scholarly journals Making doctors available for rural India:

2020 ◽  
Vol 20 (2) ◽  
pp. 196-217
Author(s):  
Prasanth Subrahmanian ◽  
Shivangi Rai ◽  
Himanshu Bhushan
Keyword(s):  
Medical Education ◽  
Rural Areas ◽  
Health Care Services ◽  
Central Government ◽  
Rural India ◽  
Medical Council ◽  
State Governments ◽  
Medical Practitioners ◽  
Care Services ◽  
State Interventions

In the backdrop of acute shortage of allopathic doctors in rural India, this paper looks at the interplay and tension between central and state regulatory measures aimed at improving the availability and retention of allopathic doctors in the rural areas, within the overarching framework of centre-state relations and division of legislative powers between them, with respect to regulation of medical education. While the Central Government has introduced certain provisions in the central law to promote availability of doctors in rural areas, some States have implemented provisions with the same objective, that go beyond the stipulations of the Central Act. Several such measures taken by state governments; be it reservation of post graduate seats for doctors serving in government rural institutions or developing cadre of medical practitioners for rural area under certain conditionalities; have been challenged in courts and held to be violative of the central legislation which inter alia, regulates standards of medical education and registration of doctors. The measures introduced by the state governments for increasing availability of doctors in rural areas, even though struck down as invalid, were intended as instruments of equity and social justice, with far reaching implications for improving availability of health care services in underserved areas. Unless the Medical Council of India Act is amended or the subject matter of medical education is moved from Union list to State list, state interventions are likely to continue to be struck down if they are found to be affecting the standards of medical education.

Promoting Health in Rural India: Enhancing Job Performance of Lay Health Care Activists

2019 ◽  
Vol 9 (2) ◽  
pp. 226-242 ◽  
Author(s):  
Jatin Pandey ◽  
Manjari Singh ◽  
Biju Varkkey ◽  
Dileep Mavalankar
Keyword(s):  
Health Care ◽  
Job Performance ◽  
Community Health ◽  
Health Care Workers ◽  
Rural Areas ◽  
Health Care Services ◽  
Rural India ◽  
Community Health Care ◽  
Care Services ◽  
Care Workers

The health of people in a nation is a potential indicator of its development. Over and above that, the job performance of people involved in the delivery and facilitation of health care services within a nation reflects the actual health conditions in it. In developing countries, where a large chunk of the population lives in rural areas, the job performance of grass-roots health care workers gains significant importance in order to ensure effective and efficient delivery of health care services to the masses and marginalized communities. The present study takes the case of Accredited Social Health Activists (ASHAs) in difficult rural areas of India to identify factors that affect their job performance and suggests interventions through which it could be enhanced. Fifty-five ASHAs were interviewed and five focused group discussions (FGDs) were conducted. Additionally, triangulation was done by interviewing other stakeholders, while studying relevant documents. Through content analysis of these interviews and documents, this study identifies the demands, resources and stressors that affect the job performance of these important intermediaries in the health care supply chain (in the Indian context). The study also suggests policy-level decisions that could help in enhancing job performance of ASHAs by managing demands, increasing resources and reducing stressors. Key Messages We have developed a model that delineates the demands, resources and stressors that affect job performance of women workers in rural India. We have studied Accredited Social Health Activists (ASHAs) who are part of community health care sector. However, our findings are applicable to a wider set of similar job roles. We have studied the nuances of factors affecting job performance for a category of community health care workers who are not full-time employees, have received minimal training and work in close proximity of their residence in a closely knit society. We have looked at job performance of ASHAs who are women community health workers, with low educational qualifications, based in rural setting of a developing country. We have recommended policy implications that would aid in enhancing the performance of ASHAs and thus improve the health care situation in rural India.

scholarly journals Human Resources and Logistic Requirements in Problem Based Learning Compared to Traditional Learning

2014 ◽  
Vol 3 (2) ◽  
pp. 46-47 ◽  
Author(s):  
Satish Kumar Deo
Keyword(s):  
Medical Education ◽  
Human Resources ◽  
Health Care Services ◽  
Problem Based Learning ◽  
Medical Schools ◽  
Medical Council ◽  
Student Centered ◽  
Care Services ◽  
Minimum Requirements

