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Manthan Topic: Healing Touch
Team Glossarium
Hindu College – Delhi University
PROMOTING UNIVERSAL ACCESS TO PRIMARY HEALTHCARE
INTEGRATED MOBILE HEALTHCARE VEHICLE
FOR RURAL INDIA
ACCESS TO UNIVERSAL PRIMARY HEALTHCARE SERVICES IS LIMITED
IN RURAL AND REMOTE AREAS OF INDIA
700 MillionTotal Population
23,458Primary Healthcare Centers (PHC)
1:35000PHCs to Population Ratio
2,533 PHCs Without Doctors
0.6 Doctor per Thousand People
FACTORS LIMITING PRIMARY HEALTHCARE
SERVICE IN RURAL INDIA:
I. INADEQUATE HEALTHCARE
INFRASTRUCTURES
-Remote Locations and Limited
Connectivity
-Poor Power and Electricity Supply
II. LACK OF TRAINED HEALTHCARE
PROVIDERS
-Limited to certain cities and centers
III. AFFORDABILITY OF HEALTHCARE
SERVICES TO THE RURAL POPULATION
RURAL INDIA – A GLANCE
Hypothesis: Failure to establish universal primary healthcare happens due to
lack of infrastructure and awareness in rural areas
PROPOSED SOLUTION: MOBILE HEALTHCARE VEHICLE
Mobile healthcare vehicle
refers to a vehicle which
has been modified in
order to simulate a
healthcare center and
facilitate provision of
healthcare service.
It is provided by the
government to partnering
healthcare centers in order
to expand their operations
and reach remote area.
Vehicles are attended my
medical officers from the
partnering centers and
provides services such as
medical consultation,
distribution of medicines,
etc.
• Healthcare services are integrated with existing government
insurance schemes such as Rashtriya Swasthya Bima Yojana
(RSBY).
• Cost of healthcare services shall be born by partnering centers
and refunded by insurance agencies under such schemes
WHAT WHY WHO
HOW
PROVIDING PRIMARY HEALTHCARE SERVICE ON A MOBILE VEHICLE
IS AN EFFECTIVE WAY IN REACHING THE RURAL POPULATION
STRENGTHS
MOBILE SERVICE REACHES LARGER NUMBER OF
PEOPLE AND EXTENDS TO REMOTE AREAS
ALLOWS FOR THE INTEGRATION OF HEALTHCARE
SERVICES AND AWARNESS BUILDING PROGRAMS
MOBILITY OF MEDICAL OFFICERS TRANSLATES TO
FEWER REQUIREMENT OF MANPOWER
REDUCTION IN HEALTHCARE COSTS DUE TO
INTEGRATION WITH GOVERNMENT HEALTHCARE
AND INSURANCE SCHEMES
LOW CAPITAL INVESTMENT AS COMPARED TO
BUILDING PRIMARY HEALTHCARE CENTERS
PROBLEM-SOLUTION MATRIX
INFRASTRUCTURAL
INADEQUACY
MOBILE VEHICLE
HEALTHCARE SERVICE
LACK OF MANPOWER
DISTRIBUTION OF MANPOWER
FROM STAFFED CENTERS TO
TRAVEL TO DIFFERENT SITES
FINANCING
HEALTHCARE SERVICE
INTERGRATION WITH
GOVERNMENT
INSURANCE PROGRAM
SUSTAINABILITY
MULTI-PARTY INCENTIVE
AND THIRD-PARTY
MONITORING
Stakeholder Analysis
Central
Government
Role: Providing healthcare vehicle, monitoring performance of program
Incentive: Ensuring Universal Primary Healthcare to Citizens
Role: Planning operations, supplying medical officer, providing primary
healthcare service, maintaining healthcare vehicle
Incentive: Extension operations and source of revenue
Role: Administering and Operating funding through existing government
insurance schemes
Incentive: Expanding operations and source of revenue
Healthcare
Centers
Insurance
Agencies
Medical Officers
Role: Carrying out healthcare services and awareness programs
Incentive: Employment with healthcare centers with adjusted pay grade
as per operations
Rural Citizens
Role: Utilizing healthcare services, participating in insurance programs
Incentive: Affordable access to primary healthcare services and
awareness programs
Non-Government
Organizations
Role: Monitoring Implementation of the program
Incentive: Proper utilization of taxpayer’s funds and prevention of
corruption
WIDE RANGE OF PRIMARY SERVICES CAN BE PROVIDED ON A
MOBILE HEALTHCARE VEHICLE
MEDICAL SERVICE
Consultation with visiting
doctor over various
medical symptoms and
prevention of disease
