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Parishram Case Study 1 : Develop the long term strategy to combat the
health care problems of underprivileged people
                                                             Presented By:
                                                          Team: Active Y
                                                            Shanu Singh
                                                            Vijay Grover
                                                          NITIE, Mumbai
PROBLEM IDENTIFICATION
   Curative Care Vs Preventive Care
        Focus on the root cause of health problems is not there
        Prevention is considered as the only measure for health problems

   Ignorance
        Illiteracy ratio is 59.40% in rural areas compared to 80.30% in urban areas

   Eating Habits
        Low nutrition value
   Children’s workload
            Work is the primary occupation of 9.4% of girls and 4.2% of boys aged 5 to 14.
            Almost all girls(84.6%) do household work. Boys activities are much more diversified but
             household work being relatively frequent(24.6%)
     Uninvolved School
             Unable to keep track of school children




Source: National Council of Applied Economic Research Report
Economic Factors
       Concentration Of Resources
                   Urban areas constitute major chunk of resources

           Government Health Facilities
                    Primary health care centre has been developed as a three tier system
                    Inadequate presence of government health facilities in rural regions




Source: Ministry of Health and Family Welfare, Mar 2008 Report
Economic Factors Contd..
     Untrained Health Workers
             Trained manpower is the important prerequisite for health care




Source: Ministry of Health and Family Welfare, Mar 2008 Report
Financial Factors
   Few Public-Private –NGOs Collaboration
         Absence of public private collaboration leads to the people in rural areas either opting
         for inefficient and inadequate health facilities of government or expensive but adequate
         health facilities of private institutions

   No Community Health Insurance
        No ready access to money at the time of need
        Manipulation by money lenders in rural areas


   Unaffordable Health Care
        Low income of people in rural areas
        Commercialization of private medical practice
IMMEDIATE RESPONSE SYSTEM TO ADDRESS PROBLEMS
mHEALTH – HEALTHCARE THROUGH MOBILE
      Uses of mHealth applications
            Collecting community and clinical health data
            Delivery of healthcare information to practitioners and patients
     Motivations behind using mHealth
            Large mass, high burden disease prevalence and low health care workforce
            Lowering information and transaction costs

   mHealth Framework




Source: United Nations Foundation and Vodafone Foundation Technology Partnership Report On mHealth
mHealth Value Chain
   Value Chain Participants
        Forge strong partnerships across sectors (for-profit, non-profit and public sector).
        Understanding of the needs and interests of multiple players is required in order to
         marshal their energy and resources
Health Camp
    Challenges
           Limited resources like medical equipments, practitioners
          Immediate damage control


    SOLUTION PROPOSED
   Centralized high density location such as          Child (Age 5-15) centric diagnostic
    Melas/Haat should be leveraged to launch            and preventive camps should be
    health camp facility                                organized at the local School Level
       Night Time Camp: Highlight the                     Cover each and every child

         importance of preventive methodology              Empower faculty to understand
         through specially designed videos.                  different medical condition
       Day Time Camp: NGO can invite guest                  symptoms.
         medical practitioners from nearby cities          Disperse knowledge about good
         to provide free consultation along with             and cheap eating habits e.g.:
         free distribution of medicine like folic            cheap source of natural vitamins,
         acid and vitamins to the villager                   minerals and protein.
Collaborative Efforts
   Challenges
        Actors involved currently works independently leading to duplication
             1st Level – Panchayat/village level practitioner eg – ayurvedic vedh
             2nd Level – Separate Govt. healthcare campaign
             3rd Level – Similar cause NGO and community based organization


SOLUTION PROPOSED

   Collaboration Level A (Short Term)                     Collaboration Level B (Long Term)
      1st Level – Centralized location                        Prevent any duplication of efforts

         under single gram panchayat                              and bring in quality service
      2nd Level – Different government                        NGO can go for adoption of

         agencies and campaign should pool in                    village/gram panchayat.
         common resources                                      Responsibility of end-to-end
      3rd Level – Specialized NGOs such                         health care facility
         as eye care, maternal and child care                  Budget approved and financed
         should setup common facilities like                     by government (7th plan)
         medical van to increase the span of                   Bring in quality and efficiency.
         coverage.
Long Term Strategy to Combat Healthcare
Problems
Preventive Health Services
   Awareness Campaign – Emphasize on the need of easily available source
    of various nutrients, vitamins.
   Free distribution of medicines like folic acid, vitamins and calcium
    especially for children and pregnant ladies.
   Cost effectiveness ratio
Improvement in Infrastructure And Services
      Increase In Resources
      Equity In Distribution Of Resources
      Partnership In Quality Health Services
      PPP Framework
            Capitalization Of Resources
            Private Sector Efficiencies




Source: MGI India Consumer Model
Empowerment Of Panchayati Raj Institutions
   Ownership of public delivery system
   Village Health Committee should be given certified vocational training
   Develop and deliver village health plan

Outcome of one of such field based study in Gujarat
      Ensured better attendance of health care functionaries at the local level.