Problem-based learning (PBL) is a student-centered pedagogy in which students learn about a subject in the context of complex, multifaceted, and realistic problems. Working in groups, students identify what they already know, what they need to know, and how and where to access new information that may lead to resolution of the problem along with discussion of the solution within the group. Few medical schools in Nepal have already incorporated problem-based learning into their curricula and other medical schools are planning to adopt. However, when PBL is introduced into a curriculum, it has implications for staffing and learning resources and demands a different approach to timetabling, workload, and assessment. So, issues like human resources requirements and logistic requirements need to address specifically from Nepal Medical Council for the assurance quality of medical education which, in turn, has contributed in enhancing the quality of health care services in Nepal. Hence, this paper is prepared for developing further understanding about major difference between conventional method of Medical education and PBL in relation to human resources requirements and infrastructure. This article ends with some of the important recommendations that could be considered additionally to existing minimum requirements from Nepal Medical Council for the Medical Schools/ Universities in Nepal who are running or planning to implement Problem-based Learning in their curricula. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9530   NOAJ July-December 2013, Vol 3, Issue 2, 46-47

scholarly journals A Socio-ecological Framing of the Philippine Mental Health Act of 2017

Spectrum ◽  
2018 ◽  
Author(s):  
Josiah Michael Villareal De Los Santos ◽  
Sonya Jakubec
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Population Level ◽  
Case Review ◽  
Care Services ◽  
Barriers To Implementation ◽  
Sphere Of Influence

Filipinos experience numerous barriers to mental health care in their country, such as stigmatization ofillness and behaviours, lack of mental health care services, and resource deficits. The Philippine MentalHealth Act of 2017 was formed to resolve these issues and is in its early stages of implementation.Legislation and policy interventions of this nature are but one level of many interventions that can addresshealth care at a population level. The influence of this legislation for different levels of society is analyzed inorder to understand the different barriers and alternatives to its implementation. Solutions suggested in thelegislation, such as addressing lack of accessibility in rural areas, creating liaisons between different levelsof mental health care, and educating the population regarding mental health, are explored for their effects ondifferent spheres, or levels, of influence. The comprehensiveness of the legislation to address the needs ofmental health service users are highlighted, as are barriers to implementation that inhibit the realization ofpractical strategies. This policy case review and analysis informs program development by highlighting thestrengths and weaknesses aligned to the legislative articles’ target sphere of influence and the population.

Innovation in ICT-Based Health Care Provision

2011 ◽  
Vol 6 (2) ◽  
pp. 14-27 ◽  
Author(s):  
Synnøve Thomassen Andersen ◽  
Arild Jansen
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Innovation Process ◽  
Care Provision ◽  
Power Structures ◽  
Mobile Phone Technology ◽  
Existing Structures ◽  
Care Services ◽  
Decentralized Model

This paper describes a project redesigning psychiatric services for children and adolescents, introducing a new decentralized model into the ordinary structures of health care services in rural areas in Norway by using mobile phone technology. The authors apply a multilayer and dialectic perspective in the analysis of the innovation process that created the ICT solution that supports this treatment model. The salient challenges of the project were related to the contradictions between the existing, dominant power structures and the emergent structures in the different layers of the design structures. As a result of the development process, a new model emerged with a larger potential for creating a new innovation path than if it had been linked to existing structures. This paper contributes to the understanding of how user-driven innovation can break with existing power structures through focusing on different layers in the change processes.

iKure Techsoft: Providing Technology Enabled Affordable Health Care in Rural India

