Operation ASHA – Last mile delivery of health services and products at the doorstep of the under-served

The problem of tuberculosis.

The salient features of OA’s model :

Use of algorithms approved by Governments and WHO
Close coordination with Government and other stakeholders
Empowerment of target communities and well-trained corps of community health workers
Active case finding and contact tracing with support of a software application for TB.
Rapid response testing and education of patients’ immediate circle
Door delivery of medicine, diagnostics and education
Amelioration of side-effects, de-stigmatization and camouflage
Performance based remuneration of CHWs
Biometric devices to track compliance and other technology applications to track staff movement, communication of lab results and payment to village workers
Franchise-like operation for easy replication
low cost operating model
Advocacy with stakeholders and governments to improve policy and financial sustainability

Impact:

OA’s model has been replicated in Uganda by the Millennium Villages and Columbia University, Earth Institute. They are also using OA’s eCompliance technology in Kenya, Peru, Dominican Republic, Tanzania and Afghanistan.
Achievement of low default of up to 3.1% in TB treatment. Treatment success rate goes up to 88.3%.
OA increases detection rate of TB by 50-400% within 6-18 months of starting work in any area.
75719 patients of normal/ DST TB, 366 patients of MDR TB have been enrolled, one patient of XDR has been treated and three patients of XDR are under treatment.
Elimination of out of pocket expenses for patients by door-step delivery of services including collection of samples
24 Female TB patients were provided vocational training to prevent them from being abandoned by families.
342 Haemophilia patients detected and started on treatment
10,000 TB patients were tested for diabetes. Those who tested positive are being linked with physicians and trained to manage diabetes successfully in a market sustainable way
195 disadvantaged persons have been provided dignified work.
93 patients’ jobs have been saved by counsellors who convinced their supervisors, not to terminate them
Income of 124 micro-entrepreneurs in disadvantaged localities, who work as partners of OA, has been enhanced substantially.
On treatment, patients earn an additional $13,935 (Rs. 8.36 Lakh) through reinstated productivity in their lifetime, on an average (Annual TB Report 2013, Government of India). Thus, treated patients have benefited by a whopping $ 959 million (Rs 6,330.1 crores).
With treatment of each patient, the economy saves $12,235 (Rs 7.34 Lakh) in indirect loss (Annual TB Report 2013, Government of India). So the Indian and Cambodian economies have saved $ 842 million (Rs 5,557 crores) for patients who have successfully completed the treatment.
OA has detected and is helping with management of diabetes, heart disease, hemophilia and depression for thousands.
OA has distributed millions of analgesic, antacid, antiemetic, iron and calcium tablets.
OA has also distributed condoms, Oral Rehydration Salt, protein supplements, 8 tons of food and 9000 blankets. Thus, OA’s delivery model is truly turning into a delivery pipeline for disadvantaged areas/ Bottom of the Pyramid markets. Monitoring and Evaluation: “What gets measured, gets done” – is part of the Philosophy of OA. In this spirit, OA tracks the following key performance indicators.

Evaluation Measures for Program: Following key performance indicators are collated, tracked and reviewed monthly on a routine basis. This will be done for the Proposed Project also.

The proposed solution is law cost. For example, for TB, Operation ASHA’s drop-out rate for TB patients in India is 5 times lower that the national average of 20%. Its detection rate is also higher than national average.