LABORATORY
SERVICE
Collection of sample for
laboratory checking, with
result intimated on next
visit or by post
SCHEME
REGISTRATION
Promotion and
registration of various
government insurance
and healthcare schemes
AWARENESS
BUILDING
Integrated awareness
building program on
personal hygiene, healthy
lifestyle, and prevention
of diseases
ONSITE PHARMACY
Availability of vitamins ,
pills. and medicines ,
expanding to remote
areas
PREVENTION
SERVICES
Services for disease
prevention, such as
immunization and
vaccination
PLANNING
INFRASTRUCTURAL MAPPING
(Partnering Centers Selection)
Quality and Quantity of
Manpower and
Equipment
Ratio of PHCs to
Population
Radius Of Operation
Class A PHC
Class B PHC
Class C PHC
DISTRIBUTION AND OPRATIONAL
MAPPING (Vehicle Distribution)
Class A PHC
Class B PHC
Class C PHC
Most Number of
Vehicles
Medium Number
of Vehicles
Least Number of
Vehicles
Most Manpower
and Target Sites
Medium Manpower
and Target Sites
Least Manpower
and Target Sites
PLANNING IMPLEMENTATION
FINANCES
1. Vehicle funding under the
National Health Mission, with
approximate cost of Rs5 Lakh
per vehicle
2. Payment of Healthcare
services, travel, and medical
officer remuneration to be
integrated with existing
government insurance schemes
3. Treatment package and
payment method shall follow
same procedure applied in case
where patient visits center
directly
MANPOWER
1. Medical Officers shall be
outsourced from partner
medical centers, whether
private or public
2. Remuneration for medical
officers shall be included in
insurance schemes.
3. Drivers/clerks to be
employed by partnering
medical centers, with
remuneration package
integrated under existing
insurance schemes
SERVICES
1. Vehicle shall travel
from one panchayat to another
every working day, with
planning coordinated with
district government.
2. Services shall be integrated
with partnering healthcare
centers, including in cases of
hospitalization or need of
secondary and tertiary services.
PLANNING IMPLEMENTATION MONITORING
• Implementation shall be supervised by the national
and state department of health and family welfare
through regular checks on operation sites and reports
by partner healthcare centers
Government
Supervision
• Hotline for complain regarding the program shall be
printed on each vehicle. It shall be forwarded to the
District Health and Family Department.
Healthcare vehicle
Complain Hotline
• Non-Government Organization operating in the same
field or region shall be integrated as partners of the
program. In supervising operations.
Third-Party
Supervision
Implementation Challenges
Multi-Party Coordination
Coordination between stakeholders on implementation of the program
SOLUTION: Stakeholders must engage in coordinated dialogue to create a clear understanding regarding
respective responsibilities before implementation of the program. Regular discussions should be held upon
implementation to monitor progress and solve any existing issues.
Payment of Healthcare
Integrating Insurance Schemes and
Provision of Healthcare
SOLUTION: Insurance agencies running
government insurance schemes must
ensure prompt payment towards services
provider. Any disputes regarding
reimbursement and healthcare services
must be addressed without disrupting
operations.
Effective Monitoring
Ensuring Proper Utilization of Funds and
Mitigating Corruption
SOLUTION: Third-party reports and
evaluation must be accounted in regular
checks and given considerable attention
in determining authority and distribution
of funds
References
• Reddy et.al, “A Critical Assessment of the Existing Health Insurance
Model in India,” (Delhi: Planning Commission of India,2011).
• Mckinsey&Company, “India Healthcare: Inspiring Opportunities,
Challenging Journeys,” December 2012.
