Despite real progress since 1990, India has not achieved universal health coverage yet.
For instance, the country still has the highest infant death rate in the world. In 2013, 1.3 million children under the age of five died. For many, this was due to preventable causes like birth complications, pneumonia or diarrhea. Tragically, the majority of fatalities occurred in poor rural households.
A shortage of skilled medical staff in rural India
In India, most of the medical facilities are in the cities, where only 27 percent of the population lives. Approximately 716 million people are currently living in rural areas and they only have access to deplorable health centers. Most of the time, they have to travel a long way to get there. When they arrive, nothing assures them that they will find a practitioner to treat them. Rural India is indeed facing a 64 percent shortage of health professionals.
Aware of the situation, successive Indian governments have been working on this issue. In particular, they have hired women as health workers in remote villages. Today, they are the backbone of the public health system in the countryside. However, most of them are semi-literate and have an insufficient basic training.
A lofty young couple to tackle the Indian rural healthcare issue
They took the leap in 2013 and their dream seemed impossible to achieve. After all, Abhinav and Shrutika Girdhar had no healthcare experience. All they had were years of frustration with the rural medical system.
Shrukita grew up in Mumbai, but her grandparents live in a village of 2,000 people. Whenever they get sick, they have no choice but consult the local health workers. They are only two and they have poor medical skills. Often they cannot cure treatable problems, and often times, this leads to the patient’s death.
Such a situation worried Shrukita, so she opened up to her husband. As the son of two doctors and an entrepreneur at heart, Abhinav was willing to take action. Together they agreed they would focus on improving the training of health workers.
That’s how they left their well-paid jobs and started Bodhi Health Education.
An accessible, personalized training program for health workers
In India, road conditions are usually poor, so it was unrealistic to organize the training sessions in the villages. On the other hand, mobile coverage is good and there are over 900 million cell phone users. Plus, Shrukita being an IT engineer, they opted for an e-learning solution that could easily be delivered through Android-based devices.
That way, they would tackle the challenge of training uneducated people. Most health workers have limited formal education and it is hard for them to learn medical topics. That’s why the Girdhars and their team of medical specialists developed an adapted curriculum. They made sure to explain every concept and procedures using pictures and videos. Additionally, they deliver the lessons in Hindi and India’s regional languages. That way, the learning is simple, interactive, and engaging.
Furthermore, the Bodhi curriculum relies on a personalized educational approach. After a lesson, the learner has to answer practical questions; after a module, she must then take a quiz exam. The results are sent to the trainers who can assess the learning process. It allows them to tailor the program to the health worker’s pace and progress.
Reluctant medical authorities
At first, Shrutika and Abhinav had to overcome resistance to e-learning. The medical authorities were doubtful about using technology to train community health workers. Despite this rebuff, the young entrepreneurs persisted. In less than two years, they developed 100 training modules. The Bodhi curriculum now covers topics like maternal and child care, immunization as well as tuberculosis.
Besides, the Girdhars introduced their program to health workers, who all showed great interest. They found it easy to use and were happy for the opportunity to increase their skills and knowledge. They knew it could help them better treat people, but also earn more money.
In view of these results, the Indian medical authorities agreed to give it a try. Bodhi Health Education could develop partnerships with the government, private hospitals and healthcare companies. These organizations provided tablets, computers and smartphones to upload the Bodhi curriculum. Over 1,000 community health workers could at last access the training.
Towards a better healthcare for the ‘bottom of the pyramid’?
For Shrutika and Abhinav, this is only the beginning. In the next five years, they aim to train more than 60,000 rural health workers. They also want to go international and promote their solution in Asia and Africa.
And of course, they will focus on the regions with the worst health indicators to achieve a major impact!