In the outskirts of New Delhi, a small, locally owned shop offers a solution to patients who need convenient and affordable tuberculosis treatment. Behind colorful packages of snacks, toothbrushes, and other products, there are shelves of medicine-color-coded and dated to indicate dosage and start of treatment-and a jug of water with paper cups. As a participant in Operation ASHA, a program that is helping take DOTS (the WHO-recommended TB treatment) directly to the poor, this shop is one of many that provide a critical shift in the supply chain of the local health market.
Operation ASHA distributes medicine through high traffic locations like shops, huts, and temples, providing these sites with both education and medicinal supplies so that they can conveniently deliver TB treatment to communities in need. In addition, locally recruited and highly trained counselors work with patients and assist them throughout the course of treatment.
Because the Government of India reimburses providers for each successfully treated patient, Operation ASHA is able to provide medication free of charge-enabling each community location to become self-sustaining in two years. What's more, the program has had incredible success, lowering the treatment default rate in the slums of New Delhi from 60 percent to 1 percent, thereby "turning off the tap" that produces drug resistant strains of TB in a country where 3.4 million people are infected with the disease.
Why Health Market Innovations Matter
Operation ASHA is an example of a health market innovation, a program that is helping to improve the way health markets operate so that more of the transactions between consumers and private health care providers actually lead to better health and financial protection for the poor. These programs perform a set of needed functions within the health market including:
- Organizing service delivery to ensure that once fragmented and informal providers offer standardized and quality services;
- Financing care to mobilize funds and give purchasing power to the consumer to seek treatment for illnesses;
- Regulating performance to set standards, monitor compliance and incentivize higher quality care;
- Changing behaviors to educate patients about the kind of care to seek and train providers to deliver appropriate services; and
- Enhancing processes by introducing products and technologies that improve efficiency, increase accessibility and lower the cost of treatment
We believe these innovations have the power to correct many of the inefficiencies and inequalities within the health system, improving health and financial protection for the poorest and most vulnerable. Yet, information about them is sparse, a potential result of the relatively little attention given to market-based approaches versus traditional public sector delivery models. As we've spoken with individuals working in the health markets space, it has become clear that many see this lack of centralized and complete information as an obstacle in carrying out their work.
CHMI - A Platform to Improve Health Markets in Developing Countries
In this context we started the Center for Health Market Innovations (CHMI), through which we are seeking to collect, analyze, and disseminate information about health market innovations around the world in order to promote the effective diffusion of successful programs such as Operation ASHA. The core of CHMI is an interactive database of health market innovations that is the first of its kind to provide aggregate, standardized, and searchable information on hundreds of programs with the potential to improve how health markets operate.
If CHMI is successful in the long-term, higher performing health marketplaces with better health outcomes, improved financial protection, and greater consumer satisfaction may begin to emerge in a number of developing countries. While better metrics, trend analysis, and program evaluations will make it easier for implementers, funders, researchers, policymakers, and others to evaluate programs that are successful and call for the wider adoption and replication of successful models.
Here's how you can get involved:
- Searchand contribute to the programs database. Browse hundreds of health market programs, update existing and submit new program profiles.
- Explore the funder database. Learn about the funding priorities of donors and investors that support health market programs.
- Join the conversation on our blog. Hear from others in the health markets community and post your comments as we engage in dialogue to further the impact of innovative health market programs.
For questions and comments, contact us at firstname.lastname@example.org. You can also follow us on Twitter @CHMInnovations
CHMI is funded by the Bill & Melinda Gates Foundation and the Rockefeller Foundation, and is managed by Results for Development Institute in collaboration with a network of partners: Access Health International in India, BroadReach Healthcare in South Africa, the Consultation of Investment in Health Promotion (CIHP) in Vietnam, and the Global Health Group at the University of California, San Francisco (UCSF).