Medical practicePATIENT CARE

Mohalla Clinics in Delhi: Evolution and Prospects

Mohalla clinics have been in the center of political and public discourse for quite some time. we are exploring its  evolution from  inception as a single clinic to its future prospects of shaping our health policy  to be inclusive and affordable for everyone.

Introduction

 

(Mohalla in Hindi language means neighbourhood or community)

First set up by the Aam Admi Party government , in new Delhi( 2015), Mohalla Clinics are  first point of contact for the people seeking health care (primary health centres)  . It provides essential health services including medicines, diagnostics, and consultation free of cost and meant to reduce patient load in secondary and tertiary health facilities in the state.

Mohalla clinic in delhi. Credit: NDTV india.

Concept of Mohalla clinic in Delhi.

The Mohalla or community clinics were started by the government of Delhi in July 2015, with one single clinic in a slum locality. It was done to mimic the success of mobile vans or mobile medical units (MMU). Mobile medical units (MMU) are commonly used in different parts of the India and across the world, to provide health services to under-privileged segments of the society. The political desire to strengthen health systems rather than providing ad hoc solutions was the primary driving force behind the implementation of the idea.

 

The key design aspects of these clinics include.

  1. Primary health care services.
  2. Free of cost.
  3. Available at walking distance.
  4. Targeting poor and under privileged segment.
  5. Include medicine and diagnostic tests.
  6. Once a week visit of specialist.
  7. Low cost rented space.
  8. Engaging private doctors

Course of Mohalla clinic in Delhi.

  1. The first mohalla clinic of Delhi was inaugurated on 19 July 2015 at Peeragarhi area of West Delhi. It took another 9 months to set up additional 100 clinics. 
  1. In five months of opening of these clinics, almost eight lakh patients were treated. The data shows nearly 43,000 people got various tests done at the clinic.
  2. In August 2016, Delhi witnessed an outbreak of dengue and the Mohalla clinics became a key entry point for patients to get examined and tested. It was major relief for large health facilities and allayed the crisis in the city.
  3. By the end of the year 2016, around 1.5 million patients were examined at these facilities, 
  4. By December 2017, a total of 160 clinics were established.

The down sides in the course of Mohalla clinic in Delhi

Complains of mismanagement

Media reports say that the clinics ” are reeling under the absence of a proper maintenance system”.

Media reports suggest that CBI has launched preliminary inquiry to investigate the irregularities in its management.

The upsides in the course of Mohalla clinic in Delhi

The lancet

leading international journal, The Lancet , in editorial in December 2016 , reported  that “a network of local mohalla clinics that are successfully serving populations otherwise deprived of health services.”

The Washington Post

The Washinton Post hailed the concept of Mohalla clinic and reported  that the  concepts of universal health coverage and inclusive healthcare services was met by these. 

Kofi Annan UN secretary general

The project could be a model for all Indian states embarking on the UHC (Universal Health Care) journeys.” read the letter to Delhi chief minister Arvind Kejriwal by Kofi Annan.

Stanford Social Innovation Review

“The of the National Capital Territory of wants to change that. Since winning elections to govern India’s capital and its environs in 2015, the Aam Aadmi Party (AAP) has launched a project to offer residents free preventive health screenings through local clinics in the neighbourhoods, or mohallas, where they live,” Stanford Social Innovation Review said.

Dr Gro Harlem Brundtland
Former WHO chief & former Norway PM

Former WHO chief & former Norway PM Dr Gro Harlem Brundtland on Mohalla Clinics at Bangkok Conference talk about AAP Mohalla Clinic and it’s benefits.

Global Health Governance program

Global Health Governance program called it “ a scalable model for achieving universal health coverage”  

Prospects of Mohalla clinic in Delhi

A total of 668 new clinics are been proposed to be set.

A number of Indian states, i.e., Maharashtra, Gujarat, Karnataka, Madhya Pradesh, and a few municipal corporations (i.e., Pune) have shown interest to start a variant of these clinics.

 Delhi has been developing a four tier healthcare system (first Mohalla clinics; second polyclinics; third multispecialty hospital; fourth super specialty hospitals and medical colleges.) with referral linkages.

The urban PHCs (U-PHCs) under National Urban Health Mission (NUHM)to complement  these clinics

  • mohalla clinics to focus on clinical/curative and diagnostic services
  • U-PHC in addition to curative services deliver public health services with clearly established referral linkage

Many innovating approaches have been tested while the concept of the Mohalla clinics was tested and evolved. Most notable  are , doctors on contract for “fee for service” basis, rented premises for Mohalla Clinics, and flexible and variable timing of clinics. Few more initiatives are proposed like optimal use of interns and postgraduate students from medical colleges for staffing of these facilities.

The increased use of information technology IT has been explored in managing these facilities, most notable is medicine vending machines.

These clinics have been able to bring healthcare in the center of   political discourse, which is a change for better.

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