By Eshaan Singh
The COVID-19 pandemic exposed many vulnerabilities of the Indian healthcare system. Some of the most alarming indicators emerged from the domain of primary health care (PHC), the first point-of-contact for communities to access healthcare in both urban and rural areas. Unfortunately, PHC lags both in terms of quality and accessibility, resources and infrastructure, in India. It will require comprehensive, modern solutions through ICT to introduce primary healthcare of global standards to the very last mile in the country.
Many access-barriers to PHC in India
Among India’s primary health centres, typically catering to a population of about 30,000 each, 61% have been reported to have only one doctor at call, while 7% function without any at all. According to MoHFW’s Rural Health Statistics 2020-21, a 76.2% shortage of specialised doctors in primary and community health centres across urban and rural areas was observed in the pandemic years. States like UP, Bihar, Jharkhand and Andhra Pradesh face many infrastructural inadequacies. Inevitably, women, children and other vulnerable groups find it hard to access healthcare in the country.
These barriers to PHC access have not only turned critical in the wake of the pandemic but have also halted the country’s progress towards achieving the goal of universal health coverage under SDG Target 3.8. Average out-of-pocket costs on healthcare have increased while the pressure on secondary and tertiary-level healthcare services has multiplied in recent times.
Expanding ‘Continuum of Care’ using IT
Since PHC is the backbone of any direct, preventive and holistic health policy at the grassroot level, it becomes essential to plug its many gaps with the help of innovation, technology and collaborative enterprise. Both NHM and Ayushman Bharat Mission have recognised the need to provide ‘continuum of care’ to revitalise PHC and introduce healthcare solutions using the latest IT.
Examples include the use of drones to address logistical and transportation challenges to improve access to vaccination in remote areas, mobile-enabled devices to facilitate patient monitoring, hospital management information system (HMIS) to streamline and simplify patient data, etc.
GoI’s flagship telemedicine scheme, eSanjeevani, has been a major success story as a one-stop digital OPD connecting health specialists and local vulnerable communities during the pandemic. In its 5 million+ teleconsultations, eSanjeevani has been able to overcome technological divides to reach rural, isolated communities across the country.
Several private health-tech players have also begun to provide similar e-consultation facilities at reasonable costs. More than 50 such companies have already been roped in under Ayushman Bharat Digital Mission (ABDM) to support the goal of universal health coverage “in an efficient, accessible, inclusive, affordable, timely and safe manner.”
A family-centric approach
Given the fact that family doctors can help resolve an estimated 80% of all medical needs of a patient during the lifespan, many private players are closely integrating the traditional family-medicine based model with their advanced e-consultation facilities. True to the vision of continuum-of-care, private players are realising that family doctors are better equipped to provide effective, all-round treatment and minimise infrastructural burdens. Large scale application of this model can completely overhaul the state of PHC in India, making it affordable, accessible and approachable.
Through multi-member consultations to streamline patient and family history, the platform provides accurate and timely diagnosis using big data analytics and machine learning to predict and prevent future diseases at the level of primary care.
Towards a virtual health revolution
ABDM’s public-private partnerships towards strengthening accessibility and continuum-of-care at ground zero is only the first step towards building PHC in India from scratch. True democratisation of digital solutions will require commitment and constant collaboration.
Expanding digital infrastructure across urban and rural locales, providing proper training to local health workers, resource allocation and reducing bureaucratic interventions will further entrench these partnered solutions to the grassroots.
Most importantly, the private sector will have to be incentivised and encouraged to be able to come up with new out-of-the-box solutions to existing healthcare challenges at the primary, and then secondary and tertiary levels.
(The author is Co-Founder, MeraDoc (a serial entrepreneur & Duke Fuqua MBA). Views expressed are personal and do not reflect the official position or policy of FinancialExpress.com.)