Improving Access to Healthcare – How can Collective Approach help?

Improving access to healthcare for the underprivileged requires a multifaceted approach that addresses both infrastructure and systemic issues. In the last writeup, we discussed the issues plaguing healthcare, you can access the same using the following link.

https://sheyafoundation.com/income-inequality-limited-access-to-healthcare/

In this space we will discuss the key solutions that can help tackle the issues discussed:

1. Strengthening the Primary Healthcare Infrastructure: We need to run location wise audit on the number of PHCs present in district wise manner to under the capacity, distance and space requirements.
   • Expand and Upgrade Primary Health Centers (PHCs): Increase the number of PHCs to match population needs, particularly in underserved rural and remote areas. Help in construction of new PHCs and adoption of existing PHCS to make them model PHCs. Upgrade existing the PHCs to ensure they have adequate space, clean water, electricity, and sanitation. Ensure sponsorship of ROs for clean drinking water, ensure uninterrupted supply of electricity through installation of solar panels especially in CHCs where emergency and obstretrics services are available. It is extremely important to ensure sanitation facilities are available by construction of toilets for patients and PHC personnel.
   • Improve Medical Equipment: Equip PHCs with essential medical tools such as X-ray machines, diagnostic equipment, and basic life-saving devices to enhance service quality and reduce referrals to higher-level facilities.
   • Increase Space and Capacity: Expand space in PHCs for examination rooms, pharmacies, waiting areas, and maternity services to improve patient privacy and care delivery.
2. Addressing the Shortage of Healthcare Workers
   1. Recruit More Doctors, Nurses, and ANMs: Sponsor hiring of healthcare professionals, especially in rural areas. Sponsoring educational opportunities for ANMS, nurses so that they can upskill themselves and in turn are ablet o do a better job.
   2. Reduce Absenteeism: Apart from reducing vacancies, if we can get biometric installed for stricter monitoring to reduce absenteeism in particularly in rural PHCs. Sponsorship of CCTV cameras to be able to monitor activity at the centres by central agencies.
   3. Improve Training and Skill Development: Sponsorship of regular training programs as per need and ensuring continuous medical education (CME) for healthcare workers can ensure that they stay updated on modern medical practices.
   4. Deployment of E-learning and Digital Training Platforms: Ensure E learning via digital platforms so that health workers in remote locations can receive continuous education without the need for frequent travel.
3. Ensuring effective Supply Chain Management and Availability of Medicines
   1. Improve IT Infrastructure and Implementation of Software Solutions: Ensuring all healthcare facilities are well equipped with computers, internet access and software to Implement technology-driven solutions such as digital inventory systems to track stock levels of medicines and diagnostics supplies in real-time, reducing stockouts and shortages.
   2. Efficient Inventory Management. Better Intelligence in procurement and strengthening the procurement through good data practices so that essential medicines can available on timely basis in PHCs and also there is no wastage due to procurement of medicines which are not required in the PHCs.
4. Implementation of Technology and Digital Health Solutions
   1. Implement Electronic Health Records (EHR): ABHA card is an attempt to digitize patient records to ensure better continuity of care, track health outcomes, and provide data for health planning. Sponsorship of ABHA cards for underprivileged populations will help in digitization of health records.
   2. Telemedicine Services: Use telemedicine for specialist consultations so that patient who are not able to travel to referral centres can be benefited through diagnosis and treatment.
   3. Collection of Health Data and Analytics: Utilize data analytics to identify healthcare trends, gaps in service delivery, and areas needing intervention. Improved data collection can guide policy decisions, resource allocation, and targeted health programs.
   4. Use of Artificial Intelligence (AI): AI and machine learning can be used to predict healthcare demand, optimize resource distribution, and even assist in diagnosis in areas with a shortage of healthcare workers.
5. Improving Referral Systems and Transportation
   1. Strengthen Referral Networks: Develop robust referral systems by deploying volunteers who can ensure patients are directed to the appropriate higher-level care facilities with clear communication between PHCs and hospitals. Deployment of personnel at higher referral centres so that patients are directed to the right departments and are handheld until they are discharged.
   2. Increase Ambulance Availability: Provide more ambulances and emergency transportation services in rural areas, and ensure that they are adequately staffed, fuelled, and maintained for emergencies.
6. Reducing Out-of-Pocket Expenditure
   1. Expand Health Insurance Coverage: Help in deployment of government health insurance schemes like Ayushman Bharat – PM-JAY to ensure broader coverage, especially for the underprivileged. Deploy resources at PHCs to ensure education of patients on claim processes so that they do not fall into debt traps due to medical loans.
   2. Subsidize Medicines and Diagnostics: Offer subsidies or free access to essential medicines and diagnostic services in government health facilities to reduce the financial burden on patients.
7. Community Health Awareness and Preventive Care:
   1. Increase Health Education and Outreach: Implement more extensive community outreach programs by deploying additional resources in PHC to ensure door to door screening for NCDs, referral to PHCs for treatment for NCDs apart from raising awareness about preventive healthcare, maternal and child health, immunization, and nutrition.
   2. Mobile Health Units: Deployment of mobile health clinics to remote areas for immunization, health checkups, and screening and treatment to ensure people in faraway locations receive timely healthcare.
8. Public-Private Partnerships (PPP) in Healthcare
   1. Deployment of Private Sector Expertise: Collaboration between Government and private healthcare providers to improve healthcare infrastructure, staffing, and service delivery in underserved areas at subsidized cost. Public-private partnerships can help fill gaps in services, especially for diagnostics, telemedicine, and specialized care through their CSR budget.
   2. Setting up Affordable Clinics: Setting up private clinics in community spaces so that low-cost or subsidized healthcare services can be provided in underserved regions to complement public health efforts.

Conclusion

Addressing the healthcare gap and ensuring access equally requires a holistic approach involving infrastructural improvements, human resource development, technology adoption, and long-term commitment from donors.  It is essential to create an equitable and accessible healthcare system, especially for its underprivileged populations, let us work collaboratively on the same.