futurechat

Further to my earlier post, Health on her fingertips, where I explored the need of Sumita, a poor young woman to find out more information on basic health care, I have built up my thoughts on the need for universal, transparent health information accessible by phone.

• A Central repository of health information + local health information is added in to make it more relevant
• People can access the information through a Call desk and through SMS
• A national health number is created that is manned by people who speak the local language. SMS menu is readily available that gives basic information (in language of choice to subscribers)

Public health services in India are woefully short of reaching the urban poor let alone the vast rural population. While institutional health frameworks for urban poor and rural poor exist, they could greatly be strengthened though this simple mechanism.

A. There are 5 dimensions of access to health services (Obrist et al. 2007: 0002)

1. AVAILABILITY: The existing health services and goods meet client’s needs - What types of services exist? Which organizations offer these services? Is there enough skilled personnel? Do the offered products and services correspond with the needs of the poor? Do the supplies suffice to cover the demand?
2. ACCESSIBILITY: The location of supply is in line with the location of the clients - What is the geographical distance between services and homes of the intended users? By what means of transport can they be reached? How much time does it take?
3. AFFORDABILITY: The prices of services fit the client’s income and ability to pay - What are the direct costs of the services and the products delivered through the services? What are the indirect costs in terms of transportation, lost time and income, bribes, and other “unofficial charges”
4. ADEQUACY: The organization of health care meets the clients’ expectations - How are the services organised? Does the organizational setup meet the patients’ expectations? Do the opening hours match with the schedules of the clients, e.g. daily schedule of workers? Are the facilities clean and well kept?
5. ACCEPTABILITY: The characteristics of providers match with those of the clients - Does the information, explanation and treatment provided take local illness concepts and social values into account? Do the patients feel welcome and cared for? Do the patients trust in the competence and personality of the health care providers?

In India none of the above parameters are remotely met when it comes to the poor. Health services have poor availability, are seldom accessible due to absence of doctors, medication, infrastructure. Most poor people are illiterate and unaware of what to demand from the government health centers, therefore even inadequate and unacceptable services are accepted with gratitude.

B. Mobile phones could serve as a simple, cost effective empowerment tool. Information on the phone could help people empower themselves and solve basic issues that occur due to paucity of information and availability. At a basic level Mobile phones could give relevant information on the following:

1. Methods of identifying, preventing & controling health problems
2. Appropriate treatment of common diseases & injuries
3. Maternity & child health (including family planning)
4. Prevention and control of locally endemic diseases
5. Immunization
6. Availability and sourcing information of essential drugs
7. Health education

C. This in itself is a large body of information. This would need to be converted into a simple information architecture which is accessible on voice call as well as SMS.

To simplify this further, information could also be broken up into information by need.

I. Questions on personal and family Health and wellness

• Personal & Family Hygiene
• Prevention – Malaria, TB
• What will keep my children healthy?
• Protection

II. Questions on Cost of care

• for emergencies
• for doctor visits
• for medicine
• for surgery
• for tests and medical needs and insurance cover for each

III. Questions on Treatment

• Diseases
• Types of treatments
• Caring for chronic illnesses
• Doctor details
• Hospital information
• Types of tests
• Complaint numbers
• Blood banks
• Organ donors

D. The above method of information access would help the government by reducing the burden of health care in some ways by increasing transparency and empowering the bottom of the pyramid people who are frequently short changed because they know no better.

The information dissemination would of course need to be in multiple Indian Languages to ensure penetration and access..

Going back to the 5 dimensions, mobile services would solve some of the issues outlined above:

1. AVAILABILITY: The poor can know what is available, how they can help themselves
2. ACCESSIBILITY: Instant information increases the ability to access health services as patients can now know who to contact and where.
3. AFFORDABILITY: Overcharging and corrupt practices can be curtailed to some extent.
4. and 5. ADEQUACY and ACCEPTABILITY: Better information, means more knowledge of what to expect and therefore a bottom up pressure on service providers to give better care.

E. The issue of funding also needs to be looked at critically. Funds will be required fundamentally for the following:

1. Seed capital to establish the information databases and technology infrastructure as well as hookups to the various telco’s
2. Ongoing costs to update information, services, staff costs and technology

While a simple model would be to make this government funded, I believe that for this service to be sustainable a public private partnership would be a better idea. The revenue generation from incoming calls, SMS interactions alone could be substantial. Other revenue streams could also be explored. For example a rating system for doctors, hospitals, nurses could be set up. Doctor and hospital references could be given on the basis of their track record and customer / patient feedback.

