Manthan Topic : Healing Touch Universalizing access to quality primary healthcare

Team Details : Arjun Jaiprakash Jatin Agarwal

Disha Agarwal Swathy Babu

Maneesh Mohan ( Christ University Bangalore )

Current Healthcare Landscape

• 103,000 crores / annum spend on healthcare.

• 5.2% of GDP

• 17,000 Crores on retail Pharma. market.

• This spending matches that of other developing countries as a percentage of GDP but low on as per capita basis.

• The ratio of hospital beds to people is 9:10,000.

Below are our Suggestions / Steps to Universalize Primary Level Healthcare.

E - Consultation

PLOT

• Patients in remote localities can consult specialists in urban areas through video calling.

• All rural clinics needed to be installed with necessary equipment, i.e Computer, Internet connection.

OUTCOME

• Access to specialists consultation in the most remote locations.

• Timely discovery of illness.

• Save number of lives.

People in rural areas may be allowed to consult the doctors free of costs.

Doctors should mandatorily engage in giving free “ E - consultation “ for a fixed number of hours per week.

E - Inventory

PLOT

• Stock of all medicines in Govt. clinics are needed to be maintained in computers.

• Quantities of drugs to be maintained in every clinic as per locations to be preset by MCI.

• Order for medicines would be dispatched automatically as and when quantity reduces.

OUTCOME

• Prevent unavailability of drugs.

• Prevent malpractices like black marketing of medicines.

• Faster and smoother functioning in all aspects.

Ce

ntral

datab

ase Lo

cal Inven

tory

Patient

Bar-coding Prescriptions

PLOT

• All patients need to have an ID card/ Number.

• All prescriptions issued need to have a bar code.

• A bar code reader would reveal the drugs prescribed to the patient along with his/her identity.

OUTCOME

• Prevent the patient from being given wrong drugs.

• Enable to keep medical history of a person for future references.

• Prevent misuse of people from buying subsidized drugs in bulks.

Patient

Clinic

Medical History

Mrp. On Testing

PLOT

Unnecessary Medical test are prescribed by doctors at times so as to get commission from testing laboratories.

Commissions may range from 30 – 50%

Forcing laboratories to charge double for performing tests.

Actions Towards Future

Strict laws by MCI

Suspend doctor’s licences.

Maximum charges for each test is needed to be fixed.( Considering required profits for Labs.)

OUTCOME

Cheaper and affordable tests.

Prevent patients from undergoing unnecessary tests.

Mobile Medical Facilities

PLOT

Mobile medical vans should be provided in the rural as well as slums near the urban areas. This way people will be able to get access to primary healthcare.

A good number of vans are required to make this plan successful.

Actions

Must contain all required equipment to deal with and assist casualties.

Must contain one driver and a nurse.

Cost of vehicle and supplies: Rupees 3.5 lakh to 4 lakh per unit.

Area of initial implementation:

Mumbai because of:

Large number of slums and rural areas.

Lack of medical facilities to these areas due to wide reach.

Lack of adequate hospitals in comparison with area of state.

Equidistant Clinics

PLOT

• If clinics are provided at an equal distance in the rural areas then would be beneficial for the people and society and large.

• Clinics at an equal distance of 5 km will be optimal.

OUTCOME

• Access to health care facilities for public in both rural & urban areas.

• Would ensure universalizing primary healthcare.

• Combined with the mobile healthcare facilities this is going to be a success if implemented properly.

Cashless deliveries for pregnant women who are registered under

the Janani Shishu Suraksha Yojana

free medicines, blood, consumables and

diagnostics and free diet for 3 & 7 days post delivery.

Under NRHM TB medicines; made

available free of cost.

provided the patient is confirmed positive for

TB by a qualified doctor and is registered with the Revised National Tuberculosis Control

Program (RNTCP).

Current expenditure = 250 cr

New scheme cost = 800 cr

15 lakh new cases of TB every year

The Congress-led Scheme &its grand goal of providing free health care

In Short More of such schemes

are needed to be implemented.

Initial investment of 1300 Cr under National Rural Health Mission (NRHM) different states

purchase medicines for poorest patients, free of cost.

Focuses on 18 states - Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand,, Jammu and Kashmir, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttarkhand and Uttar Pradesh.

References

• www.nird.org.in/brgf/doc/Rural%20HealthMission_Document.pdf‎ • http://indiabudget.nic.in/ub2013-14/bh/bh1.pdf • http://en.wikipedia.org/wiki/National_Rural_Health_Mission • http://smilefoundationindia.org/smile_on_wheels.htm • http://www.frontline.in/static/html/fl1923/stories/20021122001508200.htm • http://blogs.worldbank.org/developmenttalk/shocking-facts-about-primary-health- care-in-india-and-their-implications