Primary Care through a Public-Private Partnership: Health Management and Research Institute

Primary Care through a Public-Private Partnership: Health Management and Research Institute

Sofi Bergkvist (ACCESS Health Initiative, India) and Hanna Pernefeldt (ACCESS Health Initiative, India)
DOI: 10.4018/978-1-61520-885-2.ch008
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The primary care delivery model developed by the Health Management and Research Institute (HMRI) in India, integrates innovative technical solutions and process-oriented operations for the provision of healthcare services, while supporting the public health system. Through a public-private partnership with the state government of Andhra Pradesh, HMRI has a unique base to pilot large scale health interventions. The HMRI Model includes components such as a medical helpline, rural outreach health services, a disease surveillance program, a blood bank application, and telemedicine projects. Both clinical and non-clinical procedures are strengthened by technology that enables research, tailored and evidence-based interventions, as well as improves efficiency and quality of healthcare delivery. Health management and decision-making is assisted by the organization’s large database of electronic medical records. Challenges to implementation include implications of large government contracts, funding issues, as well as technical constraints and human resources issues. This chapter describes the Model’s various components and its contextual framework with enabling and constraining factors. HMRI has developed a unique system for preventive and primary care that can serve as a model for low, middle, and high income countries, though external evaluations are critically needed for further assessment of best practices.
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Primary Care in India

The contextual picture of health care in India is the challenge to provide health services to a population of more than 1.16 billion people, the majority of whom, 71 per cent, live in rural areas. The country has a heavy burden of disease and an evolving epidemiological transition is shifting the burden of disease toward non-communicable diseases. India has one of the lowest healthcare expenditures in the world; in 2006 it was only 3.6 per cent of the GDP (WHOSIS, 2009). At the same time, the proportion of private spending on health in India is one of the highest in the world (Government of India, 2008). This context highlights the need for innovative approaches to the design and implementation of healthcare delivery models in order to meet India’s shifting healthcare needs. To fill the gaps of the public health sector, the private sector has been recognized for innovative approaches that could strengthen the quality and scope of healthcare delivery in the country. The two sectors have different strengths that should not go unnoticed; the government on one hand has an advantage in creating scale through access to funds, while the private sector has provided many efficient healthcare delivery solutions. HMRI is an example of a public-private partnership where the strengths of the private sector are amplified and brought to scale with government funding. On the same note, it is recognized that India is establishing new global standards for delivery of low-cost, quality health care through its breakthrough innovations. It has been stated that the private sector in India is driving the evolution of an ecosystem of innovations for world-class healthcare delivery (Prahalad, 2006).

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