The Indian Healthcare landscape is littered with organisations and projects that aim to improve the lot of those who do not have access to modern and professional healthcare. Yet, there is little evidence that these efforts are systematic and replicable. Health Equity seeks to bridge this vital gap.

As a venture that is rooted in developing an alternative model of bringing healthcare to the Last Citizen in our villages, one that has only recently started its work, securing funds to sustain not only its operations but to also provide a cushion for its further expansion is critical. With the funds already secured, Health Equity has made significant strides, but these need to be sustained. You can help us make this happen.

There are so many ways in which you could help. While we have established the basic infrastructure to conduct training programmes to prepare Arogya Mitras and to renovated the hospital to treat patients requiring secondary care services, there are still many gaps that need to be filled. Similarly, there are recurring expenditure, both related to the primary care programme and for patient care that is provided at the Sojitra Hospital, that need support.

Any help that we receive would, of course, be acknowledged and where possible, this acknowledgement would be displayed at prominently.

Help with the infrastructure:

Our Primary Care Programme:

Creating a better training facility:

The training of Arogya Mitras is skill-based and we use mannequins to provide them with practical experience. We have managed to acquire the minimum requirement of mannequins, but we have only one set. We are looking for at least 3 more sets; each set costing Rs.5 lakhs

Equipping Arogya Mitras in their journey as Primary Healthcare Giver:

Each Arogya Mitra is to be provided with a mobile with our app installed to enable video access to CC Patel Sarvajanik Hospital. Each mobile costs Rs.10,000.

We also provide a kit with instruments, medicines and supplies to each Arogya Mitra to help them in their work. These include Digital Blood Pressure instrument, digital thermometer, nebulizer, weight and height measurement instruments, etc. The total cost of each of these kits (including medicines and supplies) is around Rs.25,000.

Creating a Mobile Treatment Clinic:

Our team of doctors and field supervisors would start visiting villages for ensuring that the work of Arogya Mitras meet with the standards expected of them and to supplement their needs. The team would also hold clinics in each village they visit so that patients requiring chronic care and those needing consultations that Arogya Mitras are not equipped for, could be examined and treated. We would like to have one Mobile Treatment van initially and with expansion of the field programme, another in the next two years. Each of these vans is expected to cost Rs.20 lakhs. 

Providing for vehicles to connect villages with the Sojitra Hospital:

The project envisages a weekly camp in the villages which would be attended by the consultants of the hospital. We are looking for a mini-van that could be used not just to transport the team that would conduct the camp, but also carry supplies and equipment required for the camp, which is expected to cost around Rs.8-10 lakhs.

The project also envisages providing for a means through which lab samples taken at the villages could be transported to the hospital for processing and reporting and for medicines required for treatment but not part of the kit provided to Arogya Mitras to be supplies. We would like to have a couple of motor cycles for this purpose, which is expected to cost around Rs.1 lakh each.

Our Secondary Care Hospital at Sojitra:

The facilities at the secondary care centre at Sojitra also need to be strengthened. While a significant investment has already been made, there are still areas that need to be renovated and facilities that need to be acquired. We have identified the following needs over the next 2-3 years, together with their likely cost:

Help With The Recurring Expenditure:

Helping the requirements of the Primary Care Programme:

Help in organizing Multi-Diagnostic Camps in Villages:

An important strategy to popularize the Health Equity concept in general and the trained Arogya Mitras belonging to various villages in particular, we organize camps in villages; almost one every week. All services at the camp – registration, consultation, medicines, etc.- are made available free. Patients requiring further consultation, investigation or treatment are referred to the CC Patel Sarvajanik Hospital where diagnostics are made available at 50% discount and medicines at 25% discount. Further, in case of hospitalization, all charges related to the stay of the patient; bed, nursing, doctors’ fee, etc., are made completely free. 

An assistance of Rs.25,000 would help us organize one camp in a village.

