Mahesh will present an introduction to the Health Inc. project, the methods and the SPEC framework used in the project.
Mahesh Kadammanawar
IPH Staff
04-October-2018
4:00 pm – 5.00 pm
Institute of Public Health, Bengaluru
#250, 2nd C Main, 2nd C Cross,
Girinagar Ist Phase,
Bengaluru – 560085
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??
It was another day in the field collecting data for Health Inc project. The team reached village near Nelamangala. After meeting staff in Gram Panchayat (GP) we were asked to talk to Anganawadi teacher and take her help to identify the houses for collecting data. But the teacher was not happy to accompany us. She said “why should I help you? it is GPs responsibility”, however we managed to convince her to accompany us.
Source*
Interesting discussion started after that, we gave her the list of household and explained where we got that list. She said…oh then I have that list with me and I also have many cards in the cup board and she took out box full of Rashtriya Swasthya Bima Yojana (RSBY) smart cards. When asked why cards were not distributed..she said…”why should I give, it is GPs responsibility”! It was clear there was no coordination between Anganawadi teacher and GP. But it was poor who were deprived of benefit. I asked teacher, do you know what this card is. She said yes it is health card!! Do you know anything more than that? No…that is the only information given on the day of camp!!
Then team got divided and along with Mr Omkar I followed teacher to one house. Teacher first entered the house and said there are some people who want to collect information and she started walking out. I heard female voice from inside asking what information? Teacher screamed from outside.. “about that PAN card you collected from me last week”!! I said …what!! PAN card…no no we are not here to collect information about PAN card…teacher smiled and said “madam these people don’t understand” and she started walking away….I questioned myself…who does not understand? Does the teacher understand? How does she know they do not understand? Anyways it was time for me to get inside the house and sit with Omkar.
When Omkar showed RSBY smart card asked do you know about this card….informant said yes it is AADHAAR card (AADHAAR is Unique Identification number issued by Govt India) and when asked who told you that…Anganawadi teacher came and called us to take photo for AADHAAR card and she gave this card later. Informant showed some paper which was given on the day photo was taken; those papers were related to AADHAAR.
I thought on the day of camp did they take photos for AADHAAR and RSBY? Why was no information given to people about RSBY? Why did Anganwadi teacher call people for AADHAAR card? Did not get answer but thought may be people responsible to issue cards felt poor people will not understand or they did not want to give information? Not sure but I moved to next house thinking does different types of card means the same for poor…NO BENEFITS & NO INFORMATION?
*http://www.rsby.gov.in/
The second global meeting of the Health Inc project was held in Senegal between 9th and 11th November. This meeting was hosted by the Centre de Recherché sur les Politiques Sociales (CREPOS – Research Centre for Political and Social Science) in the capital city of Dakar. All partners of the Health Inc consortium attended this meeting. From IPH, the Health Inc team comprised of Dr.Devadasan N, Dr.Thriveni BS, and Dr.Tanya Seshadri.
The three day meeting began with presentation and discussion by ‘Experts by Experience’ in poverty and social exclusion from Belgium who provided insight into social exclusion from the point of view of those excluded. This enlightening start was followed by presentations from all partners regarding their localised research protocol along with challenges foreseen. While the previous meeting had allowed for discussions regarding health financing mechanisms across Ghana, Senegal, Maharashtra (India) and Karnataka (India), this time the focus was on the planning and implementation of research across the various sites. The challenge remains to develop a common skeletal protocol while allowing each team to develop protocols based on their specific context. The health financing schemes being used to study social exclusion in the African and Indian sites are National Health Insurance Scheme (NHIS, Ghana), Plan Sesame (Senegal) and Rashtriya Swasthya Bima Yojana (RSBY – Maharashtra and Karnataka).
This meeting was followed by a two day workshop for the junior researchers from the various institutes. The workshop had the group divided into country-based teams and each team worked on developing context-specific hypotheses and initiated work on the research tools.
For further details about the project, visit the recently launched website at http://www.healthinc.eu/
Photo below shows representatives of all six partners of the Health Inc consortium under the Baobab tree (national tree of Senegal) at Goree Island in Dakar, Senegal.
Dr.Devdasan and Dr.Tanya participated in the Health Inc. kick-off meeting at London between 27th and 29th June 2011.http://www.facebook.com/media/set/?set=a.238324899518867.66192.131455163539175&l=0ef5cd8e92
