News
Mechanisms Implemented through ITAP to Address the Reproductive Health Crisis in India
Voucher System
One of the primary reasons why many women in India do not receive proper
reproductive healthcare is because they simply can't afford it. In three districts
of Uttar Pradesh and Uttarakhand, Constella Futures is working with local governments
to provide health vouchers to poor families. The families can redeem the vouchers
at any of a group of participating hospitals to receive free reproductive health
services including prenatal care, childbirth, postnatal care and family planning
services. The hospitals, in turn, submit the vouchers to the government for
reimbursement. More than 20 hospitals are now participating in the voucher
program with 30 expected to be onboard by the end of 2007. The list of success
stories around families who have used the vouchers continues to grow.
Social Franchising
Promoting the Social Franchising Mechanism
On August 23, the Secretary of Health for Uttar Pradesh and the USAID Mission
Director are publicly launching the social franchising mechanism in Uttar
Pradesh via newspaper and television. They are using this opportunity to encourage
citizens to use the franchise health facilities and to recruit potential franchisers
and franchisees to help expand the network. |
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Although money is a key factor for families, they are also concerned about
quality of care and about ensuring they are going to a safe, credible facility.
In Uttar Pradesh, Constella Futures is identifying franchisers to help build
a network of hospitals that 1) provide reproductive health services at 35-40
percent cheaper than other providers and 2) follow the same set of quality standards
to ensure consistency of care. The hospitals each offer the same set of services,
have a similar look, and are branded the same so that they are easily identifiable.
Two of these hospitals are now operating with 15 expected to be up and running
by September, and 46 by the end of 2008. All profits from the hospitals are going
toward expanding the franchise network.
As a secondary component of this program, Constella is also recruiting existing
hospitals to become partial franchisees. The partial franchisees must provide
a similar set of services at similar prices to those of a full franchise facility.
They must also sign a contract for improving the quality of their healthcare
services. Once the social franchising program is publicly launched later this
month (see sidebar) the government expects to eventually have more than 700
partial franchisees throughout Uttar Pradesh.
Mobile Health Vans
Uttarakhand is a fairly mountainous state. Because of this, much of its population
lives in small villages scattered throughout the hillsides. In many cases,
families do not have transportation and the closest health facility is at least
20 miles away. To address this, Constella Futures is working to bring healthcare
services directly to the villages via a mobile health van. Donated by Uttarakhand's
Chief Health Minister, the mobile health van visits 15 villages each month
and provides several core reproductive health services. While the van is operated
by a private company, the government provides the staff, which includes three
doctors and one pharmacist. Villagers are notified ahead of time when the van
will be in their area. Impoverished women receive reproductive health services
for free, while other women receive the services at a low, government-subsidized
rate. The mobile health van has been so successful that the Uttarakhand government
hopes to eventually operate 13 vans across all 13 of the state's districts.
Clinic-based NGO Projects
While there are less-expensive, government-run health clinics throughout
India, in many of the poorer parts of the country, women are reluctant to go
to these facilities because they believe they will be mistreated or not given
quality care because of their financial status. As a result, only three percent
of the population is using the government health facilities despite the growing
number of families who need less-expensive services. Throughout Uttar Pradesh,
Constella Futures is teaming with non-government organizations (NGOs) to mobilize
communities to increase the demand for services from the government clinics.
NGO representatives are visiting the government health clinics to learn how
they operate and to evaluate their services. They are then taking this information
to different villages and hosting meetings with the local women to educate
them about the government clinics and the reproductive health services available
to them. The NGOs are also recruiting women volunteers from the villages to
help promote the government facilities to other women in their community. Today,
11 NGOs are working across 14 districts in Uttar Pradesh to promote the government
health clinics. As a result, in the nine months since the program began, use
of the government clinics has already increased by 15 percent.
Social Marketing
A key component of reproductive health centers on family planning. Many couples
throughout India want to space or limit their births, but are not using a method
of contraception. In Uttar Pradesh, Constella Futures is helping to address
this by working with a social marketing organization to market and sell condoms
and oral contraceptives at a fixed, government-subsidized price. The social
marketing company, which has its own distribution network, is using famous
personalities, such as well-known actors and actresses, to promote and endorse
the condoms. Thanks to these efforts, in only four months, 90 million condoms
have already been sold throughout rural areas of Uttar Pradesh.
