I replied to your queries very long back. For strange reasons, its not showing up in the website. However, I am responding to your queries again.
1. Regarding the fee: The Drishtee Health Entrepreneurs charge a nominal fee of INR 150 (USD 30)- for the entire maternity coverage of nine months, which comes to INR 16 per month. This fee covers ante-natal check-ups, post-natal check-ups, maternity care advise, birth preparedness, and complication readiness advise. This is the only direct cost the pregnant women have to bear, as the centre is located within the village. The objective of keeping a nominal fee is to create a sense of ownership to these women, for example, having paid the fee entire pregnancy they keep a track of due date of next check-ups. This helps us in ensuring higher percantage of women receiving all the three recommended ante-natal checkups.
2. Regarding the social inclusion: I am very glad that you have raised an important and most relevant question. As mentioned above, Drishtee charges a very nominal fee of INR 16 per month. If these women access any free maternity care services, they will end up spending much more than INR 150. Along this, they will also incur in-direct costs like, loss of wage, travel cost to the urban centre, etc. Also, Drishtee provides freeships for those who can not afford to pay for this, but are keen on getting check-ups.
3. Other social challenges: Its easier said than done. There are several social challenges that we face during the implementation of this programme. Some of them include: a) Social taboo and customs about pregnancy care b) Quacks eco-system c) Poor decision making power of women in rural India households.
Hope I have answered your queries. Feel free to contact me for any clarifications
On April 15, 2010 the judges reviewed the entries for the Changemakers "Healthy Mothers, Strong World" competition and would like to pass on the following feedback (listed below) for your entry. Thank you for applying and for your hard work in the field. We are excited to archive your entry to serve as a leading solution for the worldwide community of innovators. We wish you continued luck with your innovative, sustainable, and socially impactful initiatives.
All the best, The Changemakers Team
"What was most appealing about this initiative was that they are working with a model that gets proper care to the right people and with the right kinds of incentives. The focus on health care providers is fantastic! I think they've demonstrated great thinking, and are really trying to tackle the social and structural reasons as to why conditions are the way that they are."
We, at Drishtee, are glad that our efforts to service the marginalised population were appreciated. We will always put in our best efforts to continue the quality work.
Congratulations. Your idea is great. But i have the same question as the first commenter Vignae: How much will be charged? How profitable will that be for the DHF's? How strict will the monitoring be to ensure that the DHFs dont make themselves tin gods in their community?
1)I think I have explained about the charges while answering Vignesh's questions.
2) We have developed a business plan for the DHFs. Knowing the rural economy, we assume that each DHF should at least earn INR 1500/- to be called profitable. However, the DHFs with higher participation and motivation level earns upto INR 3500/- which is a remarkable contribution of a female to her household in the rural community.
3) We have a monitoring system for the activity of the DHF.
- While registeration, the DHF signs an agreement that limits her activities to only non invasive diagnosis, selling certain over the counter medicine, assisting the pregnant females and awareness generation. She is legally bound through this agreement for not practising unauthorised medical services.
- As mentioned in the entry, the Drishtee Health Executive (DHE) visits the health kiosk on a scheduled rota and monitors her activity and progress
- In case of any abuse of services reported by the community or the beneficiaries, her license as DHF is cancelled by Drishtee after verification. This puts an end to services provided by Drishtee to her kiosk like Doctors visit, SBA visits, supply of medicines etc.
Please let me know if you need further explanation about any of the above mentioned processes.
Dear Minal,
this is an interesting and important project to improve maternity care in the community. I have got two comments and questions:
1) You state that you offer free services to pregnant women who cannot afford the small fee. A well-known general health care challenge is the inverse care law that people at highest risk make least use of the available services. One factor but not the only one can be the financial barrier.
Do you know about the % of non-users in your area and the reasons why these pregnant women do not use your services? In case you do not know, to find out could be an important local research project.
2) It is not clear from your description where the deliveries take place. Unfortunately many serious problems occur during delivery and are not predicted by antenatal care. Therefore it is essential to have good delivery and referral services for comprehensive obstetric care.
Do you have any information whether and how delivery services have improved due to your intervention?
Thanks for your valuable feedback about the project.
1) I appreciate your recommendations about the non-users of the services. Finding out the reasons for low utilisation can be a valuable learning for future interventions.
2) As an organisation, we lack infrastructure like a hospital or delivery home. But we have tried establishing a referral system for delivery. The pregnant females are informed about the government facilities where they can avail free delivery services. The females are informed about the distance and travel options which help them in birth preparedness.
Also, we have established partnership with some private hospitals who promise discounted delivery packages to the village based pregnant females.
Comments
Hi Minal,
I read through your proposal. I have few questions on your proposal.
1. What is the nominal fee that you charge for maternal health service delivery?
2. Don't you think by charging a nominal fee, you are excluding the people you cannot afford pay this fee?
3. What are the other social challenges you are encountering this programme?
Looking forward to your response.
Best
Vignesh
Hi Vignesh,
I replied to your queries very long back. For strange reasons, its not showing up in the website. However, I am responding to your queries again.
