Rethinking Public Health Saving Lives at Birth through Strengthening Community based Structures and Referral Linkages A Social Enterprise Model for Birthing Stations www.umeedsey.org Healthcare Levels Teaching Hospital DHQ Hospital THQ Hospital 100,000 Population RHC 10,000 Population BHU/ CMW/ LHV 1000 Population LHW Family Tertiary Care (Rehabilitation) Specialist (Consultant) Community Midwife Lady Health Worker Cost Lady Health Visitor Triage General Practitioner Lab Tests/ Gynecologist D RHC Referral – Emergency Cases DHQ Referral – Special Cases Referral – Complicated Cases H H THQ H Referral – Complicated Cases Referral – Acute Diseases BHU Referral – Special Cases CMW /LHV LHW H Referral – Pregnant Women Primary HealthCare H KEY Tertiary HealthCare Private Hospital Facility DHQ District Level Health Facility THQ Tehsil Level Health Facility RHC Rural Health Centers BHU Basic Health Unit D Civil Dispensary CMW /LHV Community Midwife/ Lady Health Visitor LHW Secondary HealthCare Tertiary Level Hospital Facility (Complex) Lady Health Worker M-Health Information System LHW Pharmacy APP Developed • Register Families • Monitor Acute Symptoms • Family Planning • Growth Monitoring • Refer Patient to GP • Refer Pregnant Women to CMW/ LHV Lab Tests HIS EMR GP 1 Prescription Referral Prescription Lab Tests Lab Tests Pharmacy Slips Pharmacy Slips EMR Patient Admission SP 2 Discharge Summary 3 Basic EmOC Referral (Emergency Cases) CMW /LHV APP Developed • Register Pregnant Women (If not registered by LHW) • Monitor Symptoms (Antenatal Record, Physical Examination) • Refer Complicated Cases to RHC (Gynecologist) (Basic EmOC) • Refer Emergency Cases to Comprehensive EmOC. (DHQ/ Teaching Hospitals) H Comprehensive EmOC Referral (Emergency Cases) 1 General Practitioner (Available At) • BHU • RHC • THQ • DHQ • Private Hospital • Private Clinic 2 Specialist (Consultant) (Available At) • RHC (Gynecologist) • THQ • DHQ • Private Hospital • Private Clinic Electronic System 3 Hospital (Panel Hospital Category) • RHC • THQ • DHQ • Private Hospital Micro Health Franchise Model Project Name: UmeedSey high quality care to mother and child www.umeedsey.org Franchisor will Provide: 1. Birthing Station 2. Life Saving Drugs, Birthing Toolkit (Complete) 3. Smart Phone Supply Chain System 4. 5. 6. 7. Emergency and Transportation Services Referral Doctor (Expert Advice) Branding/ Awareness Campaign On going Trainings Financially Sustainable Franchisor CMW Coverage – Our Goal 25% Market Share 55% Market Share • PKR 14000 • PKR 30800 40% Market Share 70% Market Share • PKR 22400 • PKR 39200 Innovation in MNCH Care System CDSS EMR M&E Mobile App Supply Chain Billing & Insurance Mobile Application Add New Patients •Patient Details •Past Obstetric History •Genetic/ Family History •Surgical Medical History Calculates EDD Remembers Patients Gestational Week Show Patient List with Real Time Status Alerts Reminds CMW on pending Information Antenatal Visit Record 9 Lab Tests http://umeedsey.org/opendata.aspx CMW Trainings MNCH Triage • Anemia • Diarrhea diseases • Intestinal parasites • Acute respiratory infections tuberculosis • Malaria • Primary eye care • Scabies • AIDs and hepatitis • Monitoring/Vaccinations of Babies Under 5 CMW App LHW App LHW (Promotive healthcare - FP) CMW (Skilled Birth Attendant) • Anemia • Gestational diabetes • Pre-eclampsia (Toxemia) • High blood pressure • Eclampsia • Hyperemesis gravidarum • Placenta previa • Placental abruption • Preterm labor • Miscarriage • Multiple pregnancies • Fetal problems Doctor (Referral Center) LHW Role Community 1000 Persons Register Families Supplies Births/ Deaths Common Ailments LHW Family Planning Growth Monitoring Immunization LHW Monthly Report LHW MIS (Excel Based) LHW Program Story Board Community 1000 Persons Delay in transfer of Information (2 Months) 1 Month Delay 1 Month Delay Data Monthly Report EDO Health Office LHW MIS (Excel) Directorate of Health LHW Record Keeping LHW Register Hard Copy Soft Copy Decisions & Planning LHW Program Story Board Community 1000 Persons Real-time Data Transfer Data Daily Report LHW EDO Health Office LHW MIS (Web Based) Directorate of Health Decisions & Planning LADY HEALTH WORKER APP (Developed) Family Members WASH Anemia Register Families Medication Diarrhea Intestinal Parasites Hepatitis Poverty Score Card Symptoms Screening AIDs Scabies LHW App Primary eye care Tuberculosis Malaria Growth Monitoring Family Planning Immunization Acute respiratory infections LADY HEALTH WORKER APP (Developed) Register Families Helps in Collection of evidence based data Average Family Size Symptoms Screening Growth Monitoring Immunization Record Family Planning Poverty Score Card Polio Early Diagnosis Identification of Chronic Disorders Measles Contraceptive Disbursement Update of PSC NADRA/ BISP Hepatitis B Disease Burden Diphtheria Pregnancy Rate Birth/ Death Reporting System Pertussis Reduced Cost of Healthcare Tetanus Nutritional Status Identification of Unregistered citizens Identification of community health practices Tuberculosis Pneumonia Population Growth Rate Targeted Benefits/ Subsidies LHW Enterprise Revenue Streams Data EPI Others LHW CMW/ LHV Referral Fee Medicine Selling of Health Insurances Franchisor Management System Desktop/Web App Features Managing Referrals and Emergency Transport Health Statistics Reports Supply Chain Management System Accounting and Payroll Health Worker/ TBA Capacity Building Training Program Indicators Internet/ Wireless Network Settings Monitoring and Evaluation Reports THANK YOU! Any Questions?