2018 ◽  
Vol 22 (02) ◽  
pp. 385-411
Author(s):  
Atanu Chaudhuri ◽  
Venkatramanaiah Saddikutti ◽  
Thim Prætorius
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Care Delivery ◽  
Rural India ◽  
Medical Team ◽  
Hub And Spoke ◽  
Care Services ◽  
Primary Health ◽  
Care Delivery Model

iKure Techsoft was established in 2010 with the main objective to provide affordable and high quality primary health care to the rural population in India and to build a sustainable for-profit business model. To that end, iKure’s cloud based, and patent pending, Wireless Health Incident Monitoring System (WHIMS) technology along with their hub-and-spoke operating model are central, but also essential to exploit and explore further if iKure is to scale-up. iKure provides primary health care services through three hub clinics and 28 rural health centres (RHCs). Each hub clinic employs between one and up to six medical teams (each consisting of 1 doctor, 1 nurse, 1 paramedic and 2 health workers stationed at the hub) & 1 mobile medical team (1 doctor, 1 paramedic, 2 health workers) for catering to the RHCs). Each medical team manages six RHCs. Paramount in iKure’s health care delivery model is their self-developed software called WHIMS, which is a cloud-based award-winning application that runs on low internet bandwidths. WHIMS allow for (a) centralized monitoring of key metrics such as doctor’s attendance, treatment prescribed, patient record management, pharmacy stock management, and (b) supports effective communication, integration and contact that connects RHCs with hub clinics, but also city-based multi-specialty hospitals with whom iKure has formal tie-ups. iKure, moreover, also works extensively with Non-Governmental Organizations (NGOs). Collaboration with local NGOs in the target areas helps to build trust with the rural villagers and their local knowledge and access helps to assess service demand. NGOs also provide the necessary local logistical support and basic infrastructure in the rural areas where iKure works. Moreover, collaboration, for example, with corporate organizations are central as they contribute with part of their corporate social responsibility (CSR) funds to support iKure initiatives. At present, iKure is planning to add diagnostic services to its six hub clinics as well as expand its presence in other parts of West Bengal and other states across India. Expanding rural health care services even with the technology support of WHIMS is challenging because, for example, health is a very local issue (due to, among other things, local customs and languages) and it requires investing significant amount of time and resources to build relationship with the rural people as well as collaborators such as NGOs and corporates. The accompanying case describes iKure’s journey so far in terms of understanding: (a) the state of health care and government health care services provided in rural India, (b) the establishment and evolution of the iKure business and health care model, (c) iKure’s operations and health care delivery model including the WHIMS technology solution and hub-and-spoke set-up of operations, (d) the collaborative model which relies on NGOs and private corporates, and (e) finally iKure’s challenges related to scaling-up.

Outcomes of public health reform – service availability in rural areas

2015 ◽  
Vol 28 (1) ◽  
pp. 42-56 ◽  
Author(s):  
Mika Immonen ◽  
Jyri Vilko ◽  
Jouni Koivuniemi ◽  
Kaisu Laasonen
Keyword(s):  
Rural Areas ◽  
Health Care Services ◽  
Public Services ◽  
Economies Of Scale ◽  
Mail Survey ◽  
Service Availability ◽  
Residential Areas ◽  
Subjective Experiences ◽  
Content Type ◽  
Care Services

Purpose – The purpose of this paper is to focus on the availability and demanded locations of health care services in a rural context. The authors analyse subjective experiences because mobility and other individual factors influence the availability of public services. Design/methodology/approach – Results from a mail survey in southeastern Finland are presented. Data collection was conducted using a random sample of 3,000 people from age 60 to 90 years. A total of 1,121 valid responses were received. Findings – The acceptable distance to service sites depends on learned behaviour where differences exist between suburban and rural residents. The authors found that service networks can be sparser in rural areas if the service sites are located in the daily activity space of the residents and travel burdens caused by distance and time are adequately solved. However, continuous downscaling of the provision may lead to the loss of health benefits which is harmful for individuals and expensive for society. Research limitations/implications – Further research should assess a broader variety of residential areas from the perspective of service availability. The results presented do not enable a direct comparison of the service availability between cities and sparsely populated rural areas. Originality/value – The paper contributes to the debate on access barriers to public service in rural regions. The question of availability of public services is topical because increasing overall demand requires urgent productivity improvements in public services. Currently this is solved by centralisation to search economies of scale.

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