Help us motivate Arogya Mitras:

In order that the Arogya Mitras work with enthusiasm and purpose, we have introduced 3 schemes that provide them incentives for their work:

1. Top Up: For the first two years of the work of the Arogya Mitras, If she earns more than Rs.500 in a month, she would be eligible to receive 50% of the income earned as a Top Up upto a total amount of Rs.500 at the minimum and Rs.2000 at the maximum in the first year and Rs.1000 in the second year.
2. Travel Re-imbursement: Arogya Mitras are expected to visit twice when a patient from their village is admitted to the hospital (at the time of admission or the next day and the day of the discharge). This has been instituted so that we are able to introduce them to the patient and her family. For these visits, a pre-determined amount would be paid as re-imbursement. If the Arogya Mitras are assigned any follow up of the patient after discharge by our medical team (e.g. vitals monitoring or wound dressing), the hospital pays Rs.30 for such a follow up. It also pays Rs.10 for recording and sending to us feedback from patient and her family on their hospital stay.
3. Monthly Contests: In three areas; number of patients seen during a month, total revenue earned and quality of work performed while doing procedures as evidenced by the hospital and the patient, the best performer would be paid Rs.1000 and the next best Rs.500. Their work over each quarter, half-year and full year would also be reviewed and the top performers would be rewarded appropriately.

The monthly expenditure to pay for these schemes is estimated at around Rs.50,000 in the first year and Rs.75,000 in the second and third year.

Help in meet the cost of training Arogya Mitras:

There are two major expenditure being incurred in managing the training for Arogya Mitras:

• The cost of trainers, and
• The cost of conducting the training programme.

We need two trainers for the programme. The training needs are not only when the Arogya Mitras are first prepared, but also thereafter, for both correcting errors noticed in their work during supervision and for regular refreshing their skills. While we have one trainer at present, another would soon be required. Remuneration of a trainer is around Rs.50,000 per month. An assistance of this amount for the two trainers, for as many months as is considered feasible, would help us greatly in meeting this cost.

Each new batch that we prepare costs around Rs.2 lakhs. The major costs relate to the material that is provided to each trainee and re-imbursement of their travel costs for the duration of training. An assistance of this amount would help us meet these costs.

Help in meeting the cost of treating poor patients:

There are ways in which we support treatment of patients who are not in a position to pay for their treatment. These include:

• Waiving fully registration and consultation charges for out-patient services in line with our belief that all citizens have a right to qualified, professional medical opinion.
• Providing medicines at concessions to everyone.
• Making even more concession available to Below-Poverty-Line patients, including in diagnosis.

For in-patient treatment, we are committed to bringing the benefits of the Government’s PM-JAY (Ayushman Bharat) scheme to eligible beneficiaries. While that process is on, we also offer to charge patients for treatment at the rates prescribed under the scheme as an option to the hospital’s usual rates. There are, however, patients who do not have the means to pay even these concessional charges. We have the following schemes to support them:

1. Help a woman deliver safely: A donation of Rs.5,000 would cover a normal delivery while a donation of Rs.20,000 would meet the cost of a Caesarian Section.
2. Take care of a Newborn: A donation of Rs.7,500 covers the cost of treating a neonate for a day while a donation of Rs.50,000 would meet the entire cost of treatment.
3. Help someone see again: We would operate one patient free of cost for cataract with a contribution of Rs.5,000.
4. Pay for treatment of a patient: A donation of Rs.5,000 covers the cost of treatment of a patient requiring medical management while a donation of Rs.10,000 covers the cost of treatment of a surgical patient per day. We would charge these patients less to the extent of the donation from their final bill. Or, you could pledge to pay for treatment of a patient (medical or surgical), with or without a limit, and we would intimate you when a deserving patient needs your help.

Help in meeting the cost of making services of specialists available to the Last Citizen:

One of the most difficult aspect of a secondary care facility is the recruitment of specialists, full-time, part-time or visiting, to serve patients. Not only is the willingness to work in an area distant from urban locations a problem, for those who are able to overcome that limitation, there is usually an expectation of a competitive and relatively better remuneration.

At our Sojitra Hospital, we have been fortunate in recruiting a few full-time specialists; a couple of physicians, a gynaecologist, a dentist and a couple of physiotherapists, while there are a number of visiting consultants who come twice, thrice or more during a week. We would like to have at least 3 more specialists full-time, a paediatrician, a surgeon and an anaesthetist, for which efforts are ongoing.

As mentioned earlier, we are required to pay competitive remuneration, which we are not in a position to recover fully from patient revenues. The average cost of recruiting a specialist from branches such as medicine, surgery and gynaecology on a full-time basis is around Rs.150,000 per month. An assistance of 50% of the cost, for whatever period of time that you consider feasible, would help us greatly our efforts to bring modern and professional healthcare to the Last Citizen.