Hospital Management Information System, Gujarat
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The Government of Gujarat (GoG) launched the Hospital Management Information System (HMIS) in 2006 for streamlining the day to day operations and enabling real-time monitoring of government hospitals across the state.
The HMIS has been envisaged to help health administrators in Gujarat to exercise an enhanced monitoring control over the functioning of government hospitals by using decision support indicators, to assist doctors and medical staff to improve health services with readily reference patient records and a work flow enabled less-paper process and to provide efficient and timely treatment to patients through automatic alerts during patient treatment cycle.
Prior to the HMIS, the absence of a coherent management system made the monitoring of diversely located hospitals difficult. Senior level officials were unable to keep adequate track on usage of funds and to record development on various health indicators of the state. At the same time, hospitals were facing day to day operational challenges and inefficiency in patient handling services resulting in wastage of time, manpower and money and a non-transparent and unaccountable working environment.
Through the efforts of the Commissionerate of Health & Family Welfare and Medical Education, the Health & Family Welfare and Medical Education Department of GoG and Tata Consultancy Services Ltd., government hospital processes in Gujarat were re-engineered. This process of re-engineering included the creation of a system of online registration, simplification of diagnostic process through single sample collection, setting up of standardized administrative formats, setting up online inventory management, adoption of standardized biomedical waste management and the proper management and allocation of human resources under the HMIS. HMIS began as a pilot in four hospitals in 2006, by March 2008 the new system became live in all 30 government hospitals across the state.
With the HMIS, the loopholes in the operations of government hospitals throughout Gujarat are sought to be addressed. HMIS has enabled the provision of better care to patients by automating all the major functional areas of government hospitals. It is also facilitating the monitoring of pre-defined health indicators by generating periodic reports for the hospital management as well as state level administrators.
AIIMS Pre Paid Cash Card Seva: Enhancing access to healthcare services
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The Pre-Paid Cash Card Seva was launched as a pilot in the Cardiothoracic and Neurosciences Centre (CNC) of AIIMS by Financial Software & Systems Pvt. Ltd. in June 2012, to provide an institutionalised service delivery window to the patients, thereby relieving them from standing in long queues for accessing basic medical services separately.
Any registered patient of CNC can obtain a Pre Paid Cash Card from the specified counters and pay for all the services availed during his/her treatment at one place, at no additional costs. A simple application form needs to be filled to avail this service. It is either done by the patient himself/herself or can be done by the FSS Representative, in case of illiterate/ linguistically challenged patients. Within minutes an account number is generated which have the patients registered identification number, which is then linked to a plastic cash card, and the patient can start using the facility. The Pre Paid cash card also provides additional facilities like Patient Registration Card Linking, Card Issuance, Top up, Refund and so on.
The Pre-Paid cash card is a first of its kind initiative that integrates technological innovation with social welfare. It holds the promise of not only enhancing quality of medical service, but also boosting access to healthcare services among the general public. Since its inception more than 9000 cards have been issued, and more than 10 transactions are reported every day on an average on a single card.
Barring a few technical challenges the initiative has fared very well in its pilot phase, and will soon be extended to Dr.R.P Centre for Ophthalmic Sciences as well as the Department of Radio Diagnosis within AIIMS itself--by the end of November 2012. The initiative can go a long way in speeding up the pace of medical service delivery in India.
Aarogyam: ICT based digital health mapping programme
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Aarogyam is a unique community based reproductive and child health related service delivery programme based on an end-to-end usage of information and communication technology tools.
Aaarogyam was developed in 2008 to provide a solution to the problem of high rate of maternal and infant mortality rate in the state of Uttar Pradesh.
Under Aarogyam, a village wise database of all the beneficiaries (pregnant/lactating women, children up to 5 years) of an area is being maintained. On the basis of the information provided in the database, the Aarogyam software sends automated alerts in the form of vernacular voice calls/SMS to the beneficiary informing and reminding them about their pending antenatal care, postnatal care and immunization appointments. These alerts are also sent to local level health officials informing them about due services in the area. Aarogyam also has an in-dial facility where beneficiaries can call up to inquire about any maternal and infant related health issues and also file their grievances.
Aarogyam has benefitted more than 1.4 lakh families up to December 2010 in three districts viz. Baghpat, JP Nagar and GB Nagar of U.P. Two lakh more families will be benefitted in four other districts where the scheme has been initiated. So far more than 175,000 automated calls and SMS’s have been sent by the system.
