3rd Global Meeting of the Health Inc Consortium at Bangalore

3rd Global Meeting of the Health Inc Consortium at Bangalore

The third Global meeting of the Health Inc Consortium was held in Bangalore, Karnataka between 20th and 23rd November 2012. This meeting was hosted by the Institute of Public Health, Bangalore at Hotel Lemon Tree Premier.

In the last meeting, the four sites namely, Ghana, Senegal, Maharashtra (India) and Karnataka (India), had shared their research protocols for data collection. Since then, all of them have started conducting their data collection and this meeting provided the opportunity for them to share their progress with each other. Over the next four days, partners discussed the preliminary findings and the next phase of the project.

For more information about the Health Inc project, read the following blogs from LSE:

  1. Does social exclusion limit the impact of healthcare financing reforms in India?
  2. New research seeks to ensure that vulnerable groups benefit from health care financing reforms.
3rd Global Meeting of the Health Inc Consortium at Bangalore

Is embracing death @ 24 so easy?

This time it was neither KG Halli nor urban health project….but Health Inc…trying to find reasons for social exclusion in Bangalore Rural district.

When we entered 8×8 single room house, Jagadish was lying on the bed. We asked how he was feeling, he pushed bed sheet aside and showed his leg…yes it was badly infected & looked scary and his hospital discharge card said Cellulitis!  He said few days ago we went again to private medical college they refused to admit me, then we went to Government Hospital, doctor said nothing can be done..it is too late, so we came back home. I was speechless and ran out of words…just to listen from that  24yr old boy in a calm and composed voice, with no emotions saying I’m waiting for my death! I said to myself.. Is it so easy to accept death?

For a moment I forgot why we were in that house, started  making calls to friends and colleagues for help… one of the district surgeon assured to do his best. In the last 2 month, family which is mainly dependent on daily wage had borrowed Rs 40000 for his treatment, admitting him again means one or two family member loosing their  wage….where money lenders are already demanding repyment….can they really afford to give time to save Jagadish? After two days I get information that he is yet to reach hospital!!

It must be the frustration, helplessness and poverty forcing people accept things easily as their fate! Is it the fate which is preventing Jagadish from getting care or is our health system failed to provide care for people like Jagadish or access care? Who should be blamed for…is it the tertiary care center which did not consider worth treating him or is it so simple that we blame poverty for everything and record exclusion due to poverty??

3rd Global Meeting of the Health Inc Consortium at Bangalore

Good presentation is very important

Good presentation is very important and I apply this concept”. This is said by one laboratory technician working in a Primary Health Center (PHC). He believes that if he provides his laboratory services in a presentable way, he can earn the trust of the people. “People will come to me and they will not go to private laboratory unnecessarily where they have to pay more for the same kindof laboratory test which I can provide them free of cost”

This he is doing by simply giving the laboratory test report in a format developed by him and using the print copy of that to give report of the patients. Simple thing can make differences. He developed separate format for ANC and separate for other general laboratory test.

He is keeping all daily and monthly chart update. Well maintained registered. Neat and clean laboratory.

While talking to him and observing all these, immediately in my mind I was relating him to my recent experience with private hospitals recording system during my father’s checkup where they gave all medical records of my father in a folder and also while my friend was admitted in a hospital, nurse was visiting her after every two hours, checking her BP, temperature and putting it down in a diagnosis sheet. That time I was impressed and felt good and was thinking why these kinds of services are not available in Government health facilities.

And now when I am relating my experience with this, I am wondering if he is having the knowledge of importance of “good presentation” or good patient documentation. Why not other has this knowledge?  Are they do not know its importance and how it will benefit them? Why cannot do they do their bit like him? Is it due to they need training on it? Or they are over burden?

Anyway, I personally realized and learned from him that if I can do my bit by presenting my research work or field experience in a presentable way (through blog, article etc) and share, it can benefit the society to a large extent and also to me 

3rd Global Meeting of the Health Inc Consortium at Bangalore

Is health camp an effective stratergy

Health ‘camps’ are one of the strategies adopted by both government and non-government organizations. This literally means that a team of health professionals ‘camp’ in an area to carry out a limited health intervention. For instance, government organizes sterilization camps for women. Or an NGO organises a diabetes screening camp. Or a private hospital organises a blood donation camp. Unfortunately government pays little attention to the quality of sterilization service and tends to focus on targets. Or there are NGOs which conduct camps just as an activity, which do not yield quality.

