From the desk of Editor-in-Chief
Corporate Engagement in Govt Efforts Key to Robust Healthcare
India is home to a wealth of cultural, social and ethnic diversity across its 29 States and 7 UTs — many of which have population larger than various foreign countries.
The Sample Registration Survey of India reports state-level estimates of key indicators such as neonatal, infant, and under-5 mortality rates annually couple with annual surveys such as National
Family Health Survey, District Level Household Survey and the Annual Health Survey, bring out the state level estimation of HIV. However, comprehensive composite assessment of all major diseases and risks factors together reflects India requires a robust health system and policy development in States.
Though healthcare remains a top priority but catering to a billion plus populace isn’t a child’s play, requiring Corporate role in government efforts through NGOs. It well-known health is a state subject, with majority of public spending on health from the state budgets.
As per the Global Burden of Disease ranking of Health Care access and quality, India has fallen 11 places, ranking 154 out of 195 countries. India’s downward slide in the rankings indicates it has failed to achieve healthcare targets, especially those concerning neonatal disorders, maternal health, tuberculosis, and rheumatic heart disease.
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While the private sector is looked upon for quality healthcare, most of the Indians depend upon an under-financed and short-staffed government hospitals.
While NGOs have been genuinely working, some corporate though claim to be working in healthcare are missing the point and doing precious little about this great cause. They would be better if they could realise mere day-long health camps is not enough. They are expected to have curative in approach. But sadly they are found to be doing piecemeal work for CSR obligations under the Companies Act 2013.
The solution to the public health problems suggested in the form of the National Health Policy 2017,seeks to reduce the meaning of “health” to just provisioning of “curative care,” rather than being a state of “complete physical, mental and social well-being” as enshrined by the World Health Organization.
While discussing the challenges, vision and innovative approaches is a key step to understand and reduce healthcare sector’s woes, collective efforts of government and the corporate can bring a
major relief.
The Indian healthcare infrastructure today needs immense support of the corporate to sustain its initiatives for long and address people’s medical woes. The Corporate need to deepen their efforts in terms of CSR initiatives which gives them a long term impact.
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Collective Endeavour Key to Boost Indian Healthcare
By Choudhary Sandeep
India has been making a lot of efforts for decades in terms of consolidating the healthcare scenario. Several Government agencies have been doing their bit for decades. But limited role of the NGOs or the missing corporate is keeping the system far away from having a bit futuristic and innovative approach.
As per the Global Burden of Disease ranking of Health Care access and quality, India has fallen 11 places, and now ranks 154 out of 195 countries. Further, India’s healthcare index of 44.8 is the lowest among the sub-continental countries, as Sri Lanka (72.8), Bangladesh (51.7), Bhutan (52.7), and Nepal (50.8) all fared better.
A section of the corporate that undertakes CSR initiatives has evoked hope. But what if its efforts become a part of government endeavour? Since crores of rupees, at times, are allocated by the corporate for social activities, contributing towards boosting a healthcare ecosystem can be a great step.
While we cannot simply leave every possibility of development as the government’s responsibility, there is perhaps much that the existing healthcare systems can gain from by joining hands with the corporate.
Even though the Government has been doing a lot, much remains to be done in a strategic manner with the help of NGOs with solid grassroots knowledge.
Be it the vision, innovative approach, methodologies, good practices or even the know-how acquired over the years about local or regional challenges can be a great source of learning to benefit from.
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The Challenge
India’s inequity in healthcare access is a matter well known. The difference in health outcomes across states are strong indicators of this inequity. What is perhaps less understood is the magnitude of this inequity, its manifestation across the rural –urban divide and more income segments and its alarming upward trajectory. Catering to a populace having a mammoth size like 1.40 billion people is something that can perhaps leave anyone out of wits. Since there cannot be any one mega plan/policy that may qualify ‘one size fits all’ proverb, State-specific strategies can be employed, as per regional availability or non-availability of resources.
Though NGOs are doing their bit to take healthcare to different geographies, a lot of factors restrict them to genuinely benefit maximum people.
Some of the key challenges faced by the NGOs are:
Financial Sustainability
Sufficient and continuous funding for their work is a big challenge. Gaining access to appropriate donors is a major component of this challenge. At times, current donors shift priorities or withdraw funding.
Strategic Planning
Many NGOs suffer from the lack of a cohesive, strategic plan that would facilitate success in their activities and mission. It leaves them unable to effectively raise and capitalize on financial support.
