This week, You! takes a look at a tele-health programme, initiated by two female doctors in Karachi in a bid to provide basic healthcare facilities in underprivileged areas...
It is recorded that 51% of Pakistan’s entire population is deprived of basic healthcare facilities. One-third of this population lacks access to even primary services. The situation of maternal and child healthcare is worse, and the infant mortality rate in the country paints a gloomy picture. This is an alarming scenario especially for a country that is producing 170,000 doctors and 40,000 specialists every year and despite the increase in production of medical professionals, the situation remains questionable. One of the main reasons behind this is that while medical colleges have a high percentage of female students, only 50% of them actually work as doctors. Most end up not working due to socio-cultural restraints that forbid women to work. However, the situation is not that gloomy, there are dedicated doctors out there who are passionate about increasing access to primary healthcare in Pakistan. Dr. Sara Khurram and Dr. Iffat Zafar are two such doctors from Karachi, who are on a mission to connect home-based doctors to patients in underprivileged areas of Pakistan. Read more about their tele-health platform - Sehat Kahani.
What is Sehat Kahani?
Co-founded by Dr. Sara Khurram and Dr. Iffat Zafar, Sehat Kahani is a tele-health platform that connects at-home out-of-workforce female doctors to underserved patients in low and middle-income markets providing access to quality healthcare. The idea is to increase the reach of medical facilities to the deprived areas of Pakistan where doctors and their services may not be available. Also, Sehat Kahani aims to democratise healthcare by building an all female health provider network to deliver quality medical solutions using tele-health, a phenomenon known to be the future of healthcare globally using three main business lines - access, prevention and efficiency.
The programme increases access by using trusted intermediaries in the communities and dormant health infrastructure via Sehat Kahani E- Health Hubs where a frontline worker is trained with the help of a 5-step training based on medical knowledge, leadership and soft skills. This assists in connecting patients in these hubs to qualified home based female physicians and skills specialists using video consultation and Electronic Medical Records systems.
The second step of prevention is the preventive health care portfolio, which creates innovative preventive health care messaging activities in targeted communities, to bring out a long-term change in behaviours and health pattern barriers. The efficiency factor is regulated through the specialised Health and Wellness concierge tele-health platforms and specially designed digital health solutions to reduce the disease load of tertiary care hospitals by treating primary and secondary diseases via virtual home-based female doctors in less than 3 clicks. So far, Sehat Kahani constitutes a portfolio of 14 clinics across Pakistan in three provinces - 7 in Karachi, 3 in interior Sindh, 3 in KP and 1 in Punjab. It has launched more than 10 preventive health campaigns with leading corporate organisations and launched a wellness portal. All of these efforts have resulted in impacting over 550,000 people with an all female network provider of 500 female doctors.
Sara and Iffat’s journey began when they felt the need of having a tele-health system under female doctors (who are not practising) and providing them a chance to work from homes. Sehat Kahani was co-founded in early 2017. Sara and Ifat are working on clinical operations since May 2015. Sara mentioned that the biggest challenge was online connectivity and technical failure. “The underprivileged or rural areas have little or no Internet connectivity. A survey was performed in targeted communities. Internet boosters were placed to back up devices. The work was integrated to ensure that last saved data can be restored and the systems were designed in such a way that the switching of video to audio mode was easy”, says Dr. Sara Khurram.
Dr. Iffat also shed light on the societal challenges that involved community uptake for tele-health services in culturally conservative communities. “We would do weekly awareness sessions, mohalla (cohort) meetings with women. Live sessions were held and health awareness videos were shown to educate people in rural areas”, adds Dr. Iffat.
“We planned cost effective services for community beneficiaries to ensure maximum community participation and involvement along with subsidised health services for them. We also collaborated with the local and international partners to support/sponsor tele-health services for the beneficiaries,”
Maternal and child care:
WHO estimates that up to 15% of all maternal deaths in developing countries are caused by infections in the 6 weeks after childbirth. The conditions mainly develop due to unhygienic delivery practices, both at home and in health facilities. Anemia, a major cause of maternal death and disability, can be caused by intestinal worms, which are transmitted through contaminated water and poor sanitation and hygiene. Therefore, Sehat Kahani aims to stress on water, sanitation and hygiene. Also, it is going to work on child health given the infant mortality rate, which is very high in Pakistan.
The project is currently running 3 Mobile floats, ‘Pan Pakistan’, providing access to a female physician through a nurse assisted van going all the way to the M9 pathway. So far, 40,000 patients have been checked with its help.
Currently two of Sehat Kahani’s clinics are purely dedicated to mental health wellbeing. One is based in Dadar; a mental hospital based in Khyber Pakhtunkhwa, launched by the collaboration with KP government, where more than 1000 plus patients have been treated successfully.
The future of Sehat Kahani
The sustainability of a project like Sehat Kahani increases if the government sector is involved too. Thus, the initiative strives to sustain a neutral relationship with political parties, but the biggest challenge is having no clear policy regarding tele-health since there is no precedent of such efforts in the country. For now, the plan is that Sehat Kahani reviews all health legal acts to ensure transparency in the procedures, acquires legal consultancy and gains approvals from the local District Health Office (DHO) while also formulating partnerships with Governmental agencies such as Pakistan Military Academy (PMA) and Maternal Newborn, and Child Health (MNCH).
Sehat Kahani is not just a health start up; it is a testament to what happens when hard working people look for sustainable solutions to the country’s biggest problems. Let’s hope more people have the courage to do that. More power to Dr. Sara Khurram and Dr. Iffat Zafar for taking up this challenge making lives better.