Since its development, Aarogyam is bettering not just the reproductive and child health delivery processes in U.P but is also impacting such processes across the country. The Aarogyam model became an inspiration behind the implementation of the Mother and Child Tracking Programme (MCTP) under the NRHM by providing a workable model to other Indian States for monitoring the delivery of maternal and child health services.
Janani Express Yojana: Health referral transport service in Madhya Pradesh
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The Janani Express Yojana is providing emergency transportation facility to expectant mothers, sick infants and BPL families in rural Madhya Pradesh so as to enable them to avail adequate healthcare facilities on time.
The infant and maternal mortality rate in Madhya Pradesh (M.P) has been amongst the highest in the country as a result of which schemes like the Janani Suraksha Yojana (JSY) for promoting safe institutional deliveries acquire utmost importance.
For JSY to produce results, it has to be accompanied by various supporting factors primary among which is an adequate referral transport service which can transfer expectant women to a medical facility on time. Recognizing the importance of such a transport service, the Government of Madhya Pradesh has launched the Janani Express Yojana (JEY).
Under JEY, pregnant women , sick infants and BPL families can call a call centre and request for a vehicle to take them to the hospital at crucial emergency moments and drop them home after treatment. Call centre operators forward patients requests for transport to the drivers of ambulances that are usually stationed at government hospitals, community health centers (CHCs) and primary health centres(PHCs). The drivers then ensure that patients are transported to the nearest medical facility on time.
Operational since 2006, JEY has significantly increased the rate of institutional delivery in M.P by providing transport services to expectant mothers and ensuring that they are given adequate care on time. A primary reason for JEY's success is a tight monitoring mechanism through an offline software that stores all the details of beneficiaries like name, address, village, time of call, arrival time of ambulance, response time etc. The maintenance of such a robust database makes drivers and call centre operators perform their responsibilities without any delay. The existence of such data also ensures that periodic reports can be sent to higher officials for their review and monitoring. Very soon, the offline software will be converted into a real time online monitoring system which will facilitate regular monitoring by district and state officials.
E-Health Point: Transformation of rural health care
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Patient availing the tele-consultation facility, Source: E-Health Point
E-Health Points (EHPs) are units that provide rural and peri-urban households across five districts of Punjab with access to clean drinking water, medicines, diagnostic tools, and facilities for efficient and timely healthcare.
Healthpoint Services India (HSI) owns and operates E-Health Points (EHP) in the Malwa region of Punjab. These units provide clean filtered drinking water, generic medicines, comprehensive diagnostic services, and advanced tele-medical services to the poor at subsidized rates.
The chief objective of this initiative is to transform rural & peri-urban healthcare delivery and subsequently contribute to the realization of the Millennium Development Goals and India’s National Rural Health Mission.
The E-Health Point model is a for pay model, relying on the efficient use of modern technologies like rural broadband, tele-medical software, low-cost diagnostical equipment, and economical water treatment methods. The project's local staff has been adequately trained to adopt these standardized tools for efficiently delivering healthcare and water facilities to the people.
Since its inauguration in November 2009, these EHPs have provided more than 33,500 tele-medical consultations and performed about 19,500 diagnostic investigations along with providing safe drinking water to about 5,00,000 users daily. At present there are 100 such water points and 8 health points in operation.
By providing rural and peri-urban communities with greater access to high quality health-care and safe drinking water, EHPs are resulting in better health & well-being, enhanced productivity and improved standard of living among people in the Malwa region of Punjab.
High risk pregnancy tracking system in Bundi, Rajasthan
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The High Risk Pregnancy Tracking System in Bundi, Rajasthan, aims to monitor the health of women with high risk pregnancies in the district and ensure that they receive timely assistance and care.
Bundi district in Rajasthan has a very high rate of maternal mortality due to the prevalent illiteracy among women and the general unawareness about pregnancy related risks. In order to address this problem, the district administration designed the High Risk Pregnancy Tracking System in April 2011 to identify women undergoing difficult pregnancies and ensure that they are provided with adequate and timely pregnancy related healthcare facilities so as to avoid any complications during delivery.
Under the programme, a medical survey of pregnant women is conducted on the basis of which high risk cases are identified and marked. Rural health workers keep a track of pregnant women with high risks by marking a circle on their house and alerting the community and family members about their situation. Health workers also maintain a high risk diary with complete details of high risk cases, which is regularly checked by the district medical officers who ensure that the required assistance is extended to the expecting mothers and their families and that periodic tests are conducted to check their haemoglobin level, blood pressure and weight.
