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05/03/2023 1
REFORMING SYSTEMS FOR HEALTHCARE DELIVERY
EXPERIENCE FROM INDIA
Dr Alakananda BanerjeeFounder Chairperson: Dharma Foundation of India
Vice President: All India Senior Citizen Organisation(AISCCON)
Arctic Light E-Health Conference 1-2 February 2017
05/03/2023 Arctic Light E-Health Conference 1-2 February 2017
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CONTENT
1. Healthcare Challenges in India
2. Reforming systems for health :global vision
3. Community health workers in rural India
4. Community health centers and Active Ageing
5. mHealth and Active Ageing
HEALTHCARE CHALLENGES: INDIA
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Population1,326,801,576 (July 2016 est.)Density382 people per.sq.km (2011 est.)
In million
India currently has the largest illiterate population.
HEALTHCARE CHALLENGES: INDIA
• High proportion of out-of-pocket expenditure on health
• Weak public health systems.• Unavailability of doctors and
nurses.
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INITIATIVES BY GOVERNMENT OF INDIA
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http://bipartisanpolicy.org
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Partners for Health Reform plushttp://www.who.int/management/country/alb/ToolkitsforStrengtheningPHCAlbaniaHIS.pdf
PRESENT COMMUNITY HEALTH WORKERS IN RURAL INDIA
1. ASHA(Accredited Social Health Activist) are local women in rural areas and urban slums of India, trained to act as health educators and promoters in their communities.
2. Anganwadi workers (children)3. ANM:Auxillary Nurse Midwife
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Key components of the National Rural Health Mission / NRHM,India
IMPLEMENTING COMMUNITY HEALTH CENTRES AND ACTIVE AGEING IN INDIA
ELDERS AS SUPERVISORS OF URBAN COMMUNITY
• Lifetime experience• May have valuable time• Elder resource an
important part of the community .
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EMERGENCY/ ACUTE CARE!! DoctorAHP
Trained Community Supervisor to take care of Small Group through individual home visits, visits old age homes and conducts small group meetings
Elder from small group who needs help in health emergencies call/messages CS with the problem that she/he has.
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OUR MODEL
COMMUNITY CENTRE
Doctor
CS
Patient/elder in community
PROBABLE ROLE OF MULTIDISCIPLINARY TEAM/COMMUNITY CARE CENTRE AND URBAN
ELDERS IN SEMI RURAL/RURAL AREAS
• Health Promotion and Education (TB,HIV,malnutrition,sanitation,NCD)
• Early recognition of problems and timely intervention
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INTERVENTION AND OUTCOME MEASURES
• Need assessment toolkit• Training Module• Process guidelines • Monitor frailty ,falls, activity and
participation of elders participating in program
• http://www.who.int/management/ToolkitsforStrengtheningPHCAlbaniaPHC.pdf• http://www.who.int/ageing/publications/AF_PHC_Centretoolkit.pdf• http://phcperformanceinitiative.org/• http://www.mohfw.nic.in/showfile.php?lid=2171
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MOBILE PHONE USERS IN INDIA
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SCOPEmHEALTH AND ACTIVE AGEING
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Service providers: CS
Service User: Patients/caregivers
PROBLEMS FACED
INNOVATIVE mHEALTH APP For a common person
REFORMING HEALTHCARE DELIVERY IN INDIA
• No Medical Terms (Please I can do Google Search)
• Easy to use
• Help: Monitoring and assessing health condition
• Informative :Indications and contraindications 05/03/2023 Arctic Light E-Health Conference 1-2
February 2017 14
INNOVATIVE mHEALTH APPFROM EMPOWERMENT TO ENGAGEMENT
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Use technology with common/ natural
language
Health Status:MorbidityVitals
Health Functions: Changes in Activity and Participation (within the community) Result of medical intervention
http://icfmobile.org/
SCOPE mHEALTH AND ACTIVE AGEING
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Service providers: CS
PROBABLE SOLUTION
mHEALTH AND ACTIVE AGEINGPROPOSED ACTION STEPS
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Self-care
Mutual help
Secure mhealth
mhealth facilitates
http://icfmobile.org/
Service providers: CS
INNOVATIVE LOW-COST POINT-OF-CARE TESTING (POCT) FOR COMMUNITY CARE CENTRES AS ADJUVANT TREATMENTS UNDER eHEALTH:
MONITORING AND EVALUATION/EARLY DETECTION
• An appropriate adjuvant treatment with tDCS may be needed to facilitate postural training in elderly using telemonitoring with EPOC EEG headset, MS Kinect and Wii Balance Board under an e-Health paradigm, which needs further investigation. [“Effect of Transcranial Direct Current Stimulation on Cortico-Muscular Coherence and Standing Postural Steadiness,”Proceeding (764) Biomedical Engineering / 765: Telehealth / 766: Assistive Technologies - 2012]
• Mobile phone based daily tele-monitoring (using Google drive or Dropbox cloud storage) of quantitative EEG (EPOC EEG headset), whole body kinematics (MS Kinect), and CoP trajectories (Wii Balance Board) during functional reach tasks (e.g. Tai Chi training etc.) to identify cognitive-motor aspects of balance in community-dwelling elderly https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800576/
• Low-cost ground reaction force line Biofeedback for static posture training-Smart Mirror. http://epics.ieee.org/projects/low-cost-ground-reaction-force-line-biofeedback-for-static-posture-training-smart-mirror/
• SynPhNe – A wearable device for enhancing brain and muscle function.http://www.mae.ntu.edu.sg/Research/ResearchAreas/Documents/BiomedicalandSports/Reh001/Reh001.html
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OBJECTIVES mHEALTH AND ACTIVE AGEING
• Translate Need Assessment and Toolkit Guidelines/Training Module of Community Health Model and Active Ageing into mhealth technology
• Empower to engage people about health.
• Create technology which involve/improve human interactions.
• Maximum reach to grassroot level.
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BENEFITSmHEALTH AND ACTIVE AGEING
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EVIDENCE BASED PRACTICE
EMERGENCY/ ACUTE CARE!! DoctorAHP
Trained Community Supervisor to take care of Small Group through individual home visits, visits old age homes and conducts small group meetings
Elder from small group who needs help in health emergencies call/messages CS with the problem that she/he has.
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OUR STAKEHOLDERS
COMMUNITY CENTRE
Doctor
CS
Patient/elder in community
THANK YOU
CREATING A
HEALTHY
INDIA
www.dharmafoundationofindia.org
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