- By 2050, the country is expected to add 400 million people in urban areas, as a result a large proportion of poor population will move into environmentally-deprived urban pockets which lack access to basic health services.
- Mohalla Clinics have significantly reduced the burden of secondary- and tertiary-care hospitals in Delhi.
Delhi Mohalla Clinics: Establishing Mohalla Clinics has been the Delhi government’s flagship scheme. These clinics, equipped with a doctor, a pharmacist and a clinic assistant/multitasking worker, aim to bring primary healthcare delivery systems right to the doorsteps of citizens. These clinics, functional six days a week (from Monday to Saturday), provide services such as basic medical care for common illnesses like fever, cold, diarrhea, respiratory problems, skin diseases, first aid for injuries and burns, dressing and management of minor wounds and referral services.
In addition to these services, they also provide health-related information, education and awareness, assessment of nutritional status and counselling, and a preventive and promotive component of National/State Health programs. These clinics provide free doctor consultation, medicines as per the essential drug list, and almost 212 lab tests. The Delhi government website claims 311 such clinics are operational across Delhi. After inauguration of 152 new Mohalla Clinics across various places in Delhi on January 5, 2020, the total number of clinics has gone up to 450.
Since the launch in 2015, these clinics have served approximately 2 crore OPD patients and have conducted ~18 lakhs tests until November 2019. The average footfall of one clinic per day is about 70–90 patients. The Mohalla Clinic project has been praised by world-renowned personalities including Kofi Annan, former secretary general of the United Nations and Gro Harlem Brundtland, former director-general of World Health Organization. These world leaders see this as a move towards achieving universal health coverage.
Need Of Mohalla Clinics Like Set-Ups In Other Urban Parts Of India?
According to the UN World Urbanization Prospects 2018 Report, around 34% of India’s population lives in urban areas, indicating an increase of 3% since 2011 Census. By 2050, the country will add 400 million people in urban areas, which are currently home to 410 million people. With this rapid urbanization, a large proportion of poor population has moved into environmentally-deprived urban areas which are overcrowded, have no access to clean water, sanitation, safe accommodation, and often to, basic health services. It is estimated that 30–40% of the population in the metros lives in slum areas. The health indicators of people living in slum or slum-like areas are worse than those in rural areas, mainly because the focus on primary healthcare in urban areas was largely ignored by the government until 2013 when they introduced the National Urban Health Mission for delivering systematic primary care in urban areas.
Mohalla Clinics like set-ups which are based on “Zero Cost Model” will ensure better access to primary healthcare and reduce out-of-pocket health expenditure for people coming from underprivileged, low-income and medium-income groups. Most people from such groups avoid visiting the doctor until they feel very unwell or exhibit debilitating symptoms of disease. Now with the availability of Mohalla Clinics, they have started visiting physicians frequently for more regular check-ups, and even for flu-like symptoms. Due to the close proximity, patients on an average take 10 minutes to reach the Mohalla Clinics from their home.
According to a research study, prior to the advent of Mohalla Clinics, 56% of people used to visit government hospitals, dispensaries and polyclinics, and almost 35% to private facilities for consultation and tests. However, post the advent of Mohalla Clinics, the scenario has changed to a considerable extent. Almost 45% of people who earlier visited alternate facilities now only visit the Mohalla Clinics for their treatment, indicating Mohalla Clinics like set-ups will significantly reduce the footfall in secondary- and tertiary-care hospitals. Approximately 80% of the respondents of the study reported that their medical expenditure had declined manifold owing to the facilities provided by the Mohalla Clinics, while the remaining 20% reported no change in their medical expenditure.
Since Mohalla Clinics, in association with WISH Foundation, promote the use of electronic health records to store patients’ personal details, symptoms, diagnosis, tests and prescriptions per visit, the system will be able to gather immense data on public health in near future which can be used for public health policy, preventive care and treatment during disease outbreaks.
This scheme has inspired other states including Maharashtra, Telangana, Karnataka, Rajasthan, Madhya Pradesh, Jharkhand, and union territories of Jammu and Kashmir which have announced their plans to set up primary health centers for urban slums on similar lines as Mohalla Clinics. It would be interesting to see if Mohalla Clinics like concept will be viable to address primary healthcare needs of the citizens of these places.
Author’s disclaimer: Shamsuzzaman Ansari is a pharmacy graduate with a MBA in Business Strategy. He is currently working as a Healthcare Research Analyst with an MNC based in Noida. He has more than 6 years of experience in healthcare business research and pharma consulting. The opinion expressed here is his personal and has nothing to do with author’s employer.