Lack of Governance
A lack of effective governance is all too common in NGOs. Many have a deficit of understanding as to why they must have a Board and how to set one up. A founder may be too focused on running the NGO for their own purposes; however, governance is foundational to transparency.
Limited Capacity
NGOs often lack the technical and organisational capacity to implement and fulfil their mission, and few are willing or able to invest in training for capacity building. Weak capacity affects fundraising ability, governance, leadership and technical areas.
There are, however, some NGOs who have made a distinct mark over the years due to their quality service and smart approach towards bringing a change in healthcare. Karnataka Health Promotion Trust (KHPT) and the Lung Card Foundation are two such prominent names.
Lung Care Foundation (LCF)
The organisation came into existence to focus on lung healthcare in India. Today, it works in partnership with many educational institutions to create awareness amongst the members of society, enable the transformation through the power of the youth and efforts to own up responsibility and action.
The organisation holds numerous clinical camps where patients from all age groups benefit.
LCF believes in strong partnerships with large and small bodies committed to the common cause.
“We are strong believers in actions and refrain from indulging in blame games. We love to join hands with any organisation that can take this ‘challenge of change’ as part of a long continuous journey,” said Rajiv Khurana, Founder and Trustee of the Lung Care Foundation.
Asked if the results could be altogether different if the corporate, NGOs and the Government join hands for bringing a real change, Rajiv Khurana said: “Absolutely. The situation is so alarming that whatever is done shall look insignificant. The momentum must be carried out in each district of India. We need to go out of the advocacy and planning room to real action areas at the geometrical pace of progression.”
Karnataka Health Promotion Trust (KHPT)
Driven by a vision to empower communities to collectively assert their rights to lead a life of dignity and well-being, KHPT’s work focuses on marginalised, vulnerable, and socially excluded groups.
Prominent Among its achievements is reaching out to 32,000 poorest of the poor pregnant women, adolescent girls and children aged less than 5 years, by projects that address under nutrition.
Impacting about 8,400 TB patients and families and over 30 million community members from high risk areas reached by our TB projects.
Talking of the distinction KHPT maintains from other NGOs working for HIV prevention and care, Mohan HL, Managing Trustee, says: “Our model on HIV prevention is based from a risk and vulnerability perspective. It does not adopt a bio medical approach to HIV prevention by just test and treat but looks at several underlying factors such as education, violence, stigma and discrimination that increases the vulnerabilities of certain communities to HIV.”
“We adopt a programme science approach that looks at generating and using evidence for all stages of programme – design, implementation, evaluation. Our community mobilization approach uses an empowerment framework that has helped empower 60,000 sex workers, 25 000 MSM populations within the programmes.”
Not just that KHPT is responsible for facilitating the establishment of strong community based organisations of sex workers that run and manage the government’s targeted HIV interventions independently today.
Asked one of KHPT’s projects improving the quality of life of orphan and vulnerable children (OVC), Mohan HL said: “Orphans and vulnerable children refer to children who are either infected or affected with HIV AIDS (with or without any care givers). We systematically and sensitively engage with children to increase their uptake of health, education, social protection and welfare services.
Mohan HL, Managing Trustee, said employing a multi-sectoral approach involving government, civil society and corporates, the programmes work to ensure the welfare of the children.
“Our programmes build capacities of child counsellors, promote collaboration between government departments, mobilise communities and catalyse the development of child protection policies within institutions,” Mohan HL said.
“We have reached over 43,000 OVC in Maharashtra and Karnataka. We have also helped institutionalise a direct cash transfer scheme through the government of Karnataka to support the needs of 20,000 OVC in the state,” Mohan HL added.
Some of the leading NGOs in India that are doing an incredibly inspiring work in the healthcare sector can be mentioned as:
| NGO | Intervention | Intervention |
|---|---|---|
| Mamta Health Institute For Mother and Child |
Health | www.mamta-himc.org Ph- 011- 29220210/9220220/ 29220230 |
| Helpage | Health (Elderly) | www.helpageindia.org Ph- 011-41688955/56 |
| Vatsalya | Health | www.helpageindia.org Ph- 011-41688955/56 |
| Rural Health Care Foundation | Health | www.ruralhealthcarefoundation.com Ph- 033 40082981 |
| Lepra Society | Health | www.leprasociety.org Ph- 040- 44586060 / 27802139 / 27807314 |
| Lung Care Foundation | Health | www.lcf.org.in Ph- 011-42252328 |
| Karnataka Health Promotion Trust (KHPT) | Health | www.khpt.org Ph- 80 4040 0200 |
| Voluntary Health Association of India | Health | www.vhai.ord Ph- 011 4700 4300 |
Need of the Hour
While the Corporate has emerged as a big ray of hope in developing a strong social welfare system, a few of the reputed names are definitely doing a commendable job and are playing a substantial role in achieving the objectives of ‘Universal Health Coverage’, which aimed to cover every India irrespective of their economic, social or cultural backgrounds. At the same time there are some corporate who are only organising health camps just to comply companies act without making any significant impact.As transforming the health systems is a long-term journey, championed and driven by political leadership over a sustained period which need very strategic approach. The government need to engage the private sector in an robust and impactful manner to achieve the constructive dialogue about the vision of the country health system and the private sector’s role in it. The question which hits time and again whether the current trajectory of development in the health sector couple with burgeoning health demand, existing and growing inequalities in access and delivery of health services will be able to achieve the objective of National Health Policy 2017, ambitious program aimed to reach out to every Indian in a comprehensive and in integrated manner to move towards wellness.
