Month: December 2022

During the onslaught of COVID, India’s healthcare infrastructure faced several challenges as we struggled with a shortage of beds and oxygen during the two waves of the pandemic. While the crisis has slowly receded, it has left an indelible impact by disrupting primary healthcare delivery in India in the following ways:

Restricted access to healthcare facilities: During the lockdown, healthcare facilities were either closed, converted to COVID hospitals/containment zones or were operated with reduced staff. Patients were thus unable to get timely treatment and medicines.

Transportation challenges: Patients faced challenges in travelling to healthcare facilities due to unavailability of adequate transportation.

Diversion of healthcare workers: ASHA workers were diverted towards COVID-19 screening through door-to-door visits. This adversely impacted their other primary healthcare responsibilities.

Reduction in home visits by ASHAs: Many ASHAs did not have adequate PPE (Personal Protective Equipment) including masks, gloves and sanitizers. Due to this, they were unable to perform their regular home visits.

Loss of family income: A large number of families were affected by loss of income. This impacted their access to proper nutrition, medicines and clinical treatment.

High-risk stratification for patients with comorbidities: Patients with existing chronic conditions were more vulnerable to COVID and thus, classified as a high-risk category. They faced severe challenges in accessing healthcare facilities and getting medicines regularly.

Sunderbans is a geographically vulnerable place as it experiences natural calamities on a regular basis and this vulnerability of the delta often affects people’s access to healthcare services. As per the International Research Journal of Social Sciences in 2014, not a single block has been found where less than 30,000 people are served by one PHC.

COVID has further exacerbated the situation by impacting the livelihoods of the 5 million people in Sunderbans, making healthcare even more inaccessible than it already was.

To combat this gap in healthcare delivery, solutions such as iKure are meeting primary healthcare and prevention needs through a unique combination of health outreach initiative, skills development and technology intervention.

iKure’s health management services span preventive, promotive and curative aspects of healthcare and focuses on addressing primary healthcare needs across rural, semi-urban as well as urban areas. Leveraging the power of ICT, they have developed a medical collaboration platform called Wireless Health Incident Monitoring System – WHIMs – which is an aided telemedicine platform used by doctors & iKure’s community health workers to screen and monitor patients at their doorstep.

The platform allows patients to:

1. Connect with doctors instantly
2. Manage patients health profiles
3. Make patient diagnosis
4. Provide access to treatment plans and prescriptions

ACT For Health is supporting iKure in strengthening primary care delivery in Satjelia and Kumirmari islands of Sunderbans by setting up clinics to offer face to face and teleconsultation services, pathology, ophthalmology, physiotherapy, dermatology, sale of medicine, health screening camps and other such services.

Through this project we aim to cater to 1 lakh people across these islands by leveraging technology to train community health workers and deploy primary care protocols on ground.

According to a survey, 70-80% of clinical decisions require lab reports and on an average, two tests are prescribed per patient. However, the entire process is still dependent on the access to pathology labs and trained pathologists. In their absence, health professionals often resort to empirical decision making or ‘gut feelings’ for treatment, leading to massive misuse of antibiotic prescriptions.

Although point of care devices (POC) continue to foray into underserved locations, they’re limited by recurring cost and minimal options. Microscopy continues to be a crucial component for pathology labs to inspect body fluids in order to detect infections and identify cellular abnormalities. However, primary and secondary care in the country faces an acute shortage of manpower and trained pathologists; with only 1 pathologist serving approx. 65K people in the country. This shortage has led to the proliferation of many unlicensed labs and personal operations in the market. On the other hand, pathology labs are majorly concentrated in urban areas and far from reach of the rural population. It is therefore important to address these massive gaps in the healthcare delivery system.

We’re observing a paradigm shift in pathology with the growing acceptance of digital microscopes over optical ones – given the ability to instantly store and share images from a remote primary healthcare set-up with a pathologist sitting in an urban setting. It is also easier to train the lab technicians in digital microscopes and the solution reduces the time taken for diagnosis by enabling better clarity of the images.

Cilika, a digital microscopy solution developed by MedPrime Technologies, aims to facilitate telepathology in low resource settings where both infrastructure and human resources are limited. For example, patients in Melghat in the Amravati district of Maharashtra have to travel about 100 km to get tests done. Additional costs incurred due to travel and wage loss often discourage them from availing diagnostic conditions, thereby often exacerbating their medical conditions due to lack of timely treatment. Cilika will allow pathologists to remotely analyse the test reports for patients living in Melghat without the hassle of transporting or storing the sample slides which will turn out to be quite cost-effective in the long term.

ACT For Health will support MedPrime in generating evidence for tele-pathology use cases by deploying Cilika devices in various CHC’s, rural hospitals, NGOs across India with the aim of decentralising such healthcare services.