Indian Journal of Public Health

COMMENTARY
Year
: 2017  |  Volume : 61  |  Issue : 4  |  Page : 297--298

Bridging miles to achieve milestones: Corporate social responsibility for primary health care


Ruchie Gulati 
 Senior Specialist, Paediatrics, Sardar Vallabh Bhai Patel Hospital, Patel Nagar, Government of NCT Delhi, New Delhi, India

Correspondence Address:
Ruchie Gulati
R-641 Ground Floor, New Rajinder Nagar, New Delhi - 110 060
India

Abstract

Sustainable Developmental Goals aim to provide “Good health for all”. The task though immense ,requires equitable and efficient distribution of health resources to the community, reached predominantly by the Primary Health Centres. Strengthening these centres is essential to attain the goal. Adequate health financing is one of the important determinants for utilizing the optimal potential of these centres . Pooling funds from alternate financing strategies as Corporate Social Responsibility (CSR) funds may give impetus and facilitate healthcare affordability to the underserved population. This convergence of vision of corporate funding for “basic health services” may bridge the gap arising out of inadequate funding and facilitate “Good Health for all” in India.



How to cite this article:
Gulati R. Bridging miles to achieve milestones: Corporate social responsibility for primary health care.Indian J Public Health 2017;61:297-298


How to cite this URL:
Gulati R. Bridging miles to achieve milestones: Corporate social responsibility for primary health care. Indian J Public Health [serial online] 2017 [cited 2021 Dec 9 ];61:297-298
Available from: https://www.ijph.in/text.asp?2017/61/4/297/220059


Full Text



It has been seen that globally 55% of the rural population is “unserved.”[1] Goal number 3 of Sustainable Developmental Goals launched recently aims to provide good health for all or universal health care (UHC). Although a restatement of Alma-Ata, it refocuses attention to “basic health care for all.” With the nation's sincere commitment to the cause, some low- and middle-income countries such as Brazil, Thailand, Chile, and Mexico despite challenges have already moved closer to achieving UHC.[2] This requires equitable distribution of resources and effective cost planning in the context of the individual country.

Studies showed that “underfunding” of global health finances results in accessibility deficit of 48% of world population (almost half the people of the world). Moreover, this distribution is unequal in rural and urban population, the deficit being almost double in the rural areas (63%) as compared to the urban areas (33%). Dimensions other than accessibility are affected by health financing such as infrastructure, quality of care, availability of health-care worker, and feasibility of the patient getting treatment for the basic health services at that primary level.[2] In most countries including India, conventional sources of health financing have been general government expenditure via taxation, national health finances, insurance (social or private), not-for-profit organizations, international donors, and out-of-pocket expenditure. The out-of-pocket expenditure accounts for 60% of total health spending in India (compared to 13% and 9% in Germany and UK, respectively).[3] In this context of health financing, the Addis Ababa Action Agenda recently noted that most countries need to raise additional domestic funds for health by diversifying funding resources.[4]

An interesting evolving concept is the “corporate social responsibility” or CSR. CSR is a contribution of the business community to development by integrating socially relevant issues with their business operations. In India, as per the new Company Act, 2013, every company which has a net worth of 5 crore or more is to spend 2% of its net profit in CSR activities. This mandatory spending may be on education, community services, health, or other socially relevant issues.[5]

We understand that primary health centers (PHCs) or their outreach is absolutely essential to providing basic health services. The PHCs definitely have immense potential for curative, preventive, and family welfare services. Strengthening primary health services is of vital importance to achieve universal health coverage. The Gadchiroli and Jamkhed projects in Maharashtra and Narangwal project in Northern India have been exemplary models of primary health-care delivery with remarkable improvements in health indicators. Such models require vision, resolute commitment and finances. To optimize the utilization of basic health services by the beneficiaries, an adequate balance of infrastructure, workforce, and diagnostics has to be ensured. One of the determinants to ensure this is by “adequate funding” of the outreach units whether formal government PHCs or not-for-profit health centers providing the basic health-care services.

It would be interesting to evolve a convergence of vision between providing basic curative and preventive health services and social responsibility of the industry for an economically productive healthy population. It may imply having model PHCs or Basic Health Care centers, financed and nurtured by pooling revenues from CSR. Goals targeted may be on priority areas as Maternal Health, Child health and Communicable diseases. Such CSR-funded centers would address the gap of 'affordability' in the underserved population.

They may act as a hand-holding tool till such units cascade similar vision for adequate utilization of funds and resources for the desired goals. Achieving quantifiable results as women receiving antenatal care, percentage of children immunized, and under-five mortality would exemplify and facilitate other similar units to be guided. It has to be however ensured that the funding is with genuine philanthropic intent and not as a strategic commercial operation for sale of medicines by pharmaceutical industry or the sale of certain biomedical equipment.

Different strategies for utilization of CSR funds for primary health care may be envisioned. To encourage funding of basic health services with CSR funds, the government may consider earmarking a specific percentage of CSR spend as “obligatory spend” to augment primary health care services. Alternatively, the government may also consider constituting a nodal agency at center/state level which is committed to promoting CSR funds for primary health care. This dedicated team at the government nodal agency may have the responsibility to analyze specific data relating to gaps and evaluate if an existing gap at primary health care level can be bridged by financial assistance from pooled CSR funds. It may also evaluate health-care outcomes for utilization and future recommendations. It may also identify underserved outreach areas and recommend the opening of newer centers (with pooled CSR funds) and motivate industry to contribute funds to basic essential health services.

The way ahead is to evolve specific baseline data relating to CSR initiatives in health care and the actual measurement of the impact of CSR initiatives in quantifiable results.

The present article aims to draw attention on bridging the gap between health-care needs of the unreached population, served largely by PHC, strengthening them, providing available alternate financing sources as CSR funds, and moving closer to our dream of accessible and affordable health care for all.

References

1International Labour Organization. Global Evidence on Inequities in Rural Health Protection; 2015. Available Available from: http://www.socialprotection.org/gimi/gess/RessourcePDF.action?ressource.ressourceId=51297. [Last accessed on 2016 Feb 15].
2World Health Organization: Executive Summary – The World Health Report; 2010. Available Available from: http://www.who.int/whr/2010/10_summary_en.pdf. [Last accessed on 2016 Mar 20].
3Organisation of Pharmaceutical Producers of India: Universal Health Care and Sustainable Healthcare Financing in India: Lessons from other Major Healthcare Markets. Available Available from: http://www.indiaoppi.com/sites/default/files/PDF%20files/OPPI%20Paper%20on%20Healthcare%20Financing%20-%20August%202015.pdf. [Last accessed on 2016 Jun 01].
4Addis Ababa Action Agenda: Third International Conference on Financing for Development 13-16 July, 2015 Addis Ababa Ethiopia. Available Available from: http://www.un.org/esa/ffd/wp-content/uploads/2015/08/AAAA_Outcome.pd. [Last accessed on 2016 Jan 21].
5Ministry of Corporate Affairs: Companies Act 2013. Section 135. Corporate Social Responsibility. Available Available from: http://www.mca.gov.in/SearchableActs/Section135.htm. [Last accessed on 2016 Apr 05].