This is a personal post. It is not about what I am good at but instead about things that leave me in the corridor of uncertainty. Much like  batsmen who don’t quite  know  what to do with the ball pitched in the zone around the off-stump. Here are some moments that may make you laugh with me or at me. Laugh either way. Its good for your health. 

Sometimes intentions are just not enough.  

I intended to buy a gift for a lady friend and eventually I decided to buy her earrings. It seemed like a simple enough thing to buy. I spent 15 minutes and I was done with. I gave her the gift and she has not stopped laughing since. I am sure,  she is thankful, if only she can stop laughing. The problem is with the gift.  They are earrings but not quite the way she has used them. She has converted them into fancy buttons. Yes! great intentions marred by my incompetence. 

Another time, another mall and this time I was studying new beauty products for men. I was at a counter of an international brand that had just launched their range for men. Everything on display and product information seemed greek to me and I was not sure I could buy anything that I might have used. The staff too seemed equally uneasy. So I finally told the counter person , “I need you to give me a product that helps my face”. The sales person looked at the products and then at me, shrugged and said, “Sir, nothing can be done for your face!”. Honest advise, but I am not sure the sales person did much for their brand and also for my shaken self confidence. 

Undeterred , another assignment led me to a furnishings store. I looked at the products on display and behaved like a customer and to my horror purchased products for our home. I bought curtains for the entire house. Considering that , I was the “man” of the house, others were far to polite to tell me, that I had a made a terrible choice. I obviously had no talent for colour and fabric . To rectify the situation, I went back to the store with my family to undo the efforts of my “good” work. 

Yet another assignment for another home lifestyle brand led me to a similar furnishings store. I thought , this time , i was reasonably well prepared with all the right terms to ask. I entered the store and noticed a famous lady NDTV reporter shopping for products quite comfortably. All i know, is I suddenly felt that I knew nothing and I’d lost all the key questions. All I wanted to know was, “where can I find duvets?”. Mind you , I had been briefed on a duvet but i did not know how to spell it , forget about even visually finding it in the store. So finally when i confronted , the said duvet , I did not know what to make of it. Does it cover the bedsheet, is it to be used as a quilt or is it a wall hanging !! Why could somebody not have put usage instructions, is the thought that came to mind. 

Gift coupons , come standard with many premium credit cards. Have I used them, No! The minute I get one , all the lady members of the house take them and make it a point to use them. I am not sure , if there is a programming fault with my genetic code or men display such characteristics or maybe some atleast. A famous skin clinic sent me coupons , that I did nothing about despite the fact that another cosmetics company had left my confidence shaken. 

But at this point, I want to talk about Body Shop. If you go to their store, there is only a small section for men, but I do know where it is and almost always find the shortest path possible to it. Products and communication seem easy enough to relate and there is no uncertainity. I have not quite decoded how the Body Shop experience works for me, but it does. 

The reason for writing this has been that of late a range of products are being launched in categories that have been traditionally been for women. Going by my less than stellar personal experiences , I am beginning to feel that there is an experience code for men that brands still need to work out. Increasing competition will only mean that this code has to be decoded and fast. 

An experience code for men in these product categories that will make for more transactions, intelligent decisions and enough communication as may be required for that category. 

When Hamlet asks “To be, or not to be: that is the question: Whether ’tis nobler in the mind to suffer, the slings and arrows of outrageous fortune, Or to take arms against a sea of troubles’ he could have been referring to the Franchising dilemma that today’s health and wellness providers are grappling with. To Franchise and grow quickly vs own and grow in a measured way.

Probably there is no right answer without a strong context. Franchising is basically a form of ownership. In a franchisee driven business such as Pizza Hut – the brand is owned by the company – in this case Yum foods and outlets are owned and managed by independent franchisees. So no matter which Pizza Hut or McDonald’s you visit the product, pricing and service experience is always similar and consistent.

This works because the franchisor and franchisee agree to the fundamental premise that each franchisee will always follow established brand and operational guidelines. This way of working allows the Franchisor to focus on ensuring compliance while the franchisee builds the local business.

While this framework works well in several types of retail businesses, in health and wellness it posts several challenges:  (more…)