Rethinking Public Health
Saving Lives at Birth through Strengthening Community based
Structures and Referral Linkages
A Social Enterprise Model for Birthing Stations
www.umeedsey.org
Healthcare Levels
Teaching Hospital
DHQ Hospital
THQ Hospital
100,000 Population
RHC
10,000 Population
BHU/ CMW/ LHV
1000 Population
LHW
Family
Tertiary Care
(Rehabilitation)
Specialist
(Consultant)
Community
Midwife
Lady Health
Worker
Cost
Lady Health
Visitor
Triage
General
Practitioner
Lab Tests/ Gynecologist
D
RHC
Referral –
Emergency Cases
DHQ
Referral – Special
Cases
Referral –
Complicated
Cases
H
H
THQ
H
Referral –
Complicated
Cases
Referral – Acute
Diseases
BHU
Referral – Special
Cases
CMW
/LHV
LHW
H
Referral – Pregnant
Women
Primary HealthCare
H
KEY
Tertiary HealthCare
Private Hospital
Facility
DHQ
District Level
Health Facility
THQ
Tehsil Level
Health Facility
RHC
Rural Health
Centers
BHU
Basic Health
Unit
D
Civil Dispensary
CMW
/LHV
Community
Midwife/ Lady
Health Visitor
LHW
Secondary HealthCare
Tertiary Level
Hospital Facility
(Complex)
Lady Health
Worker
M-Health Information System
LHW
Pharmacy
APP Developed
• Register Families
• Monitor Acute Symptoms
• Family Planning
• Growth Monitoring
• Refer Patient to GP
• Refer Pregnant Women to CMW/ LHV
Lab Tests
HIS
EMR
GP
1
Prescription
Referral
Prescription
Lab Tests
Lab Tests
Pharmacy Slips
Pharmacy Slips
EMR
Patient Admission
SP
2
Discharge Summary
3
Basic EmOC Referral
(Emergency Cases)
CMW
/LHV
APP Developed
• Register Pregnant Women (If not registered by LHW)
• Monitor Symptoms (Antenatal Record, Physical Examination)
• Refer Complicated Cases to RHC (Gynecologist) (Basic EmOC)
• Refer Emergency Cases to Comprehensive EmOC. (DHQ/
Teaching Hospitals)
H
Comprehensive EmOC
Referral (Emergency Cases)
1
General Practitioner
(Available At)
•
BHU
•
RHC
•
THQ
•
DHQ
•
Private Hospital
•
Private Clinic
2 Specialist (Consultant)
(Available At)
•
RHC (Gynecologist)
•
THQ
•
DHQ
•
Private Hospital
•
Private Clinic
Electronic System
3 Hospital (Panel
Hospital
Category)
• RHC
• THQ
• DHQ
• Private
Hospital
Micro Health Franchise Model
Project Name: UmeedSey
high quality care to mother and child
www.umeedsey.org
Franchisor will Provide:
1. Birthing Station
2. Life Saving Drugs, Birthing Toolkit (Complete)
3. Smart Phone
Supply Chain System
4.
5.
6.
7.
Emergency and Transportation Services
Referral Doctor (Expert Advice)
Branding/ Awareness Campaign
On going Trainings
Financially Sustainable Franchisor
CMW Coverage – Our Goal
25% Market
Share
55% Market
Share
• PKR 14000
• PKR 30800
40% Market
Share
70% Market
Share
• PKR 22400
• PKR 39200
Innovation in MNCH Care System
CDSS
EMR
M&E
Mobile App
Supply
Chain
Billing &
Insurance
Mobile Application
Add New Patients
•Patient Details
•Past Obstetric History
•Genetic/ Family History
•Surgical Medical History
Calculates EDD
Remembers Patients Gestational Week
Show Patient List with Real Time Status Alerts
Reminds CMW on pending Information
Antenatal Visit Record
9 Lab Tests
http://umeedsey.org/opendata.aspx
CMW Trainings
MNCH Triage
• Anemia
• Diarrhea diseases
• Intestinal parasites
• Acute respiratory infections
tuberculosis
• Malaria
• Primary eye care
• Scabies
• AIDs and hepatitis
• Monitoring/Vaccinations of Babies
Under 5
CMW App
LHW App
LHW
(Promotive healthcare - FP)
CMW
(Skilled Birth Attendant)
• Anemia
• Gestational diabetes
• Pre-eclampsia (Toxemia)
• High blood pressure
• Eclampsia
• Hyperemesis gravidarum
• Placenta previa
• Placental abruption
• Preterm labor
• Miscarriage
• Multiple pregnancies
• Fetal problems
Doctor
(Referral Center)
LHW Role
Community
1000 Persons
Register
Families
Supplies
Births/
Deaths
Common
Ailments
LHW
Family
Planning
Growth
Monitoring
Immunization
LHW Monthly Report
LHW MIS (Excel Based)
LHW Program Story Board
Community
1000 Persons
Delay in transfer of Information
(2 Months)
1 Month Delay
1 Month Delay
Data
Monthly
Report
EDO Health
Office
LHW
MIS (Excel)
Directorate of
Health
LHW
Record Keeping
LHW Register
Hard Copy
Soft Copy
Decisions
&
Planning
LHW Program Story Board
Community
1000 Persons
Real-time
Data Transfer
Data
Daily
Report
LHW
EDO Health
Office
LHW
MIS (Web
Based)
Directorate of
Health
Decisions
&
Planning
LADY HEALTH WORKER APP (Developed)
Family
Members
WASH
Anemia
Register
Families
Medication
Diarrhea
Intestinal
Parasites
Hepatitis
Poverty Score
Card
Symptoms
Screening
AIDs
Scabies
LHW App
Primary eye
care
Tuberculosis
Malaria
Growth
Monitoring
Family Planning
Immunization
Acute respiratory
infections
LADY HEALTH WORKER APP (Developed)
Register
Families
Helps in Collection
of evidence based
data
Average Family
Size
Symptoms
Screening
Growth
Monitoring
Immunization
Record
Family
Planning
Poverty Score
Card
Polio
Early Diagnosis
Identification of
Chronic Disorders
Measles
Contraceptive
Disbursement
Update of PSC
NADRA/ BISP
Hepatitis B
Disease Burden
Diphtheria
Pregnancy Rate
Birth/ Death
Reporting System
Pertussis
Reduced Cost of
Healthcare
Tetanus
Nutritional Status
Identification of
Unregistered
citizens
Identification of
community health
practices
Tuberculosis
Pneumonia
Population Growth
Rate
Targeted Benefits/
Subsidies
LHW Enterprise Revenue Streams
Data
EPI
Others
LHW
CMW/ LHV
Referral
Fee
Medicine
Selling of
Health
Insurances
Franchisor Management System
Desktop/Web App
Features
Managing Referrals and Emergency Transport
Health Statistics Reports
Supply Chain Management System
Accounting and Payroll
Health Worker/ TBA Capacity Building Training
Program Indicators
Internet/ Wireless Network Settings
Monitoring and Evaluation Reports
THANK YOU!
Any Questions?