RAKSHA: December 2008

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drneelesh@Raksha: -Why American healthcare is so expensive?
That the American healthcare delivery system is out of control and wasteful is a no-brainer.

Needless battery of investigations and over diagnosis, branded drugs, impractical insurance laws, free-markets approach to health care and sedentary lifestyle are all major factors in creating the current scenario.Its like a bad spiraling black hole which only sucks you into unnecessary and wasteful consumption of health services.

Keeping the whole machinery ticking seems to be the raison d'itre de patient existence.

This video below touches on a few reasons on why health care is so expensive in America. Features like this convince that India must be doing something right in its public health policy. I have been a member of Public health delivery system for about 10 years, in a wide range of positions and institutions. I fully appreciate Indian obstacles (population) and limitations (poverty) in public health delivery. A good step has been taken with the Swasthya bima (govt. sponsored health insurance with private partners). This Indian central govt scheme for BPL (Below poverty line) families is built on sound understanding of indian conditions and mindset. Eighteen states, including Rajasthan, have already launched this scheme. What is needed now is to make sure ALL BPL families OBTAIN an insurance smartcard. NGOs need to come forward to ensure all BPL families get their smartcards. The cost of the insurance is Ruppees 750/- annualy, 75% paid by central govt. and 25% state govt. The consumer would have to pay an annual Ruppees (Thirty) 30/- as registration/renewal fees. Then they would be able to use services at all public hospitals, many private hospitals and most specialist health care institutions all over the country with the help of a single smartcard!! The claims section of the scheme still has to show efficiency. But all in all, its a very well thought out scheme and should work wonders in more ways than one.

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RAKSHA (Registered society for knowledge and health activities) is a Rajasthan based non-profit organization working for democratization of knowledge and health. It is headed by 1)Dr.Neelesh Bhandari, a Armed forces Medical College passout, a pathologist, post graduate in Human Rights and a medical multimedia consultant. Dr.Neelesh has more than ten years of experience in public health administration, of which about Eight years is in Rajasthan Public service commission. 2) Dr. Preeti Lodha, a psychiatrist and health rights activist with more than ten years of experience in public health administration, of which about Eight years is in Rajasthan Public service commission. Additionally, Dr. Preeti has previous experience of One year as a Project Manager in Operation Veerni. ( A maternal and child health project run by Apollo Rajdadiji Hospital, Jodhpur with international assistance).

The Swasthya Beema Yogana is an ambitious programme meant to provide cashless health care services to the poor in Rajasthan and India.

-Health Raksha Campaign, Rajasthan-

The main aims of the Project-

1) Creating New multimedia/video content for public awareness
2) Displaying multimedia content at important rural junctions using Audio-visual equipment and via local cable and news channels.Permanent IEC Boards ( 4 feet by 2 feet) to be erected at more than one thousand sites.
3) Explaining the benefits of the scheme to Doctors and health workers.
4) Screening BPL families and referring appropriate cases to public hospitals.
5) Collect data on baseline health status and scheme usage trends amongst the BPL families.

Broadly, the project would consist of

1) Four vehicles, armed with Audio-visual equipment ( Television and CD player) to be leased for One year.
2) Each vehicle manned by one driver, one paramedical staff and one Technician, ie 3 personnel.( Total Twelve employees in four vehicles). Supervision over Four vehicles by Two doctors ( Dr.Neelesh Bhandari,Pathologist and Dr.Preeti Lodha, Psychiatrist).
3) Each vehicle entrusted with carrying out IEC activities in Six ( or seven) Districts.( Total 25 districts)
4) Each vehicle makes a minimum of twenty (20) visits per month.( Total approx. One thousand visits over 25 districts in one year) These visits would be prefixed in consultation with local authorities and would consist of rural junctions with high BPL population/attendees ( like Tehsil offices, hospitals, panchayat bhawan, Bus stops, subordinate courts etc.)
5) Dr.Neelesh Bhandari and Dr.Preeti Lodha to make regular monthly visits to various district hospitals, CHCs etc. to give multimedia presentations on the Scheme to the medical and paramedical staff. These visits shall coincide with monthly block/CHC meetings and achieve the dual purpose of training and sensitization of health workers and Doctors. All District hospitals and medical staff at CHCs in all 25 districts to be covered over one year.

Creating New Multimedia

1) For this campaign original video content shall be produced . Promotional content shot in TV studios ( Surya Cine vision, Mumbai and MEdRC, Hyderabad), Interviews with BPL families and officials on site, health education videos and other such content shall be produced. RAKSHA expects to produce original video content of Tens of hours over One year. All intellectual property rights to the multimedia content will be equally shared between RAKSHA and Controlling agency / ICICI Lombard.All the content shall be branded and provided to local cable channels, TV stations and also published on our youtube channel on medical education.
2) Each visit shall be recorded via Still photographs which shall be posted on a dedicated Flickr channel created for this purpose.Copies of photographs shall be distributed to all the local newspapers. Close to five thousand photographs ( Five photographs per visit X approx. 1000 visits) shall be published on the internet.
3) All the events shall be chronicled ( updated every three days) on a new blogspot/wordpress blog created for this purpose.
Such extensive self publication via youtube, blogs and Flickr.com shall also assist in Remote Monitoring of the campaign by state and central authorities at ICICI Lombard.

During each visit by the mobile team, the activities carried out would include

1) Set up the TV and the CD player
2) Give short talks on the Bima Yojana to the gathering
3) Distribute pamphlets and other brochures.
4) Provide OTC medication only to BPL families. This will be done primarily to attract the Target audience.The seriously ill amongst these families to be referred to nearby hospitals with instructions to avail the Bima Yojana. Data regarding total number of patients seen and referred to be conveyed monthly to ICICI Lombard.

This is the skeleton sketch of the proposed Project to conduct IEC and other Promotional activities in the state of Rajasthan over one year. Initially, the four vehicles shall concentrate on the four districts of Jhalawad, Rajsamand, Barmer and Bikaner ( as recommended by you). Later, all the remaining districts shall be covered in equal proportions during the year. RAKSHA shall operate locally in conjunction with public health authorities and local NGOs like Bharat Vikas Parishad., Manav sewa sansthan and others.RAKSHA shall strive to create new partnerships with national and international organizations by using United Nations platforms like solution exchange.to furthur extend the reach of this campaign.

Copies of all the multimedia content along with analysis of before-after data accumulated over the year shall be handed over to Controlling agency / ICICI Lombard at the end of the year.

Kindly email me for receiving a detailed project report. If approved, RAKSHA can initiate the project from the First of January, 2009.

Dr. Neelesh Bhandari
MBBS(AFMC), MD(Path.)
P.G.P. in Human Rights
www.geocities.com/neeleshbhandari