The implementation of the High Risk Pregnancy Tracking System did not require major changes in the district health activities and commitments of the administration. The system leveraged existing financial and human resources to cover an additional responsibility in a simple yet effective manner.
One of the major successes of the High Risk Pregnancy Tracking System lies in its ability to create community awareness about pregnancy related risks and the necessary precautions to be taken .The system has succeeded in building a participative environment in the district wherein the entire community is watching out for the pregnant women in their area. In this manner, the new system has reduced the number of maternal deaths in Bundi from 48 in 2009-10 to 28 in 2011-12.
Based on the success of the initiative, the Medical and Health Department of Rajasthan has issued orders to all the hospitals of the state to implement the High Risk Pregnancy Tracking System.
Dr. SMS: Introducing healthcare through mobile technology in Kerala
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An innovative m-governance initiative, Dr SMS was launched by the Kerala State IT Mission in 2008 with the aim to improve people's access to health care related information through simple and innovative use of mobile telephony.
One of the primary challenges that restricts people's utilisation of medical services is the lack of reliable and easily available information related to availability of healthcare in their immediate locality. Recognising this problem, the Kerala State IT Mission (KSITM), the technology implementation wing of the Government of Kerala in India, launched Dr. SMS on 29 May 2008 as a pilot project in Kozhikode district of the state. Drs SMS is an m-health project that was initiated to improve the health of the citizens of Kerala by delivering timely and authentic information on health related resources via short message service (SMS).
The primary objective of this project is to make accessible comprehensive information on medical and diagnostic facilities and to provide informational alerts about emerging diseases through mobile phones. To avail this service, users have to send their query in a preformatted fashion by an SMS to a unique short code number 537252 and within a time frame of 2-3 seconds, they get a return SMS with the information desired. Other than the SMS channel, web portal catering to the internet users has also been prepared for delivering the health infrastructure information that is available at the website - www.drsms.kerala.gov.in.
In a little more than a year of initiation of the preliminary project, Dr. SMS was launched across the state. The project has been especially helpful for the tourists, serving as a first aid kit for them as the latter are largely unaware of sources to access in case of a medical emergency. On an average, this project witnesses 200 transactions in a day. Since the charges accruing to the users are very nominal, everyone who owns a feature phone is able to take benefits of this facility. Encouraged by the wide gained popularity of this initiative, this project that initially started in Kozhikode district has now been expanded to 13 out of 14 districts of Kerala.
HIV/AIDS prevention initiative in India
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Avahan-HIV/AIDS prevention initiative in India. Photo credit: News Tonight
The Bill and Melinda Gates Foundation designed a holistic HIV/AIDS prevention programme for six of Indian states with 83 percent of the country’s HIV infected population.
Avahan, an initiative of the Bill and Melinda Gates Foundation, was implemented in 2003 with the aim of addressing the HIV/AIDS concern in India. Although the Government of India has established National AIDS Controld Organisation (NACO) and introduced comprehensive strategies such as National AIDS Control Programme to realise the goal of HIV prevention and control among the high risk populations, Avahan aims to bridge the gaps in existing initiatives targeted at high risk populations, including female sex workers, their clients, same-sex relations between men, transgenders known as hijra and injecting drug users.
The success of Avahan intervention can be attributed to its flexible working design that allows effective community participation in the form of the provision of peer educators. As a part of its preventive strategy, Avahan established clinics to provide free diagnosis of Sexually Transmitted Infections to high risk individuals. There are provisions for mobile STI clinics as well. Further, free condoms for sex workers and needle and syringe exchange for injecting drug users are promoted by Avahan. In addition, an effective community mobilisation and structural interventions are initiated to addresses distal determinants of HIV risk such as stigma, violence, legal environment, medical infrastructure, mobility, migration.
The programme works closely with the Government of India to avoid duplication of efforts and to maximise the HIV prevention coverage in the country. Eventually, the programme is envisioned to be handed over to the government and the community. Avahan signed a MoU with the NACO in 2009 to trigger this process. In the year 2012 the process will be completed.
e-Mamta: Mother and child information tracking system
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Source: who.int
e-Mamta is a citizen-centric service delivery initiative by the Government of Gujarat. It leverages information and communication technology to track pregnant mothers and children, and integrates non-recipients of services into the health care system
e-Mamta is a name-based mother and child tracking information management system designed to facilitate effective citizen-centric service delivery. It was conceived by the State Rural Health Mission of the Health and Family Welfare department of Gujarat in January 2010.
