Shedding The “BIMARU” Tag - How Chhattisgarh Is Embracing Tech In The Healthcare Sector
In April 2018, the Honourable Prime Minister of India, Shri Narendra Modi launched two landmark projects in Chhattisgarh. One was the first ever wellness and healthcare centre to be launched in India under the ambitious Ayushman Bharat Scheme for universal healthcare. The other was the inauguration of the first phase a digital connectivity project for the vast and remote Bastar region of the state.
These two projects are emblematic of the progress the state has achieved since its creation on 1st November 2000. The early years of Chhattisgarh were marred by the challenges of endemic underdevelopment and left-wing rebel violence. After all, it was once a part of Madhya Pradesh, one of the four underdeveloped states collectively known by the acronym BIMARU. But as the end of the second decade of the 21st century looms large, the state is poised to shed the “sickly” tag and be at the forefront of the digital healthcare revolution in India.
A Doctor at the Helm of Healthcare Reform
The role played by the Chief Minister of the state in these initiatives deserves special mention. He was the first elected Chief Minister of the young state in 2003. Since then, his government has been undefeated for three consecutive elections, including in 2008 and 2013. Himself a qualified physician with a degree in Ayurveda, the traditional Indian medicine system, Dr. Singh has placed health care reform and development as a top priority during his tenure as Chief Minister. The healthcare sector is Chhattisgarh has witnessed both quantitative as well as qualitative growth and evolution during this period.
Smart Card- Enabled Universal Insurance Coverage
The Rashtriya Swasthya Bima Yojana, or RSBY, is a national health insurance scheme pioneered by the Central Government for BPL families. Chhattisgarh is one of the best performing states in India when it comes to public health insurance. The state scheme called Mukhyamantri Swasthya Bima Yojana (MSBY) widens the coverage net and also raises the amount limit.
MSBY was the first scheme anywhere in India to provide universal health coverage. It provides free medical coverage for all citizens, not just those below the poverty line. And the coverage limit of the MSBY is also higher at Rs. 50,000 as opposed to 30,000 under RSBY. Nearly 55 lakh families have benefited from this technology enabled health insurance system. The system uses smart cards to deliver insurance coverage at hospitals.
Telemedicine Under the Ayushman Bharat Scheme
Ayushman Bharat is a Central Government initiative that seeks to revolutionize the health care system in India. Its main objectives are:
Chhattisgarh has already stolen a march on the rest of the country in this regard. Plans were already finalized as early as 2015 to deploy telemedicine system in the state. The scheme has been devised as part of the Common Services Center program of Ministry of Electronics & IT, Government of India.
As part of the Digital India campaign, internet connectivity will be provided to rural areas in Chhattisgarh, under the Village/Rural Entrepreneurship scheme. The process is coordinated by designated state-level e-Governance authority for CSC. This will link all 27 district medical hospitals in the state with medical colleges using the internet. Patients can avail the service of specialist doctors without being limited by geographical boundaries.
And with the launch of the Ayushman Bharat project, this system has been extended to hundreds of wellness centres across the state as well. By 2022, all 793 Primary Health Care centres and 5200 secondary health care centres will be upgraded to wellness centres.
Bijapur District Hospital - The Epitome of Healthcare Revolution in the State
Bijapur is a district located in the south-western part of Chhattisgarh. It is part of the infamous “Red Corridor,” the region most affected by the Left-Wing Extremist (LWE) infestation. Due to the extremist violence, the district hospital was dysfunctional in the past. But things have improved, thanks to the hard work of the district administration.
Funds from the Central Government and the District Mineral fund were put to good use. The Hospital now has the following facilities:
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A fully functional modern ICU wing
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In-patient capacity of 150 beds
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Two state-of-the-art modular operation theatres
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Sick Newborn Care Unit for babies
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Laparoscopic surgery equipment
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24x7 Delivery room with Caesarean facility
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Modern Blood Bank
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Advanced diagnostic equipment, including X-ray and Sonography
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A full team of trained doctors, nurses, and other paramedical staff
The hospital now caters to the health care needs of nearly 2.5 lakh citizens in the region. In the year 2017-18 alone, it was able to treat close to 1 lakh cases in the Out-Patient wing. Over 11,000 patients were able to use the in-patient facilities. The hospital also successfully carried out 1200 childbirths, along with 200 caesarean operations. The doctors in the hospital also performed over 2000 other advanced surgical procedures. Located in the former hotbed of extremists, the Bijapur District Hospital is a clear indicator of the direction in which Chhattisgarh healthcare system is headed.
MMUs - Delivering Medical Service to Remote Areas
Mobile medical units have been in use in rural India since the 1950s. These self-contained clinics on wheels are used in extremely remote areas, especially in tribal dominated regions of central India. Due to the LWE infestation in Chhattisgarh, proper implementation of MMUs under the National Rural Health Mission was delayed until 2011-12. That year, 30 MMUs were launched under public-private partnership.
But the outsourcing program was scrapped due to poor performance of the private agencies. The Chhattisgarh government decided to operate these mobile clinics directly. The total number was also increased to 37, with plans to start the service in all districts of the state in 2018.
MMUs in Chhattisgarh provide services like immunization, screening for diseases like malaria, pregnancy tests and family planning services, basic lab tests, X-rays, and minor surgical procedures. Each MMU has a staff strength of 5, including an MBBS doctor, nurse, pharmacist, lab tech, and driver.
Bastar Net - a Digital Highway for ICT in Healthcare
Uninterrupted internet connectivity is essential for the deployment of Information and Communication Technology (ICT) services in any sector, including healthcare. The launch of the ambitious Bastar Net project in 2018 was a step in this direction by the state government. Under this project, 40,000 square km of the Bastar region will be connected to the internet. The project will require over 800 km of fiber optic lines. Initiatives like this allow hospitals to use sophisticated digital diagnostic tools and software.
The senseless chaos and violence of the LWE infestation are on the way out. In its place, efficient governance is being ushered in by the government. The healthcare system is also reaping the rewards. People no longer have to travel far and wide in search of expert medical care. IT and other digital technologies have improved accessibility to health services in the state. The future does look bright for citizens of this rich and diverse state.