Team Name: KHIFA’S 5 Farheen Aziz, Nikhil Bhargav, Qudsia Ahmad, Megha Jha, Ravi Raj

Manthan Topic: “Healing Touch: Universalising access to quality primary healthcare

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For a country that is touted as the next economic

powerhouse, India’s healthcare scenario paints a far

too dismal picture.

1. Government expenditure is amongst the lowest in the world.

2. Private spending comprises of 86% of India’s total health expenditure.

3. Appalling shortage of health workforce at all levels of health institutional network, majority of them ill trained which adversely affects the quality of care.

4. Dismal state of health infrastructure and poor funding

0

50

100

150

200

250

Govt.Spending(% GDP)

IMR MMR PrivateSpending

India

Sri Lanka

Brazil

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Infrastructural Constraints

1. Gross mismatch between the number of HSCs, PHCs, CHCs and the population covered.

2. For every 10,000 patients there are less than 7 doctors which is appalling.

3. Lack of transportation. facilities(ambulances, mobile vans)

4. Lack of availability of essential generic medicines at the PHCs- improper need assessment, supply not commensurate with indent, lack of transparency and monitory mechanism.

• Increase funding to bridge infrastructural gaps.

• More investement in custom made low-

cost ambulances, mobile vans and other economically viable IT solutions like PDA and exploring the concept of Remote Diagnosis through mobile phones.

Bootlenecks in the achievement of an inclusive and equitable heath regime

Strategic policy interventions to reduce the ruinous health burden on the community

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Educational roadblocks and environmental issues

Bootlenecks in the achievement of an inclusive and equitable heath regime

Strategic policy interventions to reduce the ruinous health burden on the community

1. Lack of Health Education and Sensitization.

2. Environment Pollution: The sordid living conditions leading to various diseases.

• Health education made an integral part of school education at the primary level.

• Promote sports activities and the importance of regular exercising.

• Proactive Municipal intervention for providing safe drinking water and clean surroundings

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Bootlenecks in the achievement of an inclusive and equitable heath regime

Social Issues

1. Prevalence of superstition, myths and misconceptions (villagers are still apprehensive about allopathic treatment) lack of health awareness, illiteracy.

2. Problem of quacks in villages. 3. Lifestyle problems

• Use of awareness drives and science workshops to inculcate a scientific temperament among the rural masses.

• Taking advantage of the fact that the villagers repose a huge trust in these quacks, the quacks should be imparted a basic training and should be allowed to function like they do.

• Awareness, healthy eating habits should be promoted like proper diet, exercising, through the help of pop culture and mass media

Strategic policy interventions to reduce the ruinous health burden on the community

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• Solution and

Manpower shortage and Skill Deficit

1. Highly understaffed and undertrained health workforce.

2. There is a high incidence of lifestyle diseases (Heart disease, hypertension, diabetes, etc) among the rural masses earlier associated with the urban population.

• Motivational training (emphasis on knowledge, skills and attitudes) should be provided.

• Need to have visiting neurologists at the PHCs to address

Bootlenecks in the achievement of an inclusive and equitable heath regime

Strategic policy interventions to reduce the ruinous health burden on the community

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Over centralised, non-participatory healthcare regime, flawed Regulatory

Mechanism and other problems

• Stricter punitive measures if found quitly of negligence.

• Implementing the concept of

regular Janta Darbar on a larger scale to address the problem of corruption at the grassroot level.

• Proper monitoring sytem, social auditing, proper accounting and auditing

1. Inexpertise of the bureaucracy and red tapism leading to wastage, mismanagement and corruption.

2. Underutilization of ‘discretionary funds’ at the HSCs and PHCs.

3. Lack of community pariticipation. 4. Poor monitoring and reporting system

leading to gross negligence, unaccountability, corruption and inefficiency.

Bootlenecks in the achievement of an inclusive and equitable heath regime

Strategic policy interventions to reduce the ruinous health burden on the community

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STAKEHOLDERS

LOCAL GOVT.

BODIES PUBLIC

GOVT. AGENCIES DONORS

NGO’s, Civil

Society, etc

PRIVATE FUNDERS

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MOBILIZATION OF

RESOURCES

Attracting donations

from public by providing tax

benefits.

Funding from Private

Corporate Hospitals on the

lines of Corporate Social

Responsibility (CSR)

Community funding on

the model of Kerala NNPC

Government spending: Increase

GDP share to at least 6%

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CHALLENGES MITIGATION

Concept Risk of Social Participation et al.

• Home-to-home awareness drive with the help of NGOs through the use of mass media, organising nukkad nataks, etc

Unwillingness of Health workforce to serve in rural setup

• Rotational Posting • Rural Posting Allowance and

better facilities • Incentives like negotiable

salary,etc.

Lack of Political will and bureaucratic resistance.

• Mobilization of pressure groups . • Education of public opinion.

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How the proposed reforms will positively impinge on

the current health scenario: A Projection

Significantly improved health indicators (IMR, MMR, etc), helping India reap its demographic dividend and achieve (MDGs)

Change in behavioral pattern of the masses through adoption of healthy, hygienic habits.

Ushering in of a more responsive bureaucratic regime.

Minimal out of pocket expenditure bringing down poverty numbers drastically (nearly 40 million are thrown into poverty due to out of pocket expenditure)

Deepening of democracy through community participation at the grassroot level.

Healthy workforce putting GDP curve on a higher growth trajectory.

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Reference

http://nrhmrajasthan.nic.in/HealthFacalities.htm

http://articles.timesofindia.indiatimes.com/2013-02-27/pre-budget/37329890_1_12th-plan-public-health-allocation

http://health.india.com/diseases-conditions/what-ails-indias-healthcare-system/

http://knowledge.wharton.upenn.edu/india/article.cfm?articleid=4734

http://indiabudget.nic.in/ub2013-14/bh/bh1.pdf

http://articles.timesofindia.indiatimes.com/2013-02-27/pre-budget/37329890_1_12th-plan-public-health-allocation

http://www.indianexpress.com/news/untrained-or-trained-errors-mark-rural-healthcare/1049296/

http://www.indiahealthprogress.in/reports-and-papers/primary-healthcare-needs-top-priority

http://articles.timesofindia.indiatimes.com/2013-07-11/lucknow/40513268_1_patient-medical-university-doctors

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093249/

Economic Survey, 2013

www.indianexpress.com/news/healthcare

data.worldbank.org/indicator

De.Geyndt, Willy, Managing the quality of health care in developing countries, 1995

Crossing the quality chasm: a new health system for the 21st century-2001

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