• R.Srinivasan, “Healthcare in India: Vision 2020,”
<http://planningcommission.nic.in/reports/genrep/bkpap2020/26_bg2
020.pdf>.

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Glossarium

  • 1. Manthan Topic: Healing Touch Team Glossarium Hindu College – Delhi University PROMOTING UNIVERSAL ACCESS TO PRIMARY HEALTHCARE INTEGRATED MOBILE HEALTHCARE VEHICLE FOR RURAL INDIA
  • 2. ACCESS TO UNIVERSAL PRIMARY HEALTHCARE SERVICES IS LIMITED IN RURAL AND REMOTE AREAS OF INDIA 700 MillionTotal Population 23,458Primary Healthcare Centers (PHC) 1:35000PHCs to Population Ratio 2,533 PHCs Without Doctors 0.6 Doctor per Thousand People FACTORS LIMITING PRIMARY HEALTHCARE SERVICE IN RURAL INDIA: I. INADEQUATE HEALTHCARE INFRASTRUCTURES -Remote Locations and Limited Connectivity -Poor Power and Electricity Supply II. LACK OF TRAINED HEALTHCARE PROVIDERS -Limited to certain cities and centers III. AFFORDABILITY OF HEALTHCARE SERVICES TO THE RURAL POPULATION RURAL INDIA – A GLANCE Hypothesis: Failure to establish universal primary healthcare happens due to lack of infrastructure and awareness in rural areas
  • 3. PROPOSED SOLUTION: MOBILE HEALTHCARE VEHICLE Mobile healthcare vehicle refers to a vehicle which has been modified in order to simulate a healthcare center and facilitate provision of healthcare service. It is provided by the government to partnering healthcare centers in order to expand their operations and reach remote area. Vehicles are attended my medical officers from the partnering centers and provides services such as medical consultation, distribution of medicines, etc. • Healthcare services are integrated with existing government insurance schemes such as Rashtriya Swasthya Bima Yojana (RSBY). • Cost of healthcare services shall be born by partnering centers and refunded by insurance agencies under such schemes WHAT WHY WHO HOW
  • 4. PROVIDING PRIMARY HEALTHCARE SERVICE ON A MOBILE VEHICLE IS AN EFFECTIVE WAY IN REACHING THE RURAL POPULATION STRENGTHS MOBILE SERVICE REACHES LARGER NUMBER OF PEOPLE AND EXTENDS TO REMOTE AREAS ALLOWS FOR THE INTEGRATION OF HEALTHCARE SERVICES AND AWARNESS BUILDING PROGRAMS MOBILITY OF MEDICAL OFFICERS TRANSLATES TO FEWER REQUIREMENT OF MANPOWER REDUCTION IN HEALTHCARE COSTS DUE TO INTEGRATION WITH GOVERNMENT HEALTHCARE AND INSURANCE SCHEMES LOW CAPITAL INVESTMENT AS COMPARED TO BUILDING PRIMARY HEALTHCARE CENTERS
  • 5. PROBLEM-SOLUTION MATRIX INFRASTRUCTURAL INADEQUACY MOBILE VEHICLE HEALTHCARE SERVICE LACK OF MANPOWER DISTRIBUTION OF MANPOWER FROM STAFFED CENTERS TO TRAVEL TO DIFFERENT SITES FINANCING HEALTHCARE SERVICE INTERGRATION WITH GOVERNMENT INSURANCE PROGRAM SUSTAINABILITY MULTI-PARTY INCENTIVE AND THIRD-PARTY MONITORING
  • 6. Stakeholder Analysis Central Government Role: Providing healthcare vehicle, monitoring performance of program Incentive: Ensuring Universal Primary Healthcare to Citizens Role: Planning operations, supplying medical officer, providing primary healthcare service, maintaining healthcare vehicle Incentive: Extension operations and source of revenue Role: Administering and Operating funding through existing government insurance schemes Incentive: Expanding operations and source of revenue Healthcare Centers Insurance Agencies Medical Officers Role: Carrying out healthcare services and awareness programs Incentive: Employment with healthcare centers with adjusted pay grade as per operations Rural Citizens Role: Utilizing healthcare services, participating in insurance programs Incentive: Affordable access to primary healthcare services and awareness programs Non-Government Organizations Role: Monitoring Implementation of the program Incentive: Proper utilization of taxpayer’s funds and prevention of corruption