The programme adopts an innovative working design that harnesses ICT as a tool to strengthen primary health care facilities and service delivery in Gujarat. Based on a case-based tracking software, ‘e-Mamta’ aims at integrating all pregnant mothers and children as recipients of maternal and child health care services.
The innovative information management tool facilitates the completion and continuum of health care by identifying the recipients and non recipients of services and availing necessary services (ante natal care, child birth, post natal care, immunization, and nutrition, adolescent and family planning services) to the non recipients on time.
The impact of the initiative has been widespread. Almost 80% of the total population of Gujarat has been registered into the system. Steps have been adopted by the state government to converge this information management tool with other national level policies and programmes with the objective of enhancing their effectiveness. Moreover, given the success of the programme in Gujarat, NRHM is planning to implement the project across the country.
The contributions of the initiative to the field public health service delivery has been recognised and acknowledged nationally. ‘e-Mamta’ has received the NASSCOM Social Innovation Honour in 2012 and the 15th National e-Governance Award in 2012 for outstanding contributions in citizen-centric delivery.
Mobile-based sanitation monitoring
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OneWorld Foundation India,in collaboration with Water and Sanitation Program, has developed a mobile innovation to capture sanitation data directly from the rural areas.
Total Sanitation Campaign (TSC) is a comprehensive programme to accelerate sanitation coverage in rural areas with access to toilets to all by 2012. The main objective is to eradicate the practice of open defecation, and bring about an improvement in the general quality of life in the rural areas. Since 1999, government made several attempts to improve the sanitation monitoring policy however it still lacks effective implementation of sanitation campaign in most rural areas and requires attention.
Presently, the emphasis is to capture the nature of sanitation behavior rather than just counting the number of toilets constructed in households. The number of toilets provides information on toilet accessibility however it does not tell us the actual usage of toilets as most households continue to openly defecate irrespective of having toilets or not. Secondly, the process of collecting data on toilet construction and sanitation behaviour is cumbersome because development practitioners collect data manually at the village level and as a result; the data collected is inaccurate and not verified.
To address these two main challenges, Water Sanitation Program of World Bank approached OneWorld Foundation to design an IT enabled sanitation monitoring strategy to strengthen TSC by conducting a pilot project in two blocks- Rajir in Bihar and Kandaghat in Himachal Pradesh. The strategy involved training 11 surveyors in each block to collect data from every household via mobile phones with GPS coordinates of location based on a survey questionnaire and the data was sent to the server on real time basis. All sent data were uploaded on the MIS directly in the form of reports. At the completion of data collection, total of 12,842 and 5,664 households were surveyed in Rajgir and Kandaghat, respectively. Despite few challenges, this pilot project was completed in six months and was successful in capturing information based on sanitation behaviour and toilet usage. Owing to its success, it is now ready to be scaled up in other states as well.
Presently, the emphasis is to capture the nature of sanitation behavior rather than just counting the number of toilets constructed in households. The number of toilets provides information on toilet accessibility however it does not tell us the actual usage of toilets as most households continue to openly defecate irrespective of having toilets or not. Secondly, the process of collecting data on toilet construction and sanitation behaviour is cumbersome because development practitioners collect data manually at the village level and as a result; the data collected is inaccurate and not verified.
To address these two main challenges, Water Sanitation Program of World Bank approached OneWorld Foundation to design an IT enabled sanitation monitoring strategy to strengthen TSC by conducting a pilot project in two blocks- Rajir in Bihar and Kandaghat in Himachal Pradesh. The strategy involved training 11 surveyors in each block to collect data from every household via mobile phones with GPS coordinates of location based on a survey questionnaire and the data was sent to the server on real time basis. All sent data were uploaded on the MIS directly in the form of reports. At the completion of data collection, total of 12,842 and 5,664 households were surveyed in Rajgir and Kandaghat, respectively. Despite few challenges, this pilot project was completed in six months and was successful in capturing information based on sanitation behaviour and toilet usage. Owing to its success, it is now ready to be scaled up in other states as well.
