Project outline and goal
Ayushman Bharat – Health and Wellness Centres aim to deliver comprehensive range of health care services spanning preventive, promotive, curative, rehabilitative and palliative care. Under its mandate, 10,477 Health and Wellness Centers (HWCs) have been operationalized by October 2022 in the State of Maharashtra. The delivery of Comprehensive Primary Health Care (CPHC) through HWCs is complex and requires a paradigm shift at all levels of the health system.
PATH India intends to develop a model CPHC district in collaboration with the Public Health Department Maharashtra and stakeholders of DCCC, where multiple innovations are tested with a potential to scale-up across India and other Lower Middle-Income Countries (LMICs). The developed integral care model aims to strengthen health service delivery at the HWCs in the selected district of Satara (in the State of Maharashtra, India).
The scoping phase of the project reflected field level gaps related to screening and early detection of cases for non-communicable diseases in Satara. An evidence-based intervention was designed to ensure optimal utilization of available resources. Part of this intervention was to find innovators and entrepreneurs in the health care sector with a Primary Health Care Tech Challenge to identify promising MedTech and digital health innovations for bridging identified gaps in primary health care.
Three innovations were selected to be deployed in Satara:
- Mythri (Niramai) is an affordable, portable, radiation-free, non-contact, privacy-aware test for breast cancer screening. It can detect early-stage breast cancer. The test can be operated by low skilled health workers and hence is scalable. Since it is portable, it can be used either in a hospital or for large scale screening in rural areas.
- AiSteth is a smart stethoscope to early screen, detect, and predict cardiorespiratory disorders.
- RHEMOS health monitor is a point of care device that can measure 8 body vitals in a matter of minutes. A single device can measure – Blood pressure, Heart rate, Respiratory rate, ECG, Heart rate variability (HRV), Blood oxygen, Body temperature & Blood glucose with medical grade accuracy.
In fall 2022, the procurement and deployment of these selected innovative point-of-care diagnostic devices will start in 17 selected facilities. The deployment plan also includes a wide range of support by PATH India such as providing technical support to the district in terms of capacity building; continuum of care design; information, education and communication material prototypes development; and development of standard operating procedures.
Ecosystem players involved
The implementation of Ayushman Bharat requires a mammoth effort on all fronts, not just from Government of Maharashtra but other stakeholders as well. Therefore, PATH India collaborates closely with the Public Health Department of the department Maharashtra, and other governmental actors at national, state and district level. Various interdepartmental stakeholders are involved like Commissioner Health Services, Nodal officers from HWC Cell and NCD Cell at State level and District Health Officer (DHO) and nodal officers at district level. PATH collaborated with external agencies like Final Mile and CORT for intervention planning and implementation. DCCC and its partners, in particular Philips and Philips Foundation, supported the design of the integrated health care model in advisory role.
Anticipated outcomes and impact
This model aims to support the introduction of transformative solutions for strengthening diagnostics services at HWCs to strengthen service delivery at primary unit of health care centers. At the current phase a comprehensive and integrated care model at HWCs is piloted in 17 PHCs. Ultimately, it should be rolled out to 84 PHCs and 323 SHCs impacting 1.6 million population directly.
The project also aims to minimize the barriers in the uptake of health services from HWCs. Deploying innovative products at HWC level has the potential to increase access to quality healthcare services. PATH India and the partners in this project therefore putting continuous efforts to enhance institutional capacity and enabling environment by partnering with stakeholders in health industry and beyond.
Potential for scalability / next steps
The implementation of the three innovative products is in process of procurement and further deployment at Satara. However, selected innovations can be scaled up to other facilities based on performance of the solutions. Simultaneously, PATH team with program division at State and district level is exploring various innovative solutions to increase uptake of services and to implement package of services at health and wellness centers.
As a next step, the project will build capacity of service providers on digital devices and provide handholding support for effective utilization of these solutions. PATH will provide technical assistance for standardization of processes in use of these solutions by developing standardized Resource materials including SoPs, work instructions etc.
In addition, the project will develop monitoring mechanism to track the progress on utilization of these solutions and share progress with key stakeholders and develop proof of concept for its scale up across the district or in other districts of the state.
Recently, PATH India has received a PSI-USAID grant of $3M for further roll out of transformative solutions for primary health care in Urban settings of three states and with support from Foundation Botnar, PATH is supporting state of Manipur to strengthen service delivery at urban health care centers. The learnings from integrated innovative model in Satara will be utilized for scaling up the solution in newer geographies.
Opportunities for other organizations in the project
The collaborative approach inherent in this model for transformative solutions for primary health care, allows for ample collaboration possibilities, such as:
- Technology Support: Partners can bring newer digital health or point of care solutions. Deployment or testing digital health or point-of-care solutions
- Financial Support: Partners can provide funding support for scaling of the project in newer geographies
- Technical Expertise: Partners can bring technical expertise in terms of learnings or insights to strengthen the transformative solutions and effective implementation
- Knowledge Management: Partners can collaborate for knowledge management and wider dissemination of the learnings
Please note: we are looking for contributors and collaborators, aimed at jointly creating value – and ultimately jointly benefiting from it, as well.