360 degree Mapping to gauge Primary Health Care Performance

Primary health care is the bedrock of any health system, more so in low- and middle-income countries. Being accessible, affordable, socially acceptable, equitous and accountable Primary Health care services provided by the public sector is often seen as an end in itself. Lack of monitorable parameters, or systems of assessment hinder the potential of Primary Care. For example, in India, Primary Care is measured through parameters like infrastructure, staffing, drug availability in its annual Bulletin of Rural Health Statistics publication – all of which are input level parameters. The results in terms of usage, effect or impact on the target population is never assessed. Absence of a measurement framework  based on a sound understanding of what Primary Health Care is expected to deliver is the foremost stumbling block to its efficient delivery. We propose to address this problem of measurement, since what is measured well is managed well.  

In this task, we use a social health approach. We are building a generation that shifts from the webs of poverty and despair to the heights of hope. We recognize and understand that health is not stethoscope and pills.

We build people and communities, not bricks and walls. Because people’s health outcomes, their ability to be healthy is simply influenced by the country they live in, where they are born, where they grow up and what their circumstances turn out to be. Primary Health care is often not accessible to a large majority of population in low income countries for a variety of reasons, of which is lack of measrable indicators of its performacne, 

Our solution is built on the model of social health that approaches care in a multi-disciplinary perspective, with a focus on the preventive element through active involvement of the recipient of the service, on behavior change communication, leveraging technology for health screening, uses telemedicine and mobile laboratories for outreach and for regular care.

Hence, the social health initiative plugs curative and preventive gaps, closes in social protection through entitlements, supports livelihood through skill building and empowers a community through knowledge and scientific updates.

It relies on modern, as well as traditional medicine to  put holistic healing at the heart of patient care and not isolated piecemeal models that have not been able to withstand the test of time.

We propose to use the data spread across line ministries and departments that dive into the depth of what influences outcomes of care, and in turn are impacted by the level of perormance of health set up. We propose utilizing publicly available data with different development agencies and use of AI, ML to interpret it in a way that gives insight on the outputs, outcomes and impact of performance of Primary Care system.

We would use a territorial approach to assess the performance of Primary Care, assigning a defined territory of jurisdiction as the area of responsibility, and accountability of each Primary Care set up. We will gather data on the defined territory and ascribe it to the performance of the Primary Care set up. This will expand primary care in its widest dimensions, and cover all social determinants of health.

It is only through this interpretation that a risk informed policy solution is achievable.

The target population are largely under privileged communities with limited education and no practical knowledge of public health evidence-based medicine. Additionally this is also the same communities who largely depend on public health systems to cure their ills, social and medical.

Plugging this gap needs a holistic systems approach for primary care. Once the Primary Care set-up becomes efficient and responsive, it will lead to fewer avoidable loss of disability, death or ill-health, and thus, better health, well-being and productivity. It will lead to happier people, realizing thier fullest potential. The change will get reglected in evey social and economic activity that people do.

Our deployment on ground with local stakeholders provides for the buy-in  necessary for community and stakeholder engagement. Our backend strategy team comprising of experts working with intergenerational solidarity in mind which serves to connect priceless wisdom to modern ideas. Our team comprises experts with a lifetime of experience in administering development  programs. This work gets blended into community programming where primary care is carried out through a multi-disciplinary approach.

Need financial support to scale for geometric outcomes built on evidence informed public health models and policies

The metrix through which the solution is approached is built on the foundations of putting humans at the heart of progress, and inter-sectoral nature of health. There is a two way relation between economic, social sectors and Health. This presents an opportunity to capture the performance of health system at the Primary Level using data handles beyond those from the health sector. We alsofollow a life-cycle appraoch. This corss-sectoral breadth makes it powerful and unique.

A resilient primary health system, that is accessible, responsive, affordable and inclusive, is likely to make a game changing impact on the overall quality of life of people in that area. Wokring through lesser disability, better health status, and lower spending on health, it is expected to lead to better health and nutritional status, higher productivity, lower fertility and better overall wellness.

We would be analyzing existing available data, breakdown the same further and providing a multi-dimensional solution in terms of feedback loops. 

The suggested Log Frame is:

Goal: To build healthy communities by social health integration 

Outcomes: Population in millions to benefit. Reduction in disease dynamics and burden, decreasing incidence and prevalence of selected infectious diseases, enriching community entitlements and advancing social protection. 

Output: App based, raw data in excel to be analyzed using AI and machine learning tools. 

Activity: Preventive care & curative care analysis, dynamic action plans at district and sub-district levels for better gaps to be addressed around primary care

Our solution builds on existing data models collected over years which have scope that subsequently provides for risk informed planning to base primary care solutions upon. This would also serve to suggest a future roadmap as to what should be the areas of policy intervention and how must the approach be to ensure we leave no one behind. 

At each phase this would go through a monitoring and evaluation process with stakeholder consultation to rejig and retrofit existing frameworks into public health evidence informed policies that integrate human health and well-being. 

We access routinely collected and openly available administrative data to gain a 360 degree insight into all dimensions of performance of Primary Health Care system. We will use APIs (wherever avaibale) to access databases, use relational database tools to relate the data coming in from different sources, apply alogrithams based on expert understanding of inter-relation between social, economic determinants and Health and use AI, ML to draw inferences on the Strengths, Weaknesses, Opportunities and Threats to the Primary Care ecosystem. We also propose to deploy an App to gause user's feedback and hone in data sources based on it.

We follow a blended approach data available in public servers, and also social media networks which works in a diverse country like India that has diversity to the very last mile with socio-economic and cultural determinants that influence outcomes.

Our backend team will search all related data sources in public domain, as well in Social media. If necessary, we will deploy field functionaires to collect data from public sources, which has not been digitized. We will also float an app into which citizens and users of Primary Health Care services can annonymously share their insight, experience, concerns and suggestions on the performance of the system. Hence, ours will be an intellignent, evolving and learning platform which will map the performance of Primary Health Care institutions over time.

We don't observe any particular diversity focus as for us everyone is a human being capable of being cared for and loved by. So our implementation factors in inclusion and integration at the very core of process implementation. 

We don't believe in a one size fits all model, but our model thrives on social health integration from a systems perspective to plug evidential gaps in implementation processes that support primary care delivery to a greater extent. Data analysis will serve at the crux of policy framework and outcomes, thereby

This is a pilot and the outcomes of this solution will be self sustainable and provide for policy based solutions that can be easily addressed with existing systems

The proof of concept when executed at large will serve as a buy-in for Government to deploy. Sustainability at scale can be achieved for the area of intervention, but at scale implementation will rest on this becoming a policy decision for a 1.2 billion nation.