Abstract
BackgroundTelehealth can improve access to high-quality healthcare for rural populations in India. However, rural communities often have other needs, such as sanitation or employment, to benefit fully from telehealth offerings, highlighting a need for systems-level solutions. A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals. The approach is expected to improve economic performance and long-term value creation for partners, thus supporting sustainability.MethodsA demonstration project was conducted in Tuver, a rural and tribal village in Gujarat, India. The project included seven components: a partnership that emphasized power-sharing and complementary contributions; telehealth services; health promotion; digital services; power infrastructure; water and sanitation; and agribusiness. Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach.ResultsFindings highlight the importance of taking a systems perspective and engaging inter-sectoral partners through alignment of values and goals. Additionally, the creation of a synergistic, health-promoting ecosystem offers potential to support telehealth services in the long-term. At the same time, engaging rural, tribal communities in the use of technological advances posed a challenge, though local staff and intermediaries were effective in bridging disconnects.ConclusionOverall, this early process evaluation highlights the promise and challenges of using a Business of Humanity approach for coordinated, sustainable community-level action to improve the health and well-being of marginalized communities.
Highlights
A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals
Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach
Partnership-based telehealth in rural India cover access to the minimal data set as defined by PLOS One
Summary
Telehealth offers the opportunity to improve the health and well-being of marginalized and excluded communities, with benefits including cost savings and cost-effectiveness for patients/ families and systems, health service access and utilization, health education, patient satisfaction, and quality of life [1,2]. To benefit from telehealth services, patients and community members must have access to public health services, including maternal and child health offerings, clean water, sanitation and hygiene, and nutrition, which are insufficient in many rural regions across India [10]. Together, these requirements highlight the need to take a longterm, systems-focused approach to design, deliver, and sustain telehealth initiatives in rural India. The approach is expected to improve economic performance and long-term value creation for partners, supporting sustainability
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