OUTPUT BASED AID (OBA) FROM GOVERNMENT
WHP’s project in Rajasthan successfully demonstrates an Output Based Aid model, an approach advocated and finally abandoned over a decade ago by international donors. The main challenge was inability to monitor service delivery.
In Rajasthan, WHP is co-locating entrepreneurs in 30 of the government-run primary health centres (PHCs) to play a force multiplier role. Almost all the PHCs are in remote areas where hiring (and retaining doctors are a serious challenge.
Local entrepreneurs bear the entire frontend investment to join the network and facilitate consultations with city doctors for patients referred by the PHC staff. Such use of triaging principles allows simple illnesses to be handled by electronic consultations thereby freeing the doctors and quasi-medical staff on duty to attend to morbidities that require in situ attention (such as minor surgeries or physical examinations).
Each consultation is stored in a central server enabling the government to monitor them in real time or offline. The government, through an intermediary agency, pays WHP per consultation which is used to offset all the costs including payment to the village entrepreneur. The patient gets the service free. Since the teleconsultation system is aligned with the pharmacy and diagnostic lab at the PHCs, all resources are used optimally.