WHP will be launching an innovative public-private model in Uttar Pradesh in which the management systems and digital solutions developed for private entrepreneurs’ network will be re-purposed to extract better value from resources deployed in the public sector. The project in Gorakhpur district, one of the largest of the country with 4.5 million population, 81% rural, will be implemented for six months from February 2018 after one month of preparatory work.

The solutions WHP developed for its entrepreneurial model focused on telemedicine, inventory management, data warehousing, analytics and medical algorithms. (Refer to Hybrid to Optimise Resources.) In the public sector facilities, however, the needs are different. Doctors and nurse-midwives have extremely limited time available per patient. There is no mechanism to alert about disease outbreaks and the delay takes a huge toll. (Gorakhpur was recently in the news when over 30 children died in a Japanese encephalitis epidemic.) Supplies are erratic since the public sector continues to follow an outdated forecasting model which results in stock wastage at one level and non-availability at others.

The Gorakhpur proof-of-concept project will be implemented at a Primary Health Centre located in Chargawa and four of its sub-centres. While the sub-centres together cover a population of 40,000, the PHC has a catchment population of 250,000 served by a total of 26 sub-centres.

The project will enable doctors and ANMs to handle large caseloads more efficiently; provide real-time indicators on attendance and performance to supervisors at all levels; send outbreak alerts in real-time to all levels for quick remedial action; and, manage inventory at pharmacy and pathology lab on a bottom-up utilization basis. The project will utilise all resources already in place at the facilities and will bear the additional cost of technologies and human resource wherever there is a shortfall, if any. The government-identified ASHAs will play the crucial role of generating, identifying and communicating demand through a centralised facility. ANMs will provide the services to fulfil the demand at the sub-centres and outreach villages with the aid of WHP’s internally-developed AltheaPLUS device. (Refer to Technology.)

The digital solutions at the sub-centres will add a strong component of care for the long-neglected gynæcological and reproductive morbidities through a telemedicine system while providing task aids with automated checklists to maintain the current range of preventive care services (ante-natal care, immunisation and growth monitoring). The doctors at the PHC will provide medical care both to clients who are visiting the facility as well as connecting through the telemedicine system. The system will also allow for supplementing the PHC doctor with a city based doctors especially to handle gender-sensitive cases. There is currently a major shortage of lady doctors in government facilities.

The system is also tailored to generate real-time reports of availability and performance of personnel in the government facilities, for example release of incentives due for each ASHA. At the end of the demonstration project, the state government will be able to scale the model to other districts on the basis of lessons learnt.