Corporates addressing Social Concerns

28 09 2007

Reliance Industries now wants to enter into HealthCare working on developing 1500 Primary HealthCare Centers (PHC) in-line with the Government Health System in India.

Reliance would want to Invest Rs.25,000 Crores into this venture. In the article, there is a questions which has been put across whether this would fit into the Corporate responsibility or is there a business angle to it?

I feel that there is corporate touch to each aspect of service anywhere in this world. Probably, the NGO segment does not fall into this, but even NGO’s work towards creating a model for self-sustainence and longitivity of the organization. So, will this work?

My opnion is that these kind of initiatives will definitely work, and especially, when corporates this big would want to venture into social problem related areas, there would be a huge impact on people. However, corporates venturing into Social problems need to have a different strategy while working on solutions. Traditionally, corporate thinking is different from a common man’s thought process. Here are few pro’s and con’s of corporate involvement in social aspects:

Positives

  1. Initiatives are well marketed – People know about big organization and tend to look at what they are trying to do and play a role in it.
  2. Financial Strength – Organizations have good money and they are ready to take the risk of investing and taking risks.
  3. Management ability – Experienced people have good understanding of basic problems and hence they can manage solutions effectively.

Need Attention

  1. Organizations need to involve well-known and respected personalities who have worked/have been working in solving social problems. Having respective background knowledge would be a huge advantage.
  2. Corporates should not give/create their own direction to solutions of these problems, instead work in association with Government and people who are experienced in the respective fields.

This is a good change in thinking of corporates, I hope this goes in a good and meaningful direction.





HealthCare Personnel in India

7 09 2007

The number of registered Doctors in India has increased from 61,800 in 1951 to 6,45,825 in 2005, which translates to 0.61 Doctors for every 1000 people. To give a comparative analysis, Cuba has 5.91 Doctors for every 1000 people in 2002.
India has 5.9 Doctors, 0.8 Nurses and 0.47 Mid-Wives for 1,000 people which add up to 1.86 Health workers for 1,000 people. As per the Joint Learning Initiative launched by Rockefeller Foundation, on an average, countries with less than 2.5 Health Care workers fail to achieve 80% coverage rate. According to Union Ministry of Health and Family Welfare’s (MOFHW) “Health Information India”, 2004, we had 67, 576 Doctors; which translates to 1 Doctor for 15, 980 people.
The Government’s estimated requirement of specialized surgeons, obstetricians, gynecologists, physicians and pediatricians in 2001 for Community Health Centers in rural areas is 12, 172, but only 6, 617 posts were sanctioned and only 4, 124 positions were filled.

  • There are 122 Private Medical Collages and 119 Government Medical Colleges in India.
  • As per CNN-IBN Lives article published on 30 August 2007, there is 1 Doctor for every 2,200 people.
  • According to an Escorts Heart Institute research document prepared in 2005, it is estimated that India would need 1,00,000 qualified nurses and 5,00,000 Doctors by 2012.
  • There are close to 8000 Hospitals in India with a total of 6,00,000 beds, which translates to only 7 beds for every 10,000 population.
  • India spends around 10% of its GDP (amount) towards HealthCare.




PHC’s in India

26 08 2007

Statistics of PHC’s (Primary Health Center) in India:

There is 1 PHC for every 25,000 population
PHC for – Promotive, Preventive, Curative and Rehabilitative Care
This implies offering a wide range of services such as health education, promotion of nutrition, basic sanitation, the provision of mother and child family welfare services, immunization, disease control and appropriate treatment for illness and injury.

Each PHC is a hub for 5-6 Sub-Centers.
Each PHC is covers 3-4 Villages.
Each PHC is coordinated by a ANM (Auxiliary Mid Wife)

PHC’s will be referral centers for Community Health Centers (CHC), which is a minimum 30 bedded-hospital or higher at the Taluk or District Levels.

WHO Report
According to WHO, PHC’s in India specifically attribute to deterioration of quality services due to parameters like – lack of political commitment, inadequate allocation of financial resources to PHC’s and stagnation of inter-sectoral strategies and community participation. Also in the list of reasons are bureaucratic approach to HealthCare implementation, lack of accountability and responsiveness from general public.

Key Points to observe:
1. PHC’s through out the country have the same number of ANM’s even though the fertility rate varies in different parts of the country.
2. Political interference in creating PHC’s.
3. Government departments are more involved in ensuring government norms are implemented, salaries are paid and minimum facilities are available rather than concentrating on measuring Health System Performance.
4. The DHO (District Health Officer), responsible for implementation of Public Health Systems are not adequately trained.

Strengthening the capacity for Public Health Management at the District and Taluk level is crucial to improving public sector performance.

Why the system is not working as required?
1. Lack of accountability in the system.
2. No formal feedback mechanism to ensure proper implementation of the system.
3. No incentives for Doctors to work in the Rural areas.
4. Irresponsible mind-set of ANM’s (this happens as there is no feedback mechanism)
5. Lack of resources (staff).
6. Current budget allocation of Rs. 75,000 / PHC / Annum is very less when considering the population each PHC has to cater to (5000 people).

What do we do?
1. Periodic HealthCare Education in Schools, Panchayat/Taluk Offices – NGO, Private Institutions and Social Entrepreneurs.
2. Community involvement – Government / Private Partnership
3. Public Health Training programs for DMO’s and other staff – Government / Private Partnership.
4. Appropriate and functioning feedback mechanism to ensure people understand that they are cared for and their feedback is valued for betterment of the system – Government

I will revisit this topic of what we can do better in my forthcoming writings.

Due credits to Neesha Patel, author of Evaluating the role of Primary Health Centers in India.





India HealthCare Project

26 08 2007

India HealthCare Project, is an initiative of CMC which designs and develops PDA (Personal Data Assistant) systems to ANM (Auxiliary Nurse Midwife) who works at the grass-root level of delivering HealthCare. This project has been piloted and implemented in the Nalgonda District of Andhra Pradesh.

Read more on this project at http://www.iimahd.ernet.in/egov/ifip/jun2003/article4.htm.