Mobile Health Units under NRHM
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Source: NRHM, Assam
The state of Assam has implemented Mobile Health Units to bring healthcare to the doorstep of rural people with basic diagnostics and specialists
The National Rural Health Mission (NRHM) was launched by the Government of India to address the deplorable state of rural health in the country. NRHM is set to run from 2007 to 2012 in all states of India to improve the availability of and access to quality health care by people, particularly for those residing in rural and remote areas, the poor, women and children. In order to put these objectives in action, the NRHM strategies include increasing public expenditure on health, reducing regional imbalance in health infrastructure, pooling resources, integration of organisational structures, organisation of manpower related to health, decentralisation and district management of health programmes, community ownership and management of assets, induction of management and financial personnel into district health system, and operationalising community health centres into functional hospitals meeting Indian Public Health Standards in each block of the country.
Public health system in India has traditionally been marked by striking regional inequalities that have made provision of health care limited largely to certain parts and people of the country. Recognising this lacuna, the NRHM identified 18 high focus states in the country where there is a lack of basic healthcare infrastructure, thereby limiting access to primary health services. Assam is one of those states. The presence of many unserved and uncommutable areas in the state makes provision of the most basic health care services problematic.
Against this background, the Government of Assam introduced the Mobile Medical Units (MMUs) programme in November 2011 in 10 districts, gradually expanding the programme to all 27 districts of Assam. While nearly all states in the country have initiatives similar to MMUs today, it was Assam that came forward with the initiative to bring healthcare to the doorstep of rural people with basic diagnostics and specialists. The programme becomes even more significant considering the role of MMUs in the overall implementation of NRHM in the state. In April 2011, the mid-term review of NRHM adjudged Assam to be the best performing state among all north-eastern states in India.
Public health system in India has traditionally been marked by striking regional inequalities that have made provision of health care limited largely to certain parts and people of the country. Recognising this lacuna, the NRHM identified 18 high focus states in the country where there is a lack of basic healthcare infrastructure, thereby limiting access to primary health services. Assam is one of those states. The presence of many unserved and uncommutable areas in the state makes provision of the most basic health care services problematic.
Against this background, the Government of Assam introduced the Mobile Medical Units (MMUs) programme in November 2011 in 10 districts, gradually expanding the programme to all 27 districts of Assam. While nearly all states in the country have initiatives similar to MMUs today, it was Assam that came forward with the initiative to bring healthcare to the doorstep of rural people with basic diagnostics and specialists. The programme becomes even more significant considering the role of MMUs in the overall implementation of NRHM in the state. In April 2011, the mid-term review of NRHM adjudged Assam to be the best performing state among all north-eastern states in India.
Voucher for institutional delivery through post offices
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The District Health Society in Kamrup district of Assam has designed a unique approach to facilitate cash transfer of voucher for NRHM scheme through post offices.
The state of Assam has successfully implemented many innovations to provide quality healthcare to women and children under the National Rural Health Mission (NRHM). In July 2009, the District Health Society (DHS) of Kamrup-Rural district in Assam collaborated with the Department of Posts to design vouchers for cash transfer under the Janani Suraksha Yojana (JSY) for promoting institutional delivery and Mamoni scheme for providing nutritional support to pregnant women under NRHM in the state.
Till recently, the DHS of Kamrup district was using account payee cheques through recognized banks to make cash payments to women under both the schemes. However, the poor reach of banking facilities in rural Assam presents many challenges in making timely payments to beneficiaries.The voucher for institutional delivery through post office initiative seeks to address these challenges by shifting the payment medium from banks to post offices. The high penetration and accessibility of post offices across the state, rural people’s familiarity with the post office staff and the simple procedure of opening an account at a post office makes post offices a better medium for delivering the cash entitlements under NRHM efficiently and on time.
The voucher for institutional delivery through post office initiative has simplified the process of providing cash benefits under NRHM and is addressing the problem of delay in making payments. It has created an easily accessible channel for the beneficiaries to avail their benefits and has introduced efficiency by providing payments on time. By leveraging existing postal infrastructure and resources for an extra service, the voucher initiative provides a very good example of convergence efforts in public service delivery.
Controlling sickle cell anaemia
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Source: Sickle Cell Foundation of Oregaon, http://dev.yellowsolutions.ro/sicklecell/about_sickle_cell.html
A comprehensive three-step approach is used to check the spread of sickle cell anaemia among the tribal population of Gujarat.
In 2006 the Department of Health and Family Welfare, Government of Gujarat initiated the Sickle Cell Anaemia Control programme to limit the spread of sickle cell anaemia, a genetic blood disorder, in the tribal belt of the state.
