Behaviour change is key to universal health

The World Health Day, which is celebrated every year on on April 7, happens to be the day (in 1948) when the constitution of World Health Organization (WHO) came into force under the flag of the United Nations. This year’s World Health Day happens to be the 70th anniversary of WHO, which is being celebrated with the theme “Universal Health Coverage: Everyone, Everywhere”.

One can talk at length about the healthcare challenges India faces. The country’s diversity in terms of geography, culture, and demography; political system; unsafe boundaries; huge population burden; poor investment in health are some of the factors responsible for the present health scenario.

But there is something that still misses the eye. That ‘something’ is changing the behaviour pattern of the Indian masses, including the patient population.

The realisation of how behavioural patterns, old traditions, beliefs, and habits affect the success of healthcare efforts dawned upon us when we began our initiative of taking healthcare to the rural and under-served people.

After setting up the first series of Gramin Health Care clinics at IFFCO bazaars, we observed how these clinics were received by the people. The clinics were strategically located at IFFCO bazaars to ensure easy accessibility for a cluster of nearby villages. Being situated near the highways helped us to ensure continuous supply of goods to the clinics for running the operations efficiently.

We had expected people to begin accessing a modern healthcare clinic, which was operational throughout the year. However, during the period we received only few people in a day, mostly farmers who came for some other purpose. This low turnout made us shift our approach.

We began holding camps and reaching out to the villages and people started responding. The experience of hosting camps in the villages and interacting with the villagers helped us understand the strong hold that conventional beliefs and habits had on people. The lack of trust on existing healthcare models was evident, and rightly so, because over the years, thousands of villages in India were left untouched by primary healthcare. Busting various myths, sharing continued education and awareness, and rendering door-to-door services especially for women and child care — triggered a change in the behavioural patterns of the villagers who began trusting a scientifically sound model, and moved away from long entrenched practices of going to quacks and unqualified doctors.

In a short span, we began recording a daily footfall of 15-20 persons in our clinics. The signs are encouraging as today we hold around 800 camps monthly, around 25-30 camps daily, and take primary healthcare services to the villages. Most importantly, our schedules are fixed. We visit each village at least once every month and a camp is held.

The roadmap

A public policy promoting health awareness and healthcare delivery is unlikely to succeed if no efforts are made to modify individual behaviour. The focus needs to be towards the following:

• Effective people participation and engagement in following healthier practices is essential. The more interactive health policies are, the higher will be chances of developing public understanding, appealing to a larger consciousness and modifying habits.

• New care delivery models should have behaviour change as a core component. The models need to be thought-out and viewed from public behavioural psychology during inception and while being drafted.

• Convincing the influencers first is vital. From the head of the village panchayat to celebrities, there needs to be a strategic approach in taking their help in bringing about behavioural change.

• Using modern technology to bridge the gap is key. Social media, digitisation, tele-assisted medicine, video and audio campaigns can play a significant role in reaching to the remotest of regions.

• The role of incentives and penalties cannot be overstated in bringing about beahvioural change.

• Including more accountable stakeholders is also important.

Approaching healthcare policies from the behavioural angle can ensure better systemic efficiency and large-scale transformation.

(The writer is Founder of Gramin Health Care)

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