India home

About us

Culture

Post-Disaster Rehabilitation

Economic Development

Education

Health

Planning and Building

Rural Development

Other Countries

Rss

Health Activities in India

Health care initiatives help build the ability of communities to deliver, manage and sustain essential health care services.AKDN health projects in India focus on the promotion of effective and sustainable health care of underserved populations, primarily for women and children, in specific regions in the states of Andhra Pradesh, Gujarat and Maharashtra. Agencies of the AKDN strive to ensure that health needs and priorities are met by providing appropriate, effective and affordable health services that are accessible and sustainable. Health care initiatives are also designed to help build indigenous capabilities to deliver, manage and sustain essential health care services (preventive, promotive and curative), by forging partnerships with communities, private providers and government.

Introduction
Too often, health services fail poor communities in terms of access, quality, and affordability, because they are often developed without taking into account the relationship between the community and providers, making them non-responsive to local needs and conditions. Interventions tend to be centralised, top-down structures that take very little account of local conditions, either spatially or epidemiologically.

In addition to high mortality levels of children below the age of five and young mothers, illnesses also contribute to poverty through lost wages, high spending on health care and repeated treatment for easily preventable diseases. The poor often have to sell assets to finance healthcare and pushes families even deeper into poverty or debt. Young children, especially girls, often lose out on opportunities such as education.

Developing and systematically monitoring and evaluating appropriate health system delivery approaches, which include both public and private actors, can have a profound effect on improving health status and sustaining the systems and practices that protect health gains. AKDN’s experiences with delivering health services in South and Central Asian countries as well as in Africa has demonstrated that services, if delivered well, can improve outcomes even for the poorest and remotest groups.

AKDN promotes initiatives such as female literacy, health promotion and community-based water supplies and sanitation.Focus on Vulnerable Groups
Since health is more than health care, AKDN promotes initiatives such as female literacy, health promotion and community-based water supplies and sanitation (including sanitation and basic hygiene education) that offer communities the knowledge, skills and practices to avoid illness and to secure the financial means required to acquire better nutrition and improved health status. These include a wide range of measures including: enabling families to build and maintain household sanitation systems and educating school children of the importance of washing hands with soap and water.

Also, AKDN health interventions are often only one component of a multisectoral approach that includes programmes in education, habitat, rural development, micro-credit etc. This comprehensive and co-ordinated approach contributes to improving the communities’ overall quality of life. Enhancing coverage, quality and sustainability is achieved by ensuring that health policies, systems, finance and services incorporate practical and effective management, clinical practices, and respond and are accountable to the needs and demands of communities.

Strategies for Financial Self Sufficiency
Health programmes tap a number of community financing sources. These include user fees, pre-payment schemes, in-kind contributions, or funding from milk-cooperatives. Many of them successfully address equity concerns by waiving or reducing fees for those considered unable to pay. In many cases, community-generated revenue represents a significant proportion of total funds.

A significant benefit of health financing initiatives is that they help protect the income of the poor, by reducing out-of-pocket spending and by providing the poor a safety net. This also contributes to greater self-reliance and social inclusion of the poor. The other advantage is that the cost-recovery quotient of health programmes gets enhanced. The community health programmes in Gujarat state for example, has averaged cost-recovery levels of 70 percent since inception.

A Bottom-up Approach of Community Participation and Control
This is the cornerstone of all health programmes. In order to increase commitment to community control, local communities are involved in project planning, including the design of financing strategies. When established and supported correctly, community controlled financing can have a positive impact on the quality of care, equity, efficiency, and financial soundness of health programs. It can also lead to greater financial and institutional sustainability.

Significant inputs are provided to strengthen technical and institutional capacity of local institutions. This includes the development of skills in health and management, including financial management. Institutional strengthening includes helping to promote and establish good governance, such as ensuring that procedures are fair for selecting members and that mechanisms are in place to ensure local accountability (e.g., regular publication of proceedings and general meetings to which the public is invited). Institutional strengthening also requires support that is more qualitative in nature, such as efforts to support team building and promotion of good group dynamics.

Institutional strengthening is an ongoing process and community control is viewed as a continuum, with authority being handed over in a phased manner as local groups gain strength.

Addressing Disease Burdens
The AKDN package strives to include five groups of interventions that are cost-effective and address very large disease burdens. The five groups are:

• Services to ensure ante-natal and post-natal pregnancy-related care;
• Sexual and reproductive health of adolescent and women in the reproductive age;
• Non-communicable diseases control;
• Addressing HIV/AIDS;
• Child Survival: Immunisation and care for common serious illnesses of young children - diarrhoeal disease, acute respiratory infection, measles, malaria, malnutrition and tuberculosis.

Hospital Services
Prince Aly Khan Hospital is a 118-bed multi-specialty acute care hospital that, by extending the range and quality of its clinical services, has become the hospital of choice for the local population within its catchment area in South Mumbai. The hospital is ISO 9002 certified - among the first in Mumbai and Maharashtra to have such certification. Programme development is constrained by severe space restrictions and AKHS,I is planning the phased development of a 250-bed replacement hospital providing some sub-speciality services and having a major emphasis on ambulatory and intensive care. For more information, please see Prince Aly Khan Hospital.

Partners
AKDN supports three projects designed to improve the health and well being of select rural residents. Managed and funded by the Aga Khan Foundation in India, the Aga Khan Health Service, India (AKHS,I); the Aga Khan Planning and Building Service, India (AKPBS,I) and the Mahatma Gandhi Institute of Health Sciences (MGIMS) implement the projects.