The Sickle Cell Anaemia Control Programme uses a three fold approach to address sickle-cell disorder. It involves early screening of patients, administration of treatment and counselling for preventing and managing the disease. The initiative covers all the 12 tribal districts of Gujarat.
From 2006 till March 2011, a total of 13, 96, 904 tribal people have been screened under the programme. The screening helped in identifying 10, 673 sickle disease patients and aided in ensuring that adequate treatment and guidance is delivered to the victims.
Other states in India where the disease is highly prevalent can learn from Gujarat’s example and follow its foot steps to launch similar disease control programmes.
Creating linkages for blood donation
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Indian Blood Donors, a unique SMS-based helpline, connects voluntary blood donors with patients through use of the most accessible ICT tool in India.
In India, recurrent instances of road accidents and bomb blasts combined with a high maternal mortality rate escalates the need for blood in health care services. However, the insufficient number of government and private blood banks, and high prices of blood units prompt the need for an easily accessible yet cost effective channel of donor procurement.
To address these concerns, Indian Blood Donors (IBD) introduced an initiative to create a network of registered voluntary donors willing to provide blood to patient’s. Initially, IBD was a completely web-based project that recorded information of blood donors online at http://www.indianblooddonors.com/default.asp. Subsequently,the concern of accessibility inspired launch of SMS Now project. It was established that in a country with 791.38 million mobile phone users against 81 million internet users the SMS feature stands as the best option to maximise the level of penetration.
With the help of a simple SMS, the donors register themselves with IBD and their information is saved in the database. Later, when a patient sends a request for blood through an SMS, the server automatically triggers a message with relevant details of nearest donor. Simultaneosuly, the donor is informed about the blood requirement through automatic SMS.
The major achievements of the project include its innovatice use of a mobile phone, creation of a pool of voluntary donors, free service, and sharing burden of blood banks across India.
Tele-ophthalmology in Tripura
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Source: istockphoto
The government of Tripura has implemented an ICT facilitated eye care service to extend the benefits of advanced medical science to its rural population.
The government of Tripura has utilised Information and Communication Technology (ICT) to overcome the acute shortage of eye care infrastructure and specialists in the state. Tripura Vision Centre combines the advances in medical science and ICT to connect the state's only public sector hospital, Indira Gandhi Memorial Hospital to 40 blocks in rural Tripura through these vision centres.
The project has not only decentralised eye care in the state but also reduced the burden from secondary health care system. Majority of eye care patients suffering from refractive errors were treated in the Vision Centres itself. Only those with cataract surgical requirements are referred to secondary eye care service hospitals after video consultation from the Vision Centres. Tele-opthamology has improved the access and quality of service delivery by structurally integrating the primary, secondary and tertiary eye care in the state. Regular supervision of the service delivery and cross verification through MIS generated data enable accurate measurement of the quality and effectiveness of the programme.
One of the major highlights of the project has been its utilisation of infrastructure in the existing community information centres (CICs). All the Vision Centres are established in the CIC premises allowing usage of TSWAN connectivity along with bring in the much needed visibility.
The suceessful implementation of this project in Tripura has inspired the Planning Commission of India to incorporate the tele-ophthalmology programme in the 12th Five Year Plan of the country.
Janamanas: Community Mental Health Service
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Source: Anjali Mental Health Rights Organisation
Janamanas, a community healthcare service, works in collaboration with municipalities and local communities to make mental healthcare more accessible and sustainable.
Anjali Mental Health Rights Organisation implemented Janamanas programme to address the concerns of inadequate mental healthcare and to ensure inclusion of mental health in the mainstream healthcare services of the government. Major motivation in introducing this programme is to de-institutionalise mental health services to make it affordable and accessible to the marginalised section of the community.
To achieve the objectives, programme focuses on a community mental healthcare model that provides services through a kiosk managed by local resource-poor women of the community. An extensive need based mental health care training is provided to the barefoot workers to address the need of the patients. The programme works closely with the municipalities to ensure optimal use of available resources, to alter practices of oppressing treatment and to introduce innovative therapies.
Janamanas seeks to create informed and sensitive citizens through a range of awareness camps and workshops. Dissemination of relevant and updated information pertaining to mental health queries, rights and service delivery remain the major focus of these endeavours.
