To formulate a plan to help people utilize available public health care service & cut unnecessary hospital visits.
I went to a tribal village in Gujarat, India for a research project that later evolved as an intervention. The village had a public hospital that provided free healthcare services yet the village had low utilization of health care services. Most of the villagers opted for treatment in private hospitals.
It looked incongruous that majority of the villagers opted for the high-priced healthcare provider though they were too poor to afford that treatment. Per Capita Healthcare utilization rates were low for the females.
A focus group discussion was conducted with the patients who had accessed the healthcare services in past two months to identify the reasons for poor utilization of public health care services.
The research highlighted that unfamiliarity with hospital procedures such as "registration process" & "poor communication between the healthcare provider and consumer" were huge barriers to access to public health services.
There were multiple episodes when villagers were denied treatment in the public hospital due to the incomplete registration process. Hence, the villagers either opted for a private healthcare provider or sought no treatment.
This was followed by interviews with Community Health Workers and Hospital staff. I asked them about common complaints they received and probable solutions to these complaints. An intervention was then devised to to change the status quo & improve healthcare utilization rate for this population.
InterventionI gathered together with Community Health Workers & hospital management with all of my field notes & went through a long process of refining key insights.
With the help of Community Health Workers, I formed a team of women volunteers (from the community) to serve as a bridge between hospital staff and patients.
The volunteers were informed about the administrative procedures of nearby hospitals - where to go for registration, what documents are needed to register, who to approach, importance of medical records etc.. These volunteers accompanied patients for first few hospital visits to help them familiarize with hospital procedures and layout of the hospital.
Meeting with the volunteers - explaining them the registration process
IMPACTThe impact of the solution was judged by comparing the number of patients who used public healthcare services (in hospital records) before and after the intervention followed by a qualitative study. This simple arrangement reduced duplication of tests and significantly increased access to public health services.
" You saved me time and money" - Patient"
I feel that I am important to my community" - Women volunteer
The beauty of this intervention continued to unfold on a daily basis. It not only led to higher healthcare utilization rates but also empowered women of the community. It became a way for women to help other women and to support the development of sustainable solutions for their community.
This project is very special for me since it was the first time I worked with the community, diverse groups of people with strikingly different mindsets, and yet, I was able to influence them to accept and implement a plan towards a common goal.