December 2012

Rural Health

Serving bottom-of-the-Pyramid Population through Effective use of Technology Inovations







Over the years development planning in India has focused on reducing the burden of illness and mortality among women and children. A large number of development and public health programmes such as the Integrated Child Development Services (ICDS) have been geared towards this, since a long time. Yet the status of Rural Health in India is at very negligible condition, a closer look!

ICT optimises efficiency

Balaji Utla,




Equity is an important thing; everybody should have equal opportunity that provides accessibility, availability and affordability. In Andhra Pradesh, a citizen, if he/she is unwell can access emergency care even at midnight. So care centers are 24x7x365 toll free. One needs to dial 104 and it is operated only by healthcare providers in the field. It provides algorithm driven health advice. We also have data about the national health programme, integrated with Janani Suraksha Yojana. It reduces MMR and IMR, reduce mortality, reduce morbidity and it assist with implementation of national health schemes. These are the services that are rendered specialised call centres, which work beyond the citizens help line. The call centers reduce the load on the Public Health System. In Andhra Pradesh, government registered close to 1.2 million pregnant women; no other state probably in country has such a record. Similarly, close to 1.2 million hypertensives and diabetes are referred and those records are available. We also have telemedicine centers in Araku in Hyderabad to offer health services to 140 villages. 

Healthcare is all about better patient experience

Bhudeb Chakravarti
Senior General Manager & Region Head,
National Institute for Smart Governance (NISG)


Most of the healthcare facilities are not effective and efficient enough. Government is providing much facilities but the requirement is much- much higher. Doctor and patient ratio is five times lower in rural areas than the cities. In cities, patient has number of options, whereas in villages it is very less because there are less number of doctors. In rural areas, the facilities are not effective and available, distribution of medicine are not available. We have done projects in Andhra Pradesh for distribution of medicine to various places. The important factors that we should focus are medicine, skill detector and health workers, long queue etc. All the hospitals in a state or country start working at the same time (8:30 am) as if all the people will get sick at morning 8:30 am. Why they cant expand the time or why the people not follow the rotational shift? Its all because of lack of strategic vision.
The reporting of health information needs to be collected in one format. For that, we need to provide efficient care irrespective of shortage of care professionals. Technologies such as mHealth, e-referral, EMR etc. We also need to reduce duplication and adverse drug events like online availability of Critical Care Data (CCD), EMR,Clinical Decision Support System at point of care. There is a better patient experience with online access to information.

Achieving the Millennium Development Goal is all crucial

Ajay Sawhney
Principal Secretary,
Public Health & Family Welfare
Andhra Pradesh


ICT never works well if you simply apply it to the existing practices. At present, our analysis of the situation and the kind of the system where we are trying to place the ICT will get actually contracted. On top of this convergence of delivery of health and nutrition services at the same time is more difficult to bring about behavioral change in the community which we are trying to serve with the given current trajectory of achievement.
Currently our MMR is at 134 per lakh, live births and goal for 2015 is 100 per lakh whereas the current rate of MMR will be left somewhere in between. Malnutrition in Andhra Pradesh is high and in fact that is the underline problem which also feed in to IMR and MMR. With 56 percent of pregnant women being anemic, children being born with low birth rate, the number of children and children less than three years who are underweight is around 37 to 40 percent. There are large numbers of parameters prent in health system.

Train health workers for primary prevention

Girish Babu Bammakanti
Care Rural Health Mission,
Care foundation Scheme


We train village women and accommodate them in our health centres as health workers and in this way community participation in terms of reaching healthcare to rural places is ensured. One can solve 70 percent of primary health problems and most of the common problems are like cold, cough, fever, malaria. 70 percent of all diseases could be treated then and there itself by just having one remote doctor with health workers. We are doing with 50 of Maharashtra programmes so effectively that you will be able to reach lakh of population with only a group of health workers and one or two remote doctors.
The other 30 percent of the cases go to the primary health center (PHC) based on town level. This is a very cost-effective process with the model processed into four parts, the first thing is the training and capacity building of the health worker. We spend 80 percent of our time only in training programme of health workers to define areas of virtual trainings even when they visit primary centers scheduled monthly in a clinical rotation. The second part is supply chain management of your primary health centers and integrating this data with IT. The third vertical and the fourth one is health financing. If you offer primary care you can reduce your burden of hospitalisation.

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