Using Information Systems and Community Health Workers to

Promote Sustainable Health Care in Vulnerable Populations in

New Delhi, India
Davis, B.; Miller, S.; Reiersgord, B.; Wong, N.
University of Denver, Josef Korbel School of International Studies

Background Problem
Geographic Context: Four urban slum communities on the southeast side of New Delhi,
There is a disconnect between the supply of publicly subsidized health care and vulnerable
India.
populations.
Demographics of Catchment Area:
Demographics of Catchment
• Population estimate: 150,000 Area:
••Population
Vulnerable estimate: 150,000
••Vulnerable
population
Populationpopulation
(as defined by a government survey from 2008-2009): 74%
(as defined
below poverty by a government survey from 2008-2009): 74%
line: 47%
Posited Solution
••Population below poverty
Percent illiterate: 62% line: 47%
• Percent illiterate: 62%
A Community Health Worker (CHW) will mitigate the disconnect between the
Health System: supply of health care and vulnerable population’s utilization of that supply by
Health
•PubliclySystem:
funded primary health care facilities are absent within area integrating the public health insurance schemes into an existing (and heavily
••Publicly funded
Government primary
has health
recently care facilities
introduced are absent
subsidized within areaprograms for
health insurance utilized) private medical infrastructure, in two phases:
•vulnerable
Government has recently introduced subsidized health insurance programs for
populations
vulnerable
•Government populations
programs plan to create a health information infrastructure reliant on
•mHealth
Government programs plan to create a health information infrastructure reliant on
mHealth Phase 1: Phase 2:
1. Identify, survey, and map existing 1. Facilitate the empanelment of
facilities that would qualify for qualified facilities into publicly
Health Context: government subsidy programs. subsidized health insurance
Health
•Lack ofContext:
awareness of importance of antenatal care 2. Provide general community health
••Lack programs.
Lackofofawareness
knowledgeofabout
importance of antenatal
appropriate care
facilities and when to seek care education and outreach.
••Lack 2. Help women overcome
Highof knowledge
number aboutdelivering
of women appropriate at facilities
home and when to seek care 3. Encourage women to complete
••High bureaucratic and social obstacles
Care number of womenhome
seeking behavior: delivering at home
treatment > local RMP > clinic > larger hospital paperwork for eligibility into to enrollment and utilization of
Care seeking
•(Household behavior: home treatment > local RMP > clinic > larger hospital
surveys) publicly subsidized health programs. government schemes.
(Household surveys)
•8% of households surveyed treat their water 4. Tell women which services to use,
••8% 3. Support government by
of households
Common diseasessurveyed treatrash,
include skin theirinfections,
water diarrhea, worms, anemia, and fever and when available, which take
•Common diseases include skin rash, infections, diarrhea, worms, anemia, and fever monitoring community and
insurance. collecting data.

Theoretical Framework Field Methods

1. Geographic Information Systems (GIS) mapping of community
services and landmarks
2. Surveys
A. Households (102)
B. Private health care facilities
(47)
3. CHW curriculum development
A. Training for CHW trainer

Field Observations

1. Lack of points of service accepting publicly funded health insurance

2. Low utilization of government services.
- Lack of knowledge of rights-based
services
- Low community engagement and
trust of political system
3. Failure of communication between levels of government, resulting in
inability to follow through with insurance benefits after collection of
fees
4. No mechanism for dissemination of knowledge of new service
providers

Conclusion

uts for Management Information System Our findings support the need for CHWs as mediators between
vulnerable populations and publicly subsidized health services. In the
coming months, we plan to put our theoretical framework into action
by:
•Further understanding the role of CHWs in the context of
technological innovation.
•Undertaking behavioral analysis of community demand for health
services.
•Undertaking cost-benefit analysis for participation of service
providers.

Maternal Child Health Providers - Jasola Area

Facility Number Area Public/Private Insurance Cost General (Rs.) Cost Antenatal (Rs.) Cost Delivery (Rs.)

1 Jasola Village Private N 50 NA NA

2 Jasola Village Private N NG NA NA

3 Jasola Village Private N NG NG NA

4 Jasola Village Private N 100 NG NA

5 Jasola Village Private N 0 NG NA

6 Jasola Village Private N 40 NA NA