dignified posts of Medical Colleges and Hospitals with
the eligibility to submit at least one research paper in that year.
It will also provide direct funds to the medical students (who applied for it ) for
research works.

8. 8. It should run a society named ‘Sanjeevani’ , whose volunteers include doctors and
medical students, to conduct Health Awareness Camps every month and to train
ANM and ASHA , every six month . This regular training will make ANMs and
ASHAs updated. Trained activists will be able to take proper care of the people
and will be able to bring more local people to PHCs and awareness camps which
will be quite trust generating .This will curtail maternal and infant mortality and
unethical forms of treatments.
9. Even after implementation of HMCI , if quality care is denied , then the patient can
lodge complaint and after proper probe , HMCI holds right to abandon such
doctors (if he is found unethical and guilty).
10. HMCI will be under RTI and application will be entertained within 5 working days.
11. HMCI will provide 24x7 Helpline for patient care to help patients determine the
nearest site , location and travel distance to other sites where services can be
availed.
12. HMCI will ensure appropriate referral system. The focus should be on the proper
connectivity of rudiments to further higher branches. 10 or 20 Aanganwadi Kendra
will be under a PHC. 10 of PHCs will be under a reputed Govt. hospitals. And govt.
hospitals should be under an apex Hospital.
These different level health care units should be connected by video conferencing to
its subsequent lower and higher units. Prescription will be given by Doctors from
higher health care units to its subsequent lower (or in some case directly if required )
based on the history and so even critical cases can be handled properly at lower level
itself.
13. HMCI will ensure that, doctors will prescribe only generic medicines to the patients
in Govt. hospitals and PHCs.

9. If this presented solution will be followed , it will
completely change the dismal conditions of the
India’s health care system. It will make health care
units very hygienic and completely eliminate maternal
and infant mortality from India. It will ensure also
delivery of quality health care services. The solution
will also help Ayurveda to reach its new height
.Further this solution will fill the void of lack of
doctors and infrastructure. It will also allow to
flourish R&D in India in medical field. So , rather than
being trend followers , India will be the trend setter. It
will also make replacement of defective equipment
very fast and on time. Besides it will also generate
employment for youth in different fields in India.

10. Challenges Mitigation
1. It will be difficult for the
people as well as doctors
to accept the army men.
This time army men has to
deal with the civilians.
2. Land acquisition will also
be a great challenge.
3. Estimating its overall
expenses is also a big
challenge.
1. The administration of army
hospitals are finest. If
people will understand that
it is all for their benefits,
then it will solve the purpose
the army men also have to
control their temper which
can be taught during
trainings in NDA.
2. Something to make India
healthy and making it
developed in the long run
can undermine such
challenges.
3. Intellectual Indian Policy
Makers can make it possible.