Through creation of a pool of community mental healthcare professionals it is helping not only in filling the vacuum of mental health professionals but also generating employment avenues for resource poor women.
Operation Asha: Participatory Approach to Tuberculosis (TB)
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Source: www.opasha.org
Operation Asha is treating Tuberculosis in urban slum areas through the use of local counsellors to spread awareness and technologies to observe patients on a regular basis.
Operation Asha is the largest NGO in India focusing on Tuberculosis (TB) treatment in urban slum areas. Since 2005, it has been addressing TB-related problems through counselling for patients that have been discriminated against and who are largely ignorant about the disease. Counselling is provided by local community members who are trained to treat patients and regularly monitor the spreading of TB. Operation Asha has also set up treatment centres to monitor patients with a biometric attendance system.
Enhancing Access to Affordable Medicines
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Source: southasiarev.wordpress.com
To improve the healthcare system in Chittorgarh, the district administration conceptualised a simple yet effective programme to introduce low cost drugs to the people.
The Eleventh Five Year Plan recognises access to good quality, low cost medicines as a priority policy concern. In India, at least three-fourths of the total out-of-pocket expenditure is spent on buying essential medicines. The problem becomes more significant because of marketing techniques practiced by pharmaceutical companies, especially towards influencing doctors to prescribe branded medicines. To change this trend, the Chittorgarh administration took the initiative to make medicines more easily accessible.
The programme exploits existing resources to make the system function in favour of the people. The following three steps summarise the process of implemention: a) strictly executing state government orders to prescribe the drugs under salt name, b) procuring good quality medicines for the government co-ops and c) generating awareness among consumers.
The Chittorgarh model has proved constructive in improving the public healthcare system. Overall, the cost of medicines has decreased significantly. There is also increased accessibility to medicines as the government has established additional low cost drug shops and government co-op medical shops.
Boat Clinic - Health Care for Marginalised Communities in Assam
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Centre for North East Studies and Policy Research (C-NES), under the National Rural Health Mission (NRHM) has jointly designed a Boat Clinic programme to provide basic health care services to marginalised communities living in Assam riverine islands.
Starting with Dibrugarh district in 2005, there are now 15 boat clinic teams in 13 districts of Assam. The programme has reached 4.5 lakh persons so far. The organisation has 242 staff, including 30 doctors, 45 nurses, 30 allied health staff, 45 community workers, 60 boat crew, 15 district program officers, 5 family planning counselors and a full programme management unit. Each district has 15 members headed by the District Programme Officer (DPO) who is the key person in organising district plans and coordinates the team, district health departments, district administration, NRHM and the community. Each team comprises of two Doctors, three Nurses, one Laboratory Assistant, one Pharmacist, three Community workers and four Boat crew. The districts covered are Dibrugarh, Tinsukia, Dhemaji, North Lakhimpur, Jorhat, Sonitpur, Morigaon, Kamrup,Nalbari, Bongaigaon, Barpeta, Goalpara and Dhubri.
Rajiv Aarogyasri Health Insurance Scheme
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Rajiv Aarogyasri Health Insurance Scheme aims to deliver quality tertiary healthcare services to the underprivileged sector of the population in the state of Andhra Pradesh.
The Government of Andhra Pradesh launched the Rajiv Aarogyasri Healthcare Insurance Scheme in 2007 for the 2.03 crore below the poverty line (BPL) families in Andhra Pradesh. The scheme aims to achieve ‘Health for all’ by assisting poor families in their struggle out of indebtedness through the provision of free insurance through a unique PPP model.
Under the scheme, BPL families can avail health benefits through affordable insurance. The premium for this policy is financed by the government. A sum of 150,000 rupees is reserved for each BPL family with a buffer amount of 50,000 for unexpected expenditure.
Since the roll out of the scheme, the number of people and diseases covered has greatly increased. An online management system has allowed for the identification of disease trends. The scheme has also contributed to medical research and documentation and has been successful in spreading quality healthcare facilities throughout the state.
Under the scheme, BPL families can avail health benefits through affordable insurance. The premium for this policy is financed by the government. A sum of 150,000 rupees is reserved for each BPL family with a buffer amount of 50,000 for unexpected expenditure.
Since the roll out of the scheme, the number of people and diseases covered has greatly increased. An online management system has allowed for the identification of disease trends. The scheme has also contributed to medical research and documentation and has been successful in spreading quality healthcare facilities throughout the state.
