ICTPH Health System Approach

By Zeena Johar, President – ICTPH

A health system needs to provide for the requirements of an individual through various stages of life and states of health, offering promotive, health-maintenance, preventive interventions for the entire population and disease management capability addressing the tail-end of population-health distribution. Primary prevention targets prevention of disease and disability at the level of the community (immunisation and water and sanitation efforts for example need to be managed at the community level), while higher order preventive efforts at the secondary or tertiary level focus more on the individual. For accurate disease management, appropriate diagnostic capability, aided by evidence based administration of medicines and follow-up ensuring compliance, is crucial to ensure effective curative interventions. IKP Centre for Technologies in Public Health (ICTPH) a not-for-profit research organisation with its mission to design inclusive health-systems for remote rural populations, is anchoring a pilot with a Thanjavur (Tamil Nadu) based partner organisation: SughaVazhvu Healthcare. The objective of this pilot is to design an inclusive health-system ensuring accessibility and affordability for all the members of the rural community in the remote rural parts of Thanjavur.

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6 Comments on "ICTPH Health System Approach"

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Nachiket Mor
13 years 7 months ago

The way I understand it there are four parts to your Health Systems Design:

1. Infrastructure (Clinic, Hand-helds, EHR, Diagnostics, etc.)
2. Human Resources (Nurses, Guides, Doctors, Administrators)
3. Financing (Insurance, Fee for Service, etc.)
4. Interventions and Protocols (Clinic based, Community Based, Referral pathways)

I feel that in the interventions space it may be useful to add a page in this note on all the ideas that you and your team are working on, referencing the relevant blog entry for each one.

Nachiket Mor
13 years 7 months ago
One of our key roles, particularly in Tamil Nadu, once we have examined the patient in the RMHC would be give the patient: 1. Good information about their health status — including a printed report. 2. Good information about healthcare providers — particularly the government. 3. While the patient could certainly choose to purchase medicines and diagnostic services at the RMHC, I feel that it would be appropriate for us to make her aware of what is available / supposed to be available at the PHC and the ICDS Centre (perhaps obtain a booklet from the Government on this). And… Read more »
Nachiket Mor
13 years 7 months ago

This link (http://www.hrhindia.org/assets/images/HRH%20Policy%20Note6.pdf) provides an interesting insight into the career preferences of medical students and nurses in Uttar Pradesh. While the study was very limited in its scope and strictly qualitative in nature it does support the proposition that building an empowerd-nurse-centric primary health system may be a more feasible alternative than trying to force MBBS Doctors to serve in rural locations.

Nachiket Mor
13 years 7 months ago
Some of the hypothesis being tested in this note include: 1.Quality of manpower as defined by an MBBS degree is less important in a primary care setting and may even be a hindrance in the delivery of routine protocolised care in the primary care setting – they are very quickly bored with the routine and are not comfortable following strict protocols for treatment. 2.The development of clearly defined protocols for the treatment of routine illnesses and the training of personnel (ideally nurses or AYUSH providers – both of whom have some basic training in medicine but may be more comfortable… Read more »
Richard Bartlett
13 years 6 months ago

Thanks for sharing – very interesting. Have you seen any results for the pilot yet? The elements that the pilot aims to design very much resonate with the overarching gaps seen in healthcare delivery and specifically innovative or entrepreneurial new models. The only additional challenge that is seen within this space is around regulation; though typically is only more of an issue when you take the pilot you’ve got outside of the region of Karambayam into new areas.



[…] Systems approach are human resource, infrastructure & technology, financing and interventions (Johar, 2010). The healthcare delivery pilot anchored by ICTPH, along with its field partner SughaVazhvu […]

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