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‘Delhi model’ sets the benchmark in public health
By Soma Chakraborty
Over the last few years, there has been a noted increase in amenities belonging to the health sector in Delhi. Some of the initiatives like the Mohalla clinic have also earned accolades from the likes of Kofi Anan, former Secretary of the United Nations (UN), and Gro Harlem Brundtland, former Director General of the World Health Organisation (WHO). The Bridge India takes a look at the various initiatives launched by the Aam Aadmi Party-led government towards achieving better health coverage in the national capital.
Budget Allocation For The Health Sector
The focus of the Delhi government on health sector is well reflected in its budget allocations for the sector in the last four fiscals. In the fiscal year 2015-2016, the state government allocated Rs 3,138 crore towards the health sector, accounting for a 16.52% share in the budget. In 2016-2017, Rs 5,259 crore was allocated to the health sector. The next fiscal year 2017-2018 saw Rs 4,000 crore allocated for the health sector, while in the financial year 2018-2019, the government allocated Rs 6,729 crore or around 13% of its annual budget towards health.
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Aiming at expanding healthcare infrastructure, the Delhi government has chalked out a blueprint to set up 900 new Primary Health Centres (PHC) and 30,000 additional beds in Delhi hospitals. Of the 30,000 beds, 4,000 would be in maternity wards.
Quality Drugs At Affordable Pricing
Aiming at ensuring zero corruption and making high quality drugs available to general public at subsidised rates, the Delhi government is centralizing the procurement of medicines and medical equipment.
Free Surgery At Private Hospitals
Under this initiative, the Government has partnered with 48 private hospitals where people who are unable to get the required surgeries at government hospitals can get them done at these private hospitals. The surgery expenses are covered by the government.
Mohalla Clinics
The most important achievement of the Delhi government on the health front is the starting of mohalla clinics. ‘Mohalla’ in Hindi means neighbourhood or community. Mohalla clinics are primary health centres that offer basic, essential health services, including medicines, diagnostics and consultations for free. These clinics serve as the first point of contact for people. The aim is to offer timely services and reduce a load of referrals to secondary and tertiary health facilities in the state. These clinics have been conceptualised as a mechanism to provide quality primary healthcare services accessible within the communities in Delhi at their doorstep, and help de-congest crowd within government hospitals. The government plans to set up 1,000 Mohalla clinics throughout the city, with one in every five kilometre radius. Over 30 lakh people have received treatment so far in these Mohalla clinics.
Polyclinics
Next to mohalla clinics are multi-speciality polyclinics, which focus on secondary healthcare in the form of OPD consultation by specialist doctors, including diagnostics. The Delhi government targets to have 150 such polyclinics. Polyclinics are secondary healthcare centres that are referred to, by the doctors of Mohalla clinics when they feel that the patient needs an expert for diagnosis and treatment. The government of Delhi has tied up with 21 laboratories across the city to provide 13 expensive medical tests such as PET, CT and MRI for free in these polyclinics known as ‘Aam Aadmi Polyclinics‘.
Aam Aadmi Health Cards
The government plans to issue ‘Aam Aadmi Health Cards’ to all residents of Delhi. The health card scheme will have an electronic health record of all residents in terms of medical histories, on-going treatment and prescription details.
Accident Scheme
Under this scheme, the Delhi government will bear the cost of treatment for victims of road accidents, burns and acid attacks at government or private hospitals. There is no upper cap on the expenses borne by the government. Irrespective of their origin or place of residence, victims will get free treatment if mishaps or accidents take place within the jurisdiction of the NCR.