      Exerted moral pressure on health staff not to shirk from work.

      Contributed in improving the supplies of drug and equipment
Community Based Health Insurance
   The coverage by community health insurance scheme by community
    organizations is limited to 30 million.
   Imperative need to involve NGOs and community based organizations as
    insurance providers and as a third party administrators.
   Challenges – Propositions
        Premium Payment - Premium payment should be aligned with the agricultural
         production season
        Healthcare Service Access – Insurance company can provide medical van facility in
         coordination with regional NGO
        Preventive Model – Insurance companies can concentrate on preventive methodology
         to reduce premiums in long run
Resource Generation Through Philanthropy
   Current philanthropic activity framework
        Donors: Individuals, corporations and governments.
        Supporting Networks: Philanthropic venture, Red Cross, dedicated funds like the
         Prime Minister’s National Relief Fund
        Grass Root NGO: These NGO disburses donations as part of their healthcare
         activities.
Model for Philanthropy
Road Blocks – Proposed Strategy
    Lower Income Group
         Involve regional people to increase program penetration
         The community leader or the Sarpanch can be core committee member of the NGO.
         Share the success stories of any program undertaken by the NGO

    Middle Income (400 million people )
         Lack of trust in NGO – Highlight the major achievements and initiatives
         Politically motivated NGO – Promote apolitical image, associate with social figure
         Lack of transparency - Annual general meeting with open Q&A sessions

    High net worth individual
         long term association even without any financial gain will be strategic

    Corporate
         Corporate leaders can be represented in the advisory board of NGO
         NGO can collaborate in the CSR activities of the organizations.
         Corporate executive can be encouraged to form executive giving circles e.g. – Melinda
          gates foundation AIDS and Malaria initiatives
Thanks