  • 7. WIDE RANGE OF PRIMARY SERVICES CAN BE PROVIDED ON A MOBILE HEALTHCARE VEHICLE MEDICAL SERVICE Consultation with visiting doctor over various medical symptoms and prevention of disease LABORATORY SERVICE Collection of sample for laboratory checking, with result intimated on next visit or by post SCHEME REGISTRATION Promotion and registration of various government insurance and healthcare schemes AWARENESS BUILDING Integrated awareness building program on personal hygiene, healthy lifestyle, and prevention of diseases ONSITE PHARMACY Availability of vitamins , pills. and medicines , expanding to remote areas PREVENTION SERVICES Services for disease prevention, such as immunization and vaccination
  • 8. PLANNING INFRASTRUCTURAL MAPPING (Partnering Centers Selection) Quality and Quantity of Manpower and Equipment Ratio of PHCs to Population Radius Of Operation Class A PHC Class B PHC Class C PHC DISTRIBUTION AND OPRATIONAL MAPPING (Vehicle Distribution) Class A PHC Class B PHC Class C PHC Most Number of Vehicles Medium Number of Vehicles Least Number of Vehicles Most Manpower and Target Sites Medium Manpower and Target Sites Least Manpower and Target Sites
  • 9. PLANNING IMPLEMENTATION FINANCES 1. Vehicle funding under the National Health Mission, with approximate cost of Rs5 Lakh per vehicle 2. Payment of Healthcare services, travel, and medical officer remuneration to be integrated with existing government insurance schemes 3. Treatment package and payment method shall follow same procedure applied in case where patient visits center directly MANPOWER 1. Medical Officers shall be outsourced from partner medical centers, whether private or public 2. Remuneration for medical officers shall be included in insurance schemes. 3. Drivers/clerks to be employed by partnering medical centers, with remuneration package integrated under existing insurance schemes SERVICES 1. Vehicle shall travel from one panchayat to another every working day, with planning coordinated with district government. 2. Services shall be integrated with partnering healthcare centers, including in cases of hospitalization or need of secondary and tertiary services.
  • 10. PLANNING IMPLEMENTATION MONITORING • Implementation shall be supervised by the national and state department of health and family welfare through regular checks on operation sites and reports by partner healthcare centers Government Supervision • Hotline for complain regarding the program shall be printed on each vehicle. It shall be forwarded to the District Health and Family Department. Healthcare vehicle Complain Hotline • Non-Government Organization operating in the same field or region shall be integrated as partners of the program. In supervising operations. Third-Party Supervision
  • 11. Implementation Challenges Multi-Party Coordination Coordination between stakeholders on implementation of the program SOLUTION: Stakeholders must engage in coordinated dialogue to create a clear understanding regarding respective responsibilities before implementation of the program. Regular discussions should be held upon implementation to monitor progress and solve any existing issues. Payment of Healthcare Integrating Insurance Schemes and Provision of Healthcare SOLUTION: Insurance agencies running government insurance schemes must ensure prompt payment towards services provider. Any disputes regarding reimbursement and healthcare services must be addressed without disrupting operations. Effective Monitoring Ensuring Proper Utilization of Funds and Mitigating Corruption SOLUTION: Third-party reports and evaluation must be accounted in regular checks and given considerable attention in determining authority and distribution of funds
  • 12. References • Reddy et.al, “A Critical Assessment of the Existing Health Insurance Model in India,” (Delhi: Planning Commission of India,2011). • Mckinsey&Company, “India Healthcare: Inspiring Opportunities, Challenging Journeys,” December 2012. • R.Srinivasan, “Healthcare in India: Vision 2020,” <http://planningcommission.nic.in/reports/genrep/bkpap2020/26_bg2 020.pdf>.