Stree Shakti: A novel approach to women’s empowerment
3 vote(s)
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Project Stree Shakti is a joint collaboration effort of the Government of Delhi, community-based organisations and NGOs to empower women, especially those belonging to economically weaker sections of society.
The initiative comprises integrated capacity building to strengthen the ability of women to participate equally in the mainstream of society. In the first instance, the project has prioritised three areas that significantly impact the process of empowerment namely health, literacy and income generation.
The proposed objectives are met through a Gender Resource Centre. Its activities include the maintenance of a documentation centre and data bank on women’s issues; and dissemination of the data directly and through grass root level NGOs to the target groups. The centre would also act as a bridge between service providers and the community members.
Stree Shakti Camps are also organised, the underlying concept here is that these institutions/programmes should reach the target group at their doorstep within a period of two years.
E-Health.Net, Haryana
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This IT-initiative has been set up by the Haryana state government to provide better health care services to the people.
The project aimed to capture medicine inventory data and facilitated consumption pattern of various medicines location wise. This helped to monitor the pattern and occurrence of disease, pilferage, and the functioning of the health institution. The attendance of doctors and medical staff has improved, test reports are on time and certificates are contributed for the well being of the citizens. This project has been able to bring in change in the health administration of the Haryana state in terms of improving and increasing proper utilization of medicines; and providing affordable treatment at government health institutions to the poor. There has been an overall improvement in the service delivery system and information of Health Department, schemes and programmes in the state were available on the website www.haryanahealth.nic.in.
Reproductive Child Health Service in Urban Slum, Assam; Public Private Partnership for delivery of Reproductive Child Health services in Urban Slum in Guwahati, Assam
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The Reproductive and Child Health (RCH) care program implemented in urban slum locations in Guwahati has been regarded as one of the most practical and successful model for health service delivery for urban poor.
The RCH Guwahati program initiated in 2002 was launched in partnership mode to provide basic health and reproductive services to poor urban women and their children in and around Guwahati city in Assam. The main thrust of the program envisaged under the State Action Plan of the European Commission was designed to address gaps in service delivery by providing outreach services to improve maternal and child health in slum areas where public health service delivery is extremely weak. The programme has addressed issues related to family planning, facilitated the role of State Health department in providing RCH services with partners through PPP model and provided health services at minimal or free of cost. There has also been an increase in the accountability of service providers to the beneficiaries and in the speed of service delivery. As a result, the Guwahati RCH Model is sited as an example of successful Public-private sector partnership for delivery of basic health services to the common man.
Public Private Partnership to Improve Health of Urban Poor in Agra
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Due to the inadequacy of the primary health delivery system in Agra, the UHRC was assigned to develop Urban Health Plan focusing on urban poor in the region in partnership with the government officials, NGOs and the community.
The Urban Health Resource Center (UHRC) initiated an urban health program in partnership with the Government of Uttar Pradesh. It undertook two approaches: The first one involved partnerships with three NGOs in delivering reproductive health services and family planning services such as Family Planning Association of India (FPAI), Naujhil Integrated Rural Project for health and Development (NIRPHAD) and Shri Niroti Lal Buddhist Sansthan (SNBS). The second approach included mobilizing the community and volunteers to enhance demand and utilization of health care through Community Link Volunteers and Mahila Arogya Samitis; and serve the community they belonged. The Government, NGO, Community members and UHRC representatives were the key agents in improving the health care, sanitation and overall empowerment of the urban poor in the region.
Improving Maternal and Child Survival in Tamil Nadu
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The initiative of Department of Health, Tamil Nadu has brought a drastic reduction in maternal mortality and improved child health through innovative strategies and programmes on maternal and infant health policies in the state.
The Health Department with the support from the World Bank and Danish International Development Agency (DANIDA) worked on a phased manner and were successful in bringing down the maternal mortality ratio from 380 per 10,000 live births in 1993 to 90 in 2007. The female infanticide death was also reduced from 3000 per year in 1970 to 70 in 2007. The procedure involved efficiency in reporting and monitoring of maternal and infant deaths in the state and later the reports were sent to the Commissioner for Maternal, Child Health and Welfare within 15 days for investigation called the Maternal Death Audit. Workshops and Programmes were held at district and state level related to maternal care and chances of survival of pregnant women. 24 Hour Primary Health Centres (PHS) were established round the clock to meet emergencies. Other steps included were setting up of Central Emergency Obstetric Care and New Born Care, and Birth Companion Programme.
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