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Parishram case study 1

  • 1. Parishram Case Study 1 : Develop the long term strategy to combat the health care problems of underprivileged people Presented By: Team: Active Y Shanu Singh Vijay Grover NITIE, Mumbai
  • 3. Curative Care Vs Preventive Care  Focus on the root cause of health problems is not there  Prevention is considered as the only measure for health problems  Ignorance  Illiteracy ratio is 59.40% in rural areas compared to 80.30% in urban areas  Eating Habits  Low nutrition value
  • 4. Children’s workload  Work is the primary occupation of 9.4% of girls and 4.2% of boys aged 5 to 14.  Almost all girls(84.6%) do household work. Boys activities are much more diversified but household work being relatively frequent(24.6%)  Uninvolved School  Unable to keep track of school children Source: National Council of Applied Economic Research Report
  • 5. Economic Factors  Concentration Of Resources  Urban areas constitute major chunk of resources  Government Health Facilities  Primary health care centre has been developed as a three tier system  Inadequate presence of government health facilities in rural regions Source: Ministry of Health and Family Welfare, Mar 2008 Report
  • 6. Economic Factors Contd..  Untrained Health Workers  Trained manpower is the important prerequisite for health care Source: Ministry of Health and Family Welfare, Mar 2008 Report
  • 7. Financial Factors  Few Public-Private –NGOs Collaboration  Absence of public private collaboration leads to the people in rural areas either opting for inefficient and inadequate health facilities of government or expensive but adequate health facilities of private institutions  No Community Health Insurance  No ready access to money at the time of need  Manipulation by money lenders in rural areas  Unaffordable Health Care  Low income of people in rural areas  Commercialization of private medical practice
  • 8. IMMEDIATE RESPONSE SYSTEM TO ADDRESS PROBLEMS
  • 9. mHEALTH – HEALTHCARE THROUGH MOBILE  Uses of mHealth applications  Collecting community and clinical health data  Delivery of healthcare information to practitioners and patients  Motivations behind using mHealth  Large mass, high burden disease prevalence and low health care workforce  Lowering information and transaction costs mHealth Framework Source: United Nations Foundation and Vodafone Foundation Technology Partnership Report On mHealth
  • 10. mHealth Value Chain  Value Chain Participants  Forge strong partnerships across sectors (for-profit, non-profit and public sector).  Understanding of the needs and interests of multiple players is required in order to marshal their energy and resources
  • 11. Health Camp  Challenges  Limited resources like medical equipments, practitioners  Immediate damage control SOLUTION PROPOSED  Centralized high density location such as  Child (Age 5-15) centric diagnostic Melas/Haat should be leveraged to launch and preventive camps should be health camp facility organized at the local School Level  Night Time Camp: Highlight the  Cover each and every child importance of preventive methodology  Empower faculty to understand through specially designed videos. different medical condition  Day Time Camp: NGO can invite guest symptoms. medical practitioners from nearby cities  Disperse knowledge about good to provide free consultation along with and cheap eating habits e.g.: free distribution of medicine like folic cheap source of natural vitamins, acid and vitamins to the villager minerals and protein.
  • 12. Collaborative Efforts  Challenges  Actors involved currently works independently leading to duplication  1st Level – Panchayat/village level practitioner eg – ayurvedic vedh  2nd Level – Separate Govt. healthcare campaign  3rd Level – Similar cause NGO and community based organization SOLUTION PROPOSED  Collaboration Level A (Short Term)  Collaboration Level B (Long Term)  1st Level – Centralized location  Prevent any duplication of efforts under single gram panchayat and bring in quality service  2nd Level – Different government  NGO can go for adoption of agencies and campaign should pool in village/gram panchayat. common resources  Responsibility of end-to-end  3rd Level – Specialized NGOs such health care facility as eye care, maternal and child care  Budget approved and financed should setup common facilities like by government (7th plan) medical van to increase the span of  Bring in quality and efficiency. coverage.
  • 13. Long Term Strategy to Combat Healthcare Problems
  • 14. Preventive Health Services  Awareness Campaign – Emphasize on the need of easily available source of various nutrients, vitamins.  Free distribution of medicines like folic acid, vitamins and calcium especially for children and pregnant ladies.  Cost effectiveness ratio
  • 15. Improvement in Infrastructure And Services  Increase In Resources  Equity In Distribution Of Resources  Partnership In Quality Health Services  PPP Framework  Capitalization Of Resources  Private Sector Efficiencies Source: MGI India Consumer Model
  • 16. Empowerment Of Panchayati Raj Institutions  Ownership of public delivery system  Village Health Committee should be given certified vocational training  Develop and deliver village health plan Outcome of one of such field based study in Gujarat  Ensured better attendance of health care functionaries at the local level.  Exerted moral pressure on health staff not to shirk from work.  Contributed in improving the supplies of drug and equipment
  • 17. Community Based Health Insurance  The coverage by community health insurance scheme by community organizations is limited to 30 million.  Imperative need to involve NGOs and community based organizations as insurance providers and as a third party administrators.  Challenges – Propositions  Premium Payment - Premium payment should be aligned with the agricultural production season  Healthcare Service Access – Insurance company can provide medical van facility in coordination with regional NGO  Preventive Model – Insurance companies can concentrate on preventive methodology to reduce premiums in long run
  • 18. Resource Generation Through Philanthropy  Current philanthropic activity framework  Donors: Individuals, corporations and governments.  Supporting Networks: Philanthropic venture, Red Cross, dedicated funds like the Prime Minister’s National Relief Fund  Grass Root NGO: These NGO disburses donations as part of their healthcare activities.
  • 20. Road Blocks – Proposed Strategy  Lower Income Group  Involve regional people to increase program penetration  The community leader or the Sarpanch can be core committee member of the NGO.  Share the success stories of any program undertaken by the NGO  Middle Income (400 million people )  Lack of trust in NGO – Highlight the major achievements and initiatives  Politically motivated NGO – Promote apolitical image, associate with social figure  Lack of transparency - Annual general meeting with open Q&A sessions  High net worth individual  long term association even without any financial gain will be strategic  Corporate  Corporate leaders can be represented in the advisory board of NGO  NGO can collaborate in the CSR activities of the organizations.  Corporate executive can be encouraged to form executive giving circles e.g. – Melinda gates foundation AIDS and Malaria initiatives