Model wise research
In order to implement the model throughout the communities, we have been working to develop a sustainable business model.
1. Rural Model:
People with low income. Access to hospitals is not easy. Almost 70% of them do not have a health checkup in their lifetime. NCDs are becoming common. Recently people became aware of diabetes. It is expensive for them to control diabetes. PHC is providing diabetes monitoring at one-third of the cost of other service providers. PHC is trying to provide a basic health checkup service to give them an early wakeup as a preventive measure. From our experience, we assume that a healthcare worker can serve 200 patients per month as a home delivery service. In the best setup, she can save 150 USD per month after the cost what is equivalent to a standard salary in rural Bangladesh. However, promotional activity is required before she starts a business. She needs about 2,000 USD to start a PHC community business which can be ideally funded by Grameen Nobin Uddyokta (new entrepreneurship development) program.
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2. Urban Model:
Although the primary target of PHC was the low-income rural communities, we have found a good client segment in the urban ageing community as well. The urban ageing community has the same characteristics as developed countries. The rich urban patients are knowledgeable and most of them have their own blood pressure, diabetes test equipment, etc. However, sometimes it is not easy for them to take the checkup by themselves accurately and regularly as required for NCD patients. Besides, when they need to consult with a doctor, they need to visit a hospital through traffic-congested areas and stay in a long queue what is very hectic for an aged person. Now a PHC urban health worker visits registered patients at home at per preset schedule, conducts health checkup professionally and if needed, connect to our call center doctor for a consultancy from patient`s home. This low-cost service saves time, labor and money of the ageing clients. So far we have approached to 31 urban apartments with 2,602 patients. We provide free health checkup first and then register to make them regular customers. The project was funded by Toyota Motor Corporation.
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3. Community Health Camp Service:
We also send health teams to villages from time to time and hold Health Checkup Campaigns usually of 5-7 days. We offer the basic health checkup service to people aged 25 years or above and provide online consultancy by expert doctors for the patients at health risk. We usually arrange the camps in Union Parishad office or in the schools, so that people can easily gather and access the service.
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4. Corporate Service:
This community includes female employees mostly working at garments industries, and male workers working in the construction industries. Occupational health service is rare at Small & Medium Enterprise (SMEs). We carried out health checkups. The project was funded by FIRST (2013 to 2015). Developing a business model for this sector is not easy. The employers can understand the necessity of such service to enhance the productivity of their employees but are not interested spending money for the preventive healthcare service. Fortunately, we found a third party to pay from the buyer community for maintaining compliance as a requirement in the factories.
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5. Pharmacy Based Service Model:
We have millions of pharmacy/drug store across the country and people have easy access of these if they need any medicine. And more importantly, people can get medicine without showing any prescription to drug seller and even drug seller do not even ask for the prescriptions.
In a study it has been observed that irrational drug usage, insufficient access to essential drugs, wrong prescribing are major hitches affecting the overall health care scheme of Bangladesh. The National Drug Policy (NDP)-2016 has been constructed to ensure better healthcare by ensuring affordability, availability and rational use of medicine. However, lacks of knowledge and awareness among the dispensers and general people have suppressed the effective implementation of the NDP-2016. It has been found that 75% of dispensers of the country know that selling, dispensing and distribution of drugs should be conducted under the supervision of a registered pharmacist but only 5% of A grade pharmacist, 4% of B grade pharmacists and 15% of C grade pharmacists were found in the medicines shops to dispense drugs.
Read More6. PHC for Garment Workers:
Our Garment industry is also realizing the growing importance of starting healthcare services to their workforce to comply with buyers demand. And as we all know, there are huge shortage of doctors till now in Bangladesh; so it is almost impossible to ensure physical presence of doctor in every garment factory 24/7. Thus PHC could be another realistic source for our garment industry. Hence PHC has been supporting in healthcare sector for Epyllion Group and PRIMARK and as of now 12,523 garment workers have received healthcare services through PHC.
