According to 2011 Census, Rajasthan had a population of 68.6 million, of which three-quarter live in rural areas. The State has a poverty level of 24.8 with infant mortality rate (IMR) 41, (National Family Health Survey -4 2015-16) and the maternal mortality ratio (MMR) 208 (Annual Health Survey -2012-13), which are above the national average.
With poor socio-economic conditions, primary healthcare is a challenge in a geographic terrain like Rajasthan. Public health experts opine that while significant global resources have been focused on eliminating specific diseases like Polio, HIV/AIDS, TB and Malaria, relatively little has been done to strengthen primary healthcare in an integrated manner.
The humble journey of WISH began with a vision to work towards improving the quality of primary healthcare services and access to these services for the under-served communities in India.
WISH is implementing healthcare models through partnership with the State Governments, international agencies and the private sector by appropriately introducing promising healthcare innovations in the public health system in order to build an equitable, innovation-led and evidence-based quality healthcare system within easy reach of the underserved populations.
WISH curated a unique innovation-led model to transform the under-performing Primary Health Centres (PHCs) into performing health and wellness centres in Rajasthan. The facilities are implemented through Public Private Partnership in lagging behind districts, located in remote areas, with difficult geography, high levels of poverty and poor health indicators.
The foundation is operating in 14 districts with 24 rural PHCs and 99 sub-centers and 7 Urban PHCs.
These centers are fully staffed with doctors, attendants, auxiliary nursing midwifery (ANM), general nursing midwifery (GNM) and other health workers.
The centers are equipped with high-end medical services and technology, with well-maintained government-supplied pharmaceutical drugs and assured availability of healthcare services.
While these health centers are equipped to treat and serve patients with all kinds of medical conditions, the main focus remains on family wellness, maternal and childcare and preventive and promotive healthcare.
WISH has been providing comprehensive healthcare services and sustained quality services since early 2015. Few achievements –
- The average out-patient volume of rural PHCs surged from 924 per PHC per month in 2014-15 to over 1,700 in 2018-19 and the average Institutional delivery per PHC per month increased by 60 percent during this period.
- July 2015 to June 2018, the WISH-managed PHCs/SCs have provided OPD services to 19,57,720 patients and conducted 12,952 institutional deliveries.
- Child immunisation indicators are improving along with ante-natal and post-natal visits.
IQVIA an external evaluation agency, with support from USAID conducted an“Evaluation of the Rural Model of Primary Health Centers in Rajasthan”. After having upgraded the worst-performing healthcare centers handed over to WISH in 2015, the evaluation was conducted on these centers against the well-performing healthcare centers run by the Government. The report revealed the effectiveness of the transformed healthcare centers which WISH was able to bring about through its innovations and technology-led services –
The report reinforced the evidence- based work WISH has demonstrated on field, strengthening Primary healthcare services in Rajasthan.
WISH aligns itself to the vision of National Health Policy 2017 (NHP2017) which calls for “comprehensive primary healthcare package which includes geriatric health care, palliative care and rehabilitative care services’ and these ‘facilities will be called Health & Wellness Centers’. The organisation began its work early this year, by transforming the existing Primary Healthcare Centers (PHC) into Health and Wellness Centers (HMW) in the region.
WISH one of the first few organisations propelled its efforts in this direction “I envision WISH to contribute 100 Health and Wellness centers across Rajasthan, Madhya Pradesh, Uttar Pradesh and Assam by end of this year to support the grand vision of the government on Ayushman Bharat” said Sunil Wadhwani, founder of WISH Foundation in an interview.
11 centers and sub centers have already been transformed in Rajasthan. These Health and Wellness centers (H&WCs) not only connect the patients of hard to reach areas to a doctor through telemedicine via internet it also has a dispensing machine attached to dispense the medicines prescribed by the doctor at another location.
WISH continues to service and excel and through its work and establishing H&WC aims to bring in –
- Accessibility: Quality healthcare services to the population without access to doctors or medical services for approx. 200 diseases at HWC level covering maternal, neonatal, child health and nutrition (MNCHN) and geriatric healthcare services round-the-clock, with referral and transportation mobility. Improvement in the health seeking behaviour by the community it serves, improvement observed in the knowledge and awareness on general communicable and non-communicable diseases.
- Acceptability & Affordability: No social and cultural barriers amongst the community members in accessing the services.
- Equity: Fair access of healthcare services by all segments in the community for a good healthy life irrespective of their economic and social status.
- Evidence: Ready to use disease profile of the population being served by HWC and assessment for framing appropriate policy and investment of public investment/ resources, reduction of the case load at PHCs, district hospitals and tertiary care facilities – also reduction in public sector expenses on these facilities
- OOPE: Reduction of out-of-pocket expenditure, patient’s satisfaction and improved health
By empowering our work and connecting populations with comprehensive healthcare services innovations are core to WISH work and have played a key role in making the Scale Rajasthan Programme a success. The organisation continues to introduce innovations in the field and piloting new innovations to bridge the healthcare service delivery gaps.
These Innovations have been life savers –
“I am grateful to this innovation SuCheck as I always believed I can’t have diabetes. This was a boon to me diagnosing the problem at right time and saving my life. Had I not gone for this check by now I could been surrounded with many health challenges. Me and my family would like to thank WISH Foundation for all the good work they are doing and help save my life,” Siddiqui, sarpanch (Deputy head of Village) of village Kondli Nadi, District Sawai Madhopur, Rajasthan.
“Me and my child were saved because of Janitri as I never thought of any complications and believed will have a normal delivery. I owe our lives to WISH and all the good work they are doing,” Kavita from village Sobda, District Sawai Madhopur.
“My ultimate WISH for WISH Foundation is to have a healthy India@80. Our goal is that by the end of 2027 when India turns 80 years young, that because of WISH interventions, at least 100 Million families have access to quality primary healthcare; two million families stay above the poverty line; one million pregnant women’s lives are saved; 50,000 infant deaths have been averted; and that we will have piloted 50 healthcare innovations,” said Founder Donor Sunil Wadhwani.
Having more than nine million lives reach, WISH continues to work towards its vision to reach the goal as envisioned by the founder donor Sunil Wadhwani and continues to expand its work in other states like Assam, MP, UP, Chhattisgarh and Odisha apart from Rajasthan and National Capital Territory of Delhi, where WISH is the Knowledge Management and Technology partner for the Government of National Capital Territory of Delhi’s (GNCTD) Aam Aadmi Mohalla Clinics Programme (AAMC) providing technical assistance for eﬃcient management of the clinics and facilitates partnerships with a variety of private players and innovators jointly identified with the GNCTD.
Furthering its steps, WISH has partnered with the National Health Mission, Government of Madhya Pradesh, to provide technical support to improve the health outcomes and assist in strengthening Health & Wellness Centre (HWC), non-communicable diseases, urban health, RMNCH+A .
WISH is also partnering with the Amalgamated Plantations (APPL) Foundation to improve maternal and child health outcomes in the PHCs of the tea garden estates in upper Assam for 1.5 lakh population in the 25 tea estates. This is a network of 25 PHCs and a 75 bed referral hospital at Chubwa. As a way-forward WISH aims to establish Urban Model of Health & Wellness centers across its working states, play a pivotal role as Technical Support Partner in Urban Health & HWC, build in Artificial Intelligence as a tool to strengthen primary healthcare.