Building Sustainable Solutions for Quality Improvement in Primary Healthcare in Rajasthan and Haryana


Known as “e-doctor” or “e-clinic”, Karma Primary Health Care’s (KPHC) tele-medicine social business has made a unique mark in rural healthcare by making high quality primary health care affordable & accessible in rural areas of Haryana and Rajasthan. A nurse-mediated online consultation with doctors is carried out at the clinics. However, communities remain unaware and distant from the service. Thus, a Positive Deviance Inquiry (an asset based SBCC strategy), as research was carried out to discover successful practices that stakeholders involved in the process of tele-medicine undertake, to enhance the quality of health care delivery at e-doctor clinics. In this process, successful acts of communication were identified and some generated through a creative process to enhance patient centred outcomes. The process gainfully led to designing intrinsic & extrinsic SBCC intervention, whereby doctors, nurses, outreach workers and community members enabled uptake of the E-Clinics. A six-month capacity building program, and on the community front, a variety of rural marketing tactics were employed such as ‘chai bethaks’ (tea time), developing ‘friends of e-doctor, ‘swasthya salahakar samiti’(health advisory panels), and shifting offers to seasonal illnesses and pathology. The service observed a four-fold increase in patients, progressively during the six-month intervention. Communication dissemination became self-sustainable and communities became a part of the e-doctor community willfully, as the word of the e-doctor spread across. SBCC allows for human connection, even when mediated by technology.

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