February 2019
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Tele-clinics could bring about drastic changes in rural India

The government should focus on provision of information and knowledge beyond public health

The government should focus on provision of information and knowledge beyond public health

ICTpost Health IT Bureau

The lacuna in the public healthcare delivery system in the poorest regions of India has been examined. It further suggests how the rural healthcare service delivery could be improved through the use of Information and Communication Technologies (ICT) with Tele-clinics.

Tele-clinic – Aims and objectives
It is an innovative and a combination of financial protection and healthcare access. The main goal of Tele-clinic is to develop healthy and economically productive rural citizenship through facilitating affordable, reliable and high quality health information to the rural poor using ICT.

• To provide emergency healthcare to the rural poor
• To ensure safe delivery and motherhood in rural areas
• To provide access to health information and making healthcare accessible to the poor.
• To facilitate quality medical care to the poor in remote rural villages.
• To provide public health safety net to the rural poor.

Tele-clinic components
Village Call Centres: Call centres are a very important component of the Tele-clinic. These centres are established in the villages where Tele-clinic project is initiated. Call centres should provide the following main services:
a) Telephone consultation with a doctor at Christian Hospital
b) Emergency drugs
c) Clinical support through nurse-run-clinics
d) Health awareness through periodical campaigns

Tele-clinic – Levels of treatment

Tele-clinic uses a three tier healthcare service through use of Information and Communication Technology
a) Call Centre level – primary care – manned by a health worker:
b) Weekly referral clinics at Call Centre Level – Manned by nurse & laboratory technician
c) Hospital level – secondary care
At all these levels the consultation of a qualified practitioner / a specialist is important. All treatments are provided after specialist consultation over phone, except in case of causalities where health worker administer emergency drugs / refer the patient to the hospitalValue addition
• Promotion of good practices in healthcare in rural areas.
• Improved access to specialists through a telecommunication network: Tele-clinic wherever established has been successful in presenting a reliable healthcare alternative to the rural poor (in spite of problems with connectivity and electricity some times). People though consult the local practitioners for minor ailments; at times of medical emergency.
• Improved access to hospitals through a round the clock ambulance service:  Ambulance service significantly impact the health seeking behaviour of people in villages where call centres to be established. This service should be the only transport facility available at a phone call to the people in the target villages.

ICT – Not the complete answer – Need for location specific supplements
ICT is not sufficient to ensure improvement in the well-being. Application of ICT should be supplemented with appropriate social protection policies which would enable the poor to actually benefit from information/knowledge. Practicing information is not just a function of availability of options but depends on the supplementary policies that enable practicing in real life situations.

Social orientation of private sector
Not only the government, the private sector should also be socially responsible. The IT companies and educational institutions should respond to the social cause through developing rural friendly communication kiosks and rendering technology education in rural areas.
Civil society – Capacity building of traditional actors

Civil society institutions should take up the job of building the capacities of the traditional actors such as untrained health workers, private practitioners, traditional birth attendants and other health workers with in the community apart from their role of building partnerships. The Public Health Network through technology should include these actors who are working at the very local level. Linking them with qualified medical practitioners could bring change in overall health condition of the poor in rural areas. ICT could also be used in facilitating a continuing medical education to the practitioners in the rural localities. They are an important part of the ‘rural healthcare system’. However, the practices needs to be standardised through adequate trainings and regulation.

Call centres – Beyond healthcare
The call centres could also perform as ‘knowledge banks’. This would be a two-way knowledge bank that gathers tacit knowledge from rural communities and promotes current information on various issues related to rural livelihood. The information on product markets, labour markets, commerce, etc. also could be made available through call centres, which could affect the livelihood of the poor living in the rural areas. The centre could be transformed as ‘knowledge centres’, which would have information on a range of human development aspects from health, education to livelihood.

The government should focus on provision of information and knowledge beyond public health. There is no doubt that a careful promotion of information technology in rural healthcare could bring about drastic changes in the public healthcare system of India and this would benefit the poor who are excluded from the mainstream healthcare system. editor@ictpost.com