Rethinking Public Health

A Social Enterprise Model for Birthing Stationswww.umeedsey.org

Saving Lives at Birth through Strengthening Community based Structures and Referral Linkages

Teaching Hospital

DHQ Hospital

THQ Hospital

100,000 PopulationRHC

10,000 PopulationBHU/ CMW/ LHV

1000 Population LHW

Family

Healthcare Levels

Tertiary Care (Rehabilitation)

Specialist (Consultant)

General Practitioner

Lady Health Visitor

Community Midwife

Lady Health Worker

Triage

Cost

HDHQ

THQ

H

RHC

BHU

CMW/LHV

LHW

D

Primary HealthCare Tertiary HealthCareSecondary HealthCare

LHW

CMW/LHV

D

BHU

RHC

THQ

DHQ

HH

Civil Dispensary

Community Midwife/ Lady Health Visitor

Lady Health Worker

Basic Health Unit

Rural Health Centers

Tehsil Level Health Facility

District Level Health Facility

Private Hospital Facility

Tertiary Level Hospital Facility(Complex)

Referral – Pregnant Women

Refe

rral

–

Com

plic

ated

Ca

ses

Refe

rral

– A

cute

D

isea

ses

Lab Tests/ Gynecologist

Referral – Emergency Cases

Referral – Special Cases

Referral – Special Cases

Referral – Complicated Cases

H

KEY

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)

LHWAPP Developed• Register Families• Monitor Acute Symptoms• Family Planning• Growth Monitoring• Refer Patient to GP• Refer Pregnant Women to CMW/ LHV

GP SP H

Pharmacy

Lab Tests

Comprehensive EmOC Referral (Emergency Cases)

Basic EmOC Referral (Emergency Cases)

Prescription Prescription

Lab Tests

Pharmacy Slips

Discharge Summary

Patient AdmissionReferral

1 23

Lab Tests

Pharmacy Slips

General Practitioner (Available At)• BHU• RHC• THQ• DHQ• Private Hospital• Private Clinic

Specialist (Consultant)(Available At)• RHC (Gynecologist)• THQ• DHQ• Private Hospital• Private Clinic

Hospital (Panel Hospital Category)• RHC• THQ• DHQ• Private

Hospital

1 2 3

Electronic System

EMR EMRHIS

M-Health Information System

Micro Health Franchise Model Project Name: UmeedSey

high quality care to mother and childwww.umeedsey.org

Franchisor will Provide:1. Birthing Station2. Life Saving Drugs, Birthing Toolkit (Complete)3. Smart Phone

4. Emergency and Transportation Services5. Referral Doctor (Expert Advice)6. Branding/ Awareness Campaign7. On going Trainings

Supply Chain System

Financially Sustainable Franchisor

CMW Coverage – Our Goal

25% Market Share• PKR 14000

40% Market Share• PKR 22400

55% Market Share• PKR 30800

70% Market Share• PKR 39200

Innovation in MNCH Care System

Mobile App

CDSS

EMR

M&E

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

LHW App

• 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

• Anemia• Gestational diabetes• Pre-eclampsia (Toxemia)• High blood pressure• Eclampsia• Hyperemesis gravidarum• Placenta previa• Placental abruption• Preterm labor• Miscarriage• Multiple pregnancies• Fetal problems

LHW(Promotive healthcare - FP)

CMW(Skilled Birth Attendant)

Doctor(Referral Center)

MNCH Triage

Register Families

Common Ailments

Growth Monitoring

Immunization

Family Planning

Births/ Deaths

Supplies

LHW

Community1000 Persons

LHW Role

LHW Monthly Report

LHW MIS (Excel Based)

1 Month Delay 1 Month Delay

Delay in transfer of Information(2 Months)

EDO Health Office

MonthlyReport

Hard Copy

Directorate of Health

LHWMIS (Excel)

Soft Copy

LHW

Community1000 Persons

LHW Register

Data

Record Keeping

Decisions &

Planning

LHW Program Story Board

LHW Program Story Board

LHW

Community1000 Persons

Data

Decisions &

Planning

Directorate of Health

LHWMIS (Web

Based)

Real-time Data Transfer

EDO Health Office

DailyReport

LHW App

Register Families

Family Members WASH

Symptoms Screening

Anemia

Diarrhea

Intestinal Parasites

Acute respiratory infections

Tuberculosis

MalariaPrimary eye care

Scabies

AIDs

Hepatitis

Medication

Growth Monitoring

Immunization

Family Planning

Poverty Score Card

LADY HEALTH WORKER APP (Developed)

LADY HEALTH WORKER APP (Developed)

Register Families

Helps in Collection of evidence based

data

Average Family Size

Birth/ Death Reporting System

Identification of Unregistered

citizens

Symptoms Screening

Early Diagnosis

Disease Burden

Reduced Cost of Healthcare

Identification of community health

practices

Growth Monitoring

Identification of Chronic Disorders

Nutritional Status

Immunization Record

Polio

Measles

Hepatitis B

Diphtheria

Pertussis

Tetanus

Tuberculosis

Pneumonia

Family Planning

Contraceptive Disbursement

Pregnancy Rate

Population Growth Rate

Poverty Score Card

Update of PSC NADRA/ BISP

Targeted Benefits/ Subsidies

LHW Enterprise Revenue Streams

LHW

Data

EPI

CMW/ LHV Referral Fee

Selling of Health

Insurances

Medicine

Others

Franchisor Management SystemDesktop/Web App

Features

Internet/ Wireless Network Settings

Managing Referrals and Emergency Transport

Health Statistics Reports

Supply Chain Management System

Accounting and Payroll

Health Worker/ TBA Capacity Building Training

Program Indicators

Monitoring and Evaluation Reports

THANK YOU!

Any Questions?