1. Regarding the fee: The Drishtee Health Entrepreneurs charge a nominal fee of INR 150 (USD 30)- for the entire maternity coverage of nine months, which comes to INR 16 per month. This fee covers ante-natal check-ups, post-natal check-ups, maternity care advise, birth preparedness, and complication readiness advise. This is the only direct cost the pregnant women have to bear, as the centre is located within the village. The objective of keeping a nominal fee is to create a sense of ownership to these women, for example, having paid the fee entire pregnancy they keep a track of due date of next check-ups. This helps us in ensuring higher percantage of women receiving all the three recommended ante-natal checkups.
2. Regarding the social inclusion: I am very glad that you have raised an important and most relevant question. As mentioned above, Drishtee charges a very nominal fee of INR 16 per month. If these women access any free maternity care services, they will end up spending much more than INR 150. Along this, they will also incur in-direct costs like, loss of wage, travel cost to the urban centre, etc. Also, Drishtee provides freeships for those who can not afford to pay for this, but are keen on getting check-ups.
3. Other social challenges: Its easier said than done. There are several social challenges that we face during the implementation of this programme. Some of them include: a) Social taboo and customs about pregnancy care b) Quacks eco-system c) Poor decision making power of women in rural India households.
Hope I have answered your queries. Feel free to contact me for any clarifications
On April 15, 2010 the judges reviewed the entries for the Changemakers "Healthy Mothers, Strong World" competition and would like to pass on the following feedback (listed below) for your entry. Thank you for applying and for your hard work in the field. We are excited to archive your entry to serve as a leading solution for the worldwide community of innovators. We wish you continued luck with your innovative, sustainable, and socially impactful initiatives.
All the best, The Changemakers Team
"What was most appealing about this initiative was that they are working with a model that gets proper care to the right people and with the right kinds of incentives. The focus on health care providers is fantastic! I think they've demonstrated great thinking, and are really trying to tackle the social and structural reasons as to why conditions are the way that they are."
- Changemakers "Healthy Mothers, Strong World" Judges
Thanks for sending the judges feedback.
We, at Drishtee, are glad that our efforts to service the marginalised population were appreciated. We will always put in our best efforts to continue the quality work.
Thanks,
Dr Minal Singh
On behalf of Drishtee Team
Congratulations. Your idea is great. But i have the same question as the first commenter Vignae: How much will be charged? How profitable will that be for the DHF's? How strict will the monitoring be to ensure that the DHFs dont make themselves tin gods in their community?
Amaka Okafor
Thanks for your appreciation!!
Following are the answers to your queries:
1)I think I have explained about the charges while answering Vignesh's questions.
2) We have developed a business plan for the DHFs. Knowing the rural economy, we assume that each DHF should at least earn INR 1500/- to be called profitable. However, the DHFs with higher participation and motivation level earns upto INR 3500/- which is a remarkable contribution of a female to her household in the rural community.
3) We have a monitoring system for the activity of the DHF.
- While registeration, the DHF signs an agreement that limits her activities to only non invasive diagnosis, selling certain over the counter medicine, assisting the pregnant females and awareness generation. She is legally bound through this agreement for not practising unauthorised medical services.
- As mentioned in the entry, the Drishtee Health Executive (DHE) visits the health kiosk on a scheduled rota and monitors her activity and progress
- In case of any abuse of services reported by the community or the beneficiaries, her license as DHF is cancelled by Drishtee after verification. This puts an end to services provided by Drishtee to her kiosk like Doctors visit, SBA visits, supply of medicines etc.
Please let me know if you need further explanation about any of the above mentioned processes.
Thanks for highlighting your concerns.
Best,
Dr Minal Singh
I appreciate the project idea and the way it promises wide social impact at multiple level.
Drishtee keep the good work going!
The project details are quiet informative. It is good to know about a successful social enterprise model.
Best,
Ashish
Dear Minal,
this is an interesting and important project to improve maternity care in the community. I have got two comments and questions:
1) You state that you offer free services to pregnant women who cannot afford the small fee. A well-known general health care challenge is the inverse care law that people at highest risk make least use of the available services. One factor but not the only one can be the financial barrier.
Do you know about the % of non-users in your area and the reasons why these pregnant women do not use your services? In case you do not know, to find out could be an important local research project.
2) It is not clear from your description where the deliveries take place. Unfortunately many serious problems occur during delivery and are not predicted by antenatal care. Therefore it is essential to have good delivery and referral services for comprehensive obstetric care.
Do you have any information whether and how delivery services have improved due to your intervention?
All the best for your exciting project, Reinhard
Dear Reinhard,
Thanks for your valuable feedback about the project.
1) I appreciate your recommendations about the non-users of the services. Finding out the reasons for low utilisation can be a valuable learning for future interventions.
2) As an organisation, we lack infrastructure like a hospital or delivery home. But we have tried establishing a referral system for delivery. The pregnant females are informed about the government facilities where they can avail free delivery services. The females are informed about the distance and travel options which help them in birth preparedness.
Also, we have established partnership with some private hospitals who promise discounted delivery packages to the village based pregnant females.
Minal
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