Indus Health Network: Extending healthcare for all

Indus Health Network reaches out to the underprivileged Pakistanis through primary care

The Right to Health is a universal human right that calls for universal healthcare. The World Health Organisation (WHO) advocates primary healthcare as the key towards achieving universal health.
In line with the global practice, the government of Pakistan has also taken initiatives to meet the objectives of 'Health for All' and joined hands with international donor agencies to ensure the provision of various preventive, curative, and rehabilitative services to all its citizens.
The Indus Health Network (IHN) is playing a pivotal role in improving Pakistan's healthcare scenario. It has started functioning in 2007 with the emergence of the Indus Hospital (TIH) in Korangi, Karachi, which soon became a model hospital.
During the first decade of its existence, the hospital transformed into a health network of multiple hospitals across the country. Most of these hospitals are tertiary care facilities and based in cities.
However, by following the international recommendations, the network soon shifted its focus towards primary care, which is the only solution to not only provide healthcare at community level but also to lessen the burden on bigger hospitals.
Pakistan is a resource-limited country that is plagued with prevalence of malaria, tuberculosis, HIV/AIDS and many other diseases. Some international agencies are providing financial support to combat these disease. In order to channelise this supply with demand, the Indus Health Network created the Global Health Directorate (GHD).
The objective of GHD is to protect and promote health and prevent diseases by improving access to healthcare services. GHD's programmes provide primarily curative services to individuals with relatively less resources and access to quality care institutes.
It aims at providing specialised primary healthcare facilities that should not only be affordable, accessible, and available, but be apt to the health needs of the community.
The directorate is currently managing several public health programmes in collaboration with different national and international donor agencies like Global Fund. These include: Infectious Diseases, Maternal and Neonatal Child Health, Non-communicable Diseases, Global Surgery, Mental Health and Primary Care Programme. With more than 1,200 human resources, IHN's GHD is currently working in 42 districts across Pakistan and has impacted more than 410,000 lives of the people living in vulnerable communities.
The Primary Care Programme being the key initiative of GHD, currently is being run at 20 independent sites and by 2020 IHN plans to scale the programme to a total of 50 independent sites across Pakistan.
Every primary care facility is opened up after a detailed and thorough assessment of community needs so that it covers the most common and prevalent disease.
In 2017-2018, Primary Care Programme took the reins of nine hospital-based facilities, such as the flagship Family Medicine Clinic at Indus Hospital, Karachi, and others in Badin, Muzaffaragarh, Multan, and Lahore. It also launched and operates five standalone clinics in the districts of Tharparkar, Muzaffargarh, Rahim Yar Khan, and Karachi. The newest addition is acquisition of health facility in Azad Jammu and Kashmir.
The PCP seeks to improve the first point of entry for patients by introducing continuous, personalised and quality primary care countrywide, tailored to the needs of the facility's catchment population. Each PCP offers integrated health delivery: At any site, patients can avail nutrition counselling and immunisation, receive treatment for infectious diseases (such as TB and Hepatitis C), and confidential counselling for anxiety and depression.
In the vicinity of a site, the Community Engagement Centre engages residents by empowering dialogue, and partners with local schools to train Kiran Sitara girls - young volunteers who spread health awareness in their locality and help identify presumptive patients.
In remote areas such as Bhong, site staff regularly run free medical camps. By engaging communities around the clinic, Primary Care can assess healthcare needs, adjust services, and expand for maximum impact and benefit.
In April 2019, PCP launched its first prefabricated container facility in Pakistan at Khorwah Chowk, Badin. This clinic can treat up to 200 patients per day, and in conjunction with a Community Engagement Centre is estimated to impact 150,000 patients per year.
This container-based clinic includes a variety of free-of-cost services ranging from routine medical checkups by a family physician, mental health counselling, lab collection, access to medicines, and x-ray facilities.
The IHN's Primary Care Programme has 12 districts of interest in lower Sindh and lower Punjab, with Badin being the key interest in Sindh. The programme will set up 15 additional facilities, including a mobile bus in the district of Badin by 2020. Each of these facilities will have trained family medicine physicians and integrated public health programmes based on the needs of the community.
The community engagement team at each facility connects community needs with primary care and public health programmes to promote sustainable access and utilisation of healthcare services.
In addition, staff at the facility will be trained in acute care management to ensure that all patients visiting our facilities are stabilised and given the highest quality care. PCP will add on new public health programmes to under-served Pakistanis like safe circumcision, family planning, treatment for rabies, snakebites, and more.
IHN believes that these facilities are a solution to address the healthcare needs of local populations, especially in rural  areas where long distances to health facilities limit people's access to care, causing individuals to forgo their basic healthcare needs.
Reference: WHO and NIH reports
Saira Bano is the deputy manager, Communications and Resource Development, Indus Health Network.

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