KG Halli is one of the 198 wards in the greater Bangalore metropolis with a 45000 population, and we from IPH work with the community to improve the quality of health care in this area. Last year a grass root NGO which is working with the slum inhabitants requested our support in mobilizing the community for an eye camp. To our surprise, it was only screening without any follow up. After the camp, people from the community started asking us whether we would give them any material aid like spectacles and so on. We told them they need to ask the organizers- the hospital which did the screenings. Unfortunately they were advised to purchase the spectacles at their own cost.

Many times, a health camp run by with a private hospital becomes a business gimmick. The poor attend the camp with the aim of free check up and free treatment. When they do not get free treatment or subsidy for treatment they stop follow up. While organizing health camps follow up becomes one of the important ingredient in quality health camps.

Either targeted approach without quality services or an activity without follow up will not improve the health status of the patients and will not develop trust between the community and the NGOs involved in such camps

Therefore we to organize camps and at the same time we cannot ignore offers to organize camps when there is quality in it.

We could not say no to Doctor Santhosh Benjamin from CSI (Christian of South India hospital), when he requested us to ally with them in organizing an eye camp in KG Halli for cataract surgery. We UHT (Urban Health Team) wanted put this opportunity into best use. Hence we planned the eye camp with three phase pre health camp task, actual health camp and post health camp task.

We took up publicity through announcement in different language (Kannada, Tamil and Urdu), besides distribution of leaflets. Our community health assistants announced in three different languages. We had coordination with CSI, BBMP & UHC (BBMP run Urban Health Center), and got permission letter from BBMP to use the UHC premises for the eye camp. We purposely selected UHC to do eye camp, in order to strengthen the link between the government facility and the community. The message was eye camp followed with surgery was free.

The camp program began on time, as a result of two days publicity we were able to mobilize 89 patients. All the patients were registered with their name, address, with contact number for follow up. The activity went up to 3.00 pm. Out of 89, 19 were screened for cataract surgery and were given appointments by the doctor. The appointments dates stretched till 30th of May 2012.

In the midst of the camp the next door CHC (State run Community Health Center) staff wanted to ruin the spirit of eye camp, and went to the CSI doctor to tell her-“This eye camp is waste, the people from this area will never turn up, we have been conducting regular eye camp in CHC, anyway they give address and contact number but will not come”. Josphine (CHA) who followed him gave assurance to the doctor. “Since we are doing home visit and we knew all the patients we will make sure that they visit CSI hospital for surgery”.

However the patients who were asked for surgery did not wait for us to remind them. They promptly visited CSI for surgery. Out of nineteen patients 13 underwent surgery, two were sent back home because one has heart problem (he was asked to get report and letter from his doctor) and another person is diabetic (He was given medicine to control his sugar level). We are following it up with the other four patients. Both Josphine and Nagrathana met CSI doctor to ensure the visit of patients for surgery.

The eye camp program for the community has increased the trust on us and our work. The people from the community are demanding for more such programs. 

3rd Global Meeting of the Health Inc Consortium at Bangalore

Training for district supervisors for post-hospitalisation survey in November 2012

Post-hospitalisation survey training conducted at Bangalore

Post-hospitalisation survey training conducted at Bangalore


 
The Health Inc Karnataka team organized training on 8th and 9th November 2012 at Vishranti Nilayam, Bangalore for district supervisors from all four districts on administering a questionnaire to survey respondents who had been hospitalized in the last few months, also called form 3.  This training was organized to train them in administering the survey questionnaire, reviewing the Kannada version of the questionnaire, and orienting them regarding hospitalizations and the related expenditure incurred by any patient. The district coordinators conducted the training using a mix of lectures, role-plays and group discussions with inputs from Bangalore team members. This survey was aimed at collecting details of the hospitalization experience for the patient, and his/her bystanders (before admission, during the stay and at discharge), and details of utilization of RSBY during the hospitalization episode using a semi-structured questionnaire.

 

Trainers from the Health Inc Karnataka team demonstrate how to administer the questionnaire

Trainers from the Health Inc Karnataka team demonstrate how to administer the questionnaire