Overview

 

 

 

Healthcare in India is not an electoral issue, unlike in the developed countries such as the United States, where health policies hold center stage in political debates. Hence, government investment in public health in India has been historically low.

India ranks among the top countries in the world in terms of the size of private sector healthcare practice. It is also among the most populous countries in the world. Yet, good quality healthcare is out of reach for most Indians, who are very poor.

According to a paper by Dr. Prasad and Sen Gupta[1], – “public health in India is in a state of perpetual crisis from disinvestment in public health care services and persistent neglect. While successive governments have been promising allocations of 2.50% of the GDP to Health, in reality, these have hovered around the 1% mark for decades, with allocations in 2018-19 of 1.3%. Simultaneously, privatization has been increasing steadily, with over 70% of all health care now falling within the private sector and 84% people not covered under any health expenditure support (GOI 2016[2]). It stands to reason that out of pocket expenditure (OOPE) is also extremely high at 62.6% of the total health expenditure in 2014-15 (NHSRC 2017[3]).”

Hence, an acute need was felt for dialogues between established and upcoming healthcare institutions spanning various specialties to provide access to healthcare for all, irrespective of the patient’s capacity to pay. It was also felt that healthcare is not an isolated factor contributing to human well-being. Its immediate connection to livelihood and education of the next generation is apparent. Thus, the germ of an idea was born; to get like-minded organizations to form a network to create synergies. This resulted in a meeting of about forty individuals representing ten organizations in healthcare, education, and livelihood on 6th March 2018.  The basic objective of this meeting was to explore the potential for creating a forum for mutual learning, ideation to create synergies, and taking up these ideas for implementation through the stages of pilots and subsequent scale-up. The deliberations during this meeting, wherein potential for such a network was realized, led to the formation of The Equitable Healthcare Access (EHA) Consortium.

EHA is a Consortium of socially-sensitive healthcare providers, organizations involved in fostering livelihood, and education institutions from across the country, who can, through networking and resource sharing, come up with new and improved models for providing access to healthcare.

LV Prasad Eye Institute and Aravind Eye Care System have demonstrated the potential for rolling out equitable access on a massive scale in one important aspect of healthcare, viz., eye care. In a similar manner, DHAN Foundation has, on a pan-India scale, done so for livelihood.

Since the first meeting in March 2018, EHAC has had four meetings with the recent one being held at the Indian School of Business, Hyderabad on the 23rd and 24th of August 2019. The meeting was attended by over 50 participants from across India, representing organizations in the healthcare, livelihood, and education space.

Over the past five meetings, participants have engaged in vigorous discussions on the worrying gaps in public healthcare delivery, wherein large swathes of rural India lack access to basic health facilities, a problem compounded by cultural and socio-economic complexities. In recent times these gaps have manifested in extreme and troubling ways, such as the recent incidents of violence against professionals from the medical community and vandalism targeted at medical facilities. Wide ranging in their scope, the talks have also included the role private hospitals can play in addressing the public healthcare problem by joining the movement to deliver equitable healthcare across India to all Indians.

The discussions have covered novel methods and business model innovation for delivering more and better-quality healthcare services, including preventive and promotive care, at the primary and secondary levels in order to reduce the burden at the later stages of healthcare delivery. Experts have discussed the role of Government insurance programs in improving healthcare access. Members have also brainstormed on the need to continue to think of and implement out-of-the-box solutions, and on how institutions focused on education, as well as those focused on livelihood, among many other potential partners, can play a collaborative role by working closely with healthcare providers and contributing to improved healthcare models.

Organizations such as DHAN Foundation, Aravind Eye Care System, L.V. Prasad Eye Institute , Ekam Foundation, Basic Healthcare Services, Fernandez Hospital Foundation, SIICP, People Tree Hospitals, SSISM Education Institutions, SIICP, Sankalp India Foundation, Kauvery Hospitals,  SAKSHAM, Indian School of Business and the Indian Institute of Management Udaipur, are among the Consortiums growing member list.

EHA Consortium has identified 4 broad thematic areas to work on and expanded on the scope of how the member organizations can create models to provide quality healthcare.

  1. Enhancing primary healthcare efforts for the poor
  2. Creating models to ensure quality care for all with empathy and in an ethical manner
  3. Reaching out to the Medical Student fraternity by establishing a communication framework wherein, through regular panel discussions and talks, we demonstrate to them how successful models of healthcare have evolved. The objective is to expose them to the ideal that they can practice their livelihood while being ethical and equitable
  4. Launching online free Educational Courses that anyone interested in EHAC’s philosophy can learn from. These will be self-certifying courses on topics related to Empathy, Equitable Healthcare, Ethics and patient care, and other identified topics. Such learning programs are essential for scaling up EHAC to take its philosophy to a wide audience including doctors, medical students, hospital owners, hospital administrators, and the general public.

Joint pilot programs launched by the members of EHA Consortium has seen out-reach benefiting over 36,000 people in different areas including eye check-ups, signing up of blood donors to support thalassemia patients, awareness and treatment of colo-rectal diseases, and general health camps.

After a first successful panel discussion addressing the Medical College students and residents in Udaipur in the month of April 2019, L V Prasad Eye Institute along with Equitable Healthcare Access (EHA) Consortium hosted the second panel discussion on the 22nd of August 2019 in Hyderabad. The event was well attended and well received by students from Medical Colleges in the Hyderabad area. “Can today’s medical professional be Ethical, Empathetic, Successful and also be satisfied with their job”? was the theme of the discussion. EHAC is working on promoting career paths to these students and residents by giving them the opportunity to intern on short term programs and to be mentored by the best Doctors in the industry.

More information about EHAC activities is available on the Consortium’s website – www.ehaconsortium.org

The EHA Consortium is registered as a Trust on 21st February 2019, having its registered office in Hyderabad.  Individuals working on this consortium, drawn from various member organizations, volunteer their time to keep the Consortium running. The Consortium is managed by Ms. Arnaz Dalal (CEO, EHA Consortium) who can be reached at arnaz@ehaconsortium.org

 

[1] Perpetuating health inequities in India: Global ethics in policy and practice by Dr. Vandana Prasad and Amit Sen Gupta – www.tandfonline.com/doi/full/10.1080/17449626.2019.1582553
[2] GOI (Government of India). 2016. 71st Round of the National Sample Survey. India: Government of India
[3] NHSRC (National Health Systems Resource Centre). 2017. National Health Accounts Estimates for India (2014-15). New Delhi: Ministry of Health & Family Welfare