The Way Forward
The investment of huge funds into health sector and initiation of revolutionary measures by the Delhi government have tremendously improved the healthcare infrastructure of the national capital. The ‘Delhi Model’, which has direct government involvement and monitoring and appropriate discharge of budgetary fund thrust on heath sector, is the best example for other states to follow to improve their healthcare sector as well.
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Development Happenings
By The Bridge India Correspondent
POSOCO builds waiting hall in Delhi’s Safadarjung Hospital
As part of its CSR initiatives, the Power System Operation Corporation (POSOCO) has constructed a Waiting Hall in Delhi’s Safdarjung Hospital, which witnesses arrival of thousands of people from far and wide daily.
Inaugurated by Dr. Sunil Gupta, Medical Superintendent, Safdarjung Hospital along with K V S Baba, Chairman & Managing Director, POSOCO, on 12th April, the waiting hall is intended to provide relief to all.
It has been built for the use of patients and their attendants visiting the hospital for treatment.
Also present on this occasion were Meenakshi Davar, Director (HR), P K Agrawal, Director (MO), Ranjan Kumar Srivastava, Director (Finance), and other senior officers of POSOC.
POSOCO is a wholly owned Government of India Enterprise under the Ministry of Power.
Govt. sanctions prosecution of 284 firms over failing in CSR norms
The Government has given a go ahead for prosecution proceedings against 284 companies and sent 5,382 notices to others that have failed to fulfill the mandatory CSR expenditure norms, Minister of state for Corporate Affairs P P Chaudhary revealed it recently.
As per provisions of the Companies Act, 2013, the companies with a net worth of Rs 500 crore or above or revenue of Rs 1,000 crore or more, or net profit of Rs 5 crore or more in a fiscal year have to spend at least 2% of the average profits of the preceding three fiscal years on CSR activities.
Minister Chaudhary, however, appreciated efforts of other Indian companies for creating a positive impact in the areas of healthcare, education and rural development.
Tata Trusts, Microsoft to jointly empower 3,000 artisans under CSR
Tata Trusts and Microsoft India today signed a Memorandum of Understanding to jointly rejuvenate the handloom clusters in the Eastern and North-Eastern parts of the country. Through this collaboration, both the initiatives will leverage each other’s strengths to provide business & communication skills, design education and digital literacy to handloom weavers so that they may build a sustainable future.
Microsoft’s ReWeave initiative, helps preserve traditional weaving forms by upskilling, design, marketing, and entrepreneurship, besides creating sustainable livelihood options. Project ReWeave successfully implemented new e-commerce platform, digital empowerment centers and the new design curriculum to Telangana weaving clusters of Rajouli, Chottuppal, Pochampally, Naryanpet & Gadwal and shortly in Warangal & Siddipet clusters. Microsoft will enable digital training through Project Sangam, a Microsoft Azure based Learning Management System. This initiative provides necessary training and tools to other weaving communities to help realize their full potential.
Tata Trusts’ initiative, ‘Antaran’, aims at rejuvenating ailing handloom clusters through an end-to-end programme which would nurture artisans as designers and entrepreneurs. Through the ‘Antaran’ Initiative, the Trusts have initiated intensive work in Odisha, Assam and Nagaland. The programme will benefit 3,000 artisans directly involved in pre-loom, on-loom and post loom processes, impacting the livelihood of weavers in 6 weaving clusters of these states.
Commenting on the partnership R Pavithra Kumar, Chief Program Director, Tata Trusts said, “We are delighted to partner with Microsoft to digitally educate and further empower these weavers. Often, these communities are marginalized and do not receive much exposure to modern technical amenities or training to develop business skills. Through this initiative, we want to empower artisans and bring them up to par making them competitive in the industry.”
“As a part of our philanthropies’ programs in India, we are focused on reviving some of the forgotten and fading handloom forms in India’s textile heritage. Our partnership with Tata Trust will help reach down to the grass-root level of the weaver clusters and train them, hence building a digitally inclusive society. We aim to use our Project Sangam to empower the weavers across India so that they can adopt and deploy digital tools to improve their craft,” said Anil Bhansali, CVP Cloud & Enterprise and Managing Director, Microsoft India.
Employing over seven million families in India, the craft sector is the country’s largest source of employment after agriculture. In addition to having a high potential of employment, the sector also has great economic importance in terms of foreign exchange earnings. Despite this, the sector is grappling with problems like the inability to produce high quality market driven artefacts and low access to domestic and export markets. Handloom weavers, particularly the young ones, are drifting away from the sector at an alarming pace, thus painting a not-so-happy picture.