Sanjeevani2
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This document discusses improving primary healthcare in India through a public-private partnership (PPP) model called PCT. The PCT model involves PPP where private partners manage public primary health centers and provide free services. It also involves a community-based health insurance program where premiums are indexed to income to subsidize healthcare for the poor. The model leverages telemedicine to expand access to healthcare in rural and remote areas. While this approach could improve access, efficiency and quality of care, challenges like lack of policy strategy and oversight would need to be addressed through pilot testing and performance evaluations.
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Sanjeevani2
- 1. HEALING TOUCH: Universalizing access to quality primary healthcare PRESENTED BY TEAM: SANJEEVANI 2
- 2. PRIMARY HEALTH CARE Last year the Central government said it would set aside Rs. 28,560 crore over five years to provide essential medicines free and cover 57% of the population Latest budget barely finds any mention for a provision of this kind, instead is a nominal increase in outlay by Rs. 457 crore An advisor of the World Bank states: “Rs. 100 crore worth of drugs were procured. But the health secretary did not know what to do with drugs worth Rs. 35 crore. There was no demand.” “Suction equipment worth Rs. 150 crore being dumped in toilets.” In some parts of country, people have MALDISTRIBUTED PROMISED PROGRAMMES UNIVERSAL HEALTH COVERAGE NATIONAL URBAN HEALTH MISSION RURAL HEALTH MISSION FREE ESSENTIAL MEDICINES RASHTRIYA SWASTHIYA BIMA YOJANA UNDERDEVELOPED PRIMARY HEALTHCARE Like building up a bee comb for years together and not oozing out even a drop of honey…!!!!
- 4. Only have some for of insurance Have to borrow money or sell their assets to meet their health care expenses Indians slip below the poverty line because of hospitalization due to a single bout of illness Global diseases burden Highest among countries with a high rate of HIV- infected persons 10 % 40 % 25 % 21 % 3rd Maternal and Infant Mortality Rates in India’s poorest districts are worse than the sub- Saharan Africa. Allopathic physicians are highly concentrated in urban areas compared to rural areas (13.3 and 3.3 per 10,000 population, respectively). Out of the 660,856 doctors registered in India, only 12% are in the public sector. Public spending on health care in India is as low as 0.9% of the Gross Domestic Product (GDP) in contrast to a total health expenditure of 5% of GDP making public health expenditure a mere 17%. FACTS AND FIGURES
- 5. PCT MODEL P • Public Private Partnership C • Community Health Insurance T • Telemedicine: Leveraging Technology
- 6. PPP: Public Private Partnership RATIONALE TO COLLABORATE Given respective strengths and weaknesses, neither the public sector nor private sector alone is in the best interest of the health system CONTRACTING MANAGEMENT OF PRIMARY HEALTH CENTRES: Free services- diagnosis, consultation, treatment and drugs. CONTRACTING MANAGEMENT OF COMMUNITY HEALTH CENTRE: Except select surgeries all services are free for poor patients CONTRACTING MANAGEMENT OF DIAGNOSTICS: Free for all poor Patients; Subsidized rate for others
- 7. In cross subsidization schemes, premiums are indexed to the member's income, and access to health care for the poor is as good as (or better) than that for the wealthy. In such schemes, wealthy members subsidize health care costs for poorer members. Community Based Health Insurances The social security scheme's annual premium is Rs.72.5, Rs.30 of which is earmarked for medical insurance, covered to a maximum of Rs.1200/year in case of hospitalization. Women can also become lifetime members of the social security scheme by making a fixed deposit of Rs.700 rupees — interest on this deposit is used to pay the annual premium, and the deposit is returned to the woman when she turns 58. Self Employed Women's Association's Integrated Social Security Scheme Making aware to the whole community (below poverty line) and non-secured women laborers can improve Health Care System. Educating them and driving them to such participation can lessen down the problems. Proposed Solution:
- 8. Insurance coverage according to the members' income groups Protection to claimants from expenses arising from hospitalization (with catastrophic costs i.e >10% consumption of person’s annual income) Reducing the lag time between discharge from hospital and reimbursement Studies have been done on this subject and benefitted community in the following ways:
- 9. Telemedicine in India • ISRO has the following Telemedicine Program in India: 1) Remote/Rural Hospitals and Specialty Hospitals 2) Continuing Medical Education (CME) 3) Mobile Telemedicine Units 4) Disaster Management Support (DMS). Telemedicine during Tsunami The ISRO’s Telemedicine facilities at three hospitals -GB Pant Hospital, INHS Dhanvantari at Port Blair, Andaman Island and Bishop Richardson Hospital at Car Nicobar along with ISRO Grama sat network at eight islands was effectively used during post Tsunami disaster relief work for the benefit of the remote population of Andaman and Nicobar Islands. More such Telemedicine centers are being planned at the primary health centers of various islands of Andaman and Nicobar in India TELEMEDICINE “The delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities” (WHO,2008).
- 10. imPaCT Improve Access & Reach Improve Equity (Reduce out of pocket expenses) Better Efficiency Opportunity to Regulate & Accountability Improve Quality/ Rational Practice Imbibe Best practices Augment Resources- Funds, Technology, HR
- 11. Challenges and Mitigation •Mishandling or Misuse of technology •Lack of penal authority •Concept risk •May not attract enough players •Lack of Policy Driven Strategy- thus lack continuity Political Economic TechnologicalSocial- Legal Mitigation: Well defined health objectives/ Goals Prior Consultation Pilot Testing Timely Payment Performance evaluation Supervision & Monitoring Periodic review of contract clauses
- 12. 1. Bull World Health Organ vol.80 n.8 Genebra Aug. 2002 2. Disaster Medicine, Telemedicine and Integrated Vector Control: United Nation’s Space Technology Program for Disaster Management, Journal of Biology and Life Science ISSN 2157-6076, 2011, Vol. 2, No. 1: E3 3. Forbes India Magazine - India's Primary Health Care Needs Quick Reform 4. Health and Population- Perspectives & Issues 8(3): 135-167, 1985 PRIMARY HEALTH CARE IN INDIA 5. FROM PHILANTHROPY TO HUMAN RIGHT: A Perspective for Activism in the Field of Health Care Dr. Amar Jesani 6. Strengthening of Primary Health Care: Key to Deliver Inclusive Health Care Rajiv Yeravdekar, Vidya Rajiv Yeravdekar, M. A. Tutakne, *Neeta P. Bhatia, Murlidhar Tambe 7. THE PHARMA INNOVATION - JOURNAL Telemedicine- An Innovating Healthcare System In India Vol. 2 No. 4 2013 www.thepharmajournal.com Page | 1 Debjit Bhowmik, S.Duraivel, Rajnish Kumar Singh, K.P.Sampath Kumar* 8. PUBLIC-PRIVATE PARTNERSHIP IN HEALTH CARE : CONTEXT, MODELS, AND LESSONS by A.Venkat Raman, Faculty of Management Studies,University of Delhi, India REFERENCES