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JanSehat - Improving Healthcare access for rural India


Around two months ago I got to be a part of a very exciting project aiming to build a first-of-its-kind healthcare network in rural India.

Rural areas often face significant disparities in healthcare access and resources. The unique challenges faced in rural healthcare settings require innovative approaches and solutions. The need to find creative solutions makes rural healthcare an exciting space to work in.

Subsequently - once the patient gets his prescription - finding apt facilities for diagnostic tests or treatment is an onerous task. The nearest hospital does not provide all basic diagnostic tests. Patients have to use expensive private diagnostics services which take as long as 3 days to provide lab reports.

The idea behind launching – “Project JanSehat” was to build a holistic healthcare model for rural India. 

The program is a collaboration between - Spotsense x StepOne x PlusTrust. It is being piloted in the villages of Rajasthan and Madhya Pradesh. The pilot aims to be a prototype model to be replicated in villages across India.

In villages, consultation, diagnostic and treatment services are rarely found together. The nearest hospitals (usually government) are on average 15 km away. Doctors (mostly general physicians) attend to patients only for a few hours a day and the consultation wait time is very high.

Telemedicine though useful in this situation often cannot be used due to poor connectivity. Furthermore, villagers seeking the service have a fixed mindset, believing they need to be physically checked by a doctor for a proper diagnosis. This makes it difficult for them to trust the service and the doctor helping them over the phone.

The hospitals (government) do provide a few free medicines (e.g. medicines for diabetes and hypertension) but these are often not wanted by the people. They believe the medicines provided are of poor quality and ineffective. The satellite government pharmacies - Janaushadhi Kendras, have variable opening days and are poorly stocked. This leaves the patients scrambling for medication.

Thus, receiving medical care becomes a complex task that requires a day’s worth of time.  The arduous travel and loss of daily wages make the patient wary of seeking medical care on a regular basis.

The JanSehat program looks at addressing these problems in a sustainable way. A pilot was launched in May 2023 to try out the proposed model on a small-scale intervention.

Establishing and sustaining a healthcare facility in rural areas would require community engagement and support. To create this sustenance, we enable rural women to become community health entrepreneurs (CHEs) in their villages. The women are trained to provide telemedicine, diagnostic tests, and drug delivery services – using portable and simple-to-use rapid diagnostic devices which can provide diagnostic lab reports additionally supported by doctors on call. This would help bring healthcare facilities to villages while also providing women a medium to earn money.

We started by building a service that would bring consultation (general and specialty), diagnostic, and treatment services under one roof. Having these services together in one place would reduce the need for patients to visit multiple locations for their healthcare requirements.Having comprehensive facilities nearby would also encourage regular health check-ups and preventive care in rural communities.

For consultations, we combined active (e.g., video calls) and passive (e.g., messaging) telemedicine models for patient-doctor connects. This new model would allow healthcare providers to gather a comprehensive dataset that could be used to tailor care plans to individual patients. The active model would capture patient-reported information, while the passive model would provide objective data taken by the CHE (e.g., health trends, vitals). This holistic approach facilitates personalized and targeted interventions, resulting in more effective and patient-centric care. Additionally, the CHE being a part of the teleconsultation helps in conducting a physical check-up of the patient. Thus, improves the data received by the doctor and also satisfies the patient - that the check-up has been done well.

For the diagnostic services, we equipped the CHEs with point-of-care rapid testing devices (from Spotsense). These devices would help diagnostic services be available within the village and patients could get tested in the comfort of their homes. Once prescribed, the tests could be done and lab reports provided within 30 mins.  The medicine required by the patient could then be delivered to them by the CHE who would get it from central hubs (created by the JanSehat team) stocked with the basic medications.

Being integral members of this program and the community, the women would be able to build strong relationships with their patients. The close connection would allow trust-building with the patients and significantly impact the community’s health and well-being.

JanSehat is thus, a community-based care model. It has been built in a way where it involves local stakeholders and understands community dynamics – which are critical for long-term success in rural healthcare.

The CHEs involved hope to transcend boundaries and be healthcare warriors in their villages in the pursuit of healing and transforming lives.


References 
https://www.instagram.com/p/CuR0q9JpEGZ/?igshid=NTc4MTIwNjQ2YQ== 
https://www.spotsense.in/ 
https://plustrust.org/ 
https://projectstepone.org/ 
https://intelehealth.org/technology/ 

 

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