Small wins provide big gains — Scaling solutions for India’s healthcare infrastructure
Written by Sweta Daga
“It was a matter of persistence and small wins,” says an ACT Grants (Action COVID-19 Team)representative, who is part of the government engagement team within ACT Grants . “When we started in April, we were trying to offer the government solutions that we felt might support them, but we quickly learned that what we needed to do first was understand their needs and more importantly — understand the needs at each level of the government; whether municipal, district, or state.”
On March 24th, 2020, India went into a national lockdown to prevent the spread of COVID-19. During this time, the national and state governments tried to prepare hospitals and the healthcare system for increasing numbers of Covid cases and patients. ACT Grants was formed in April with the intention of supporting government bodies by providing innovative solutions.
He continues, “Our overall goal is to reduce mortality rates, and improve COVID-19 protocols for the greater impact. We tried looking at international models where we could replicate some of the learnings from, but none existed. No one seemed to have a solution to fight this one-off pandemic. We analyzed data from the government to see what was required and figure out what solutions can possibly help governments and local authorities fight this pandemic. One of the most important learnings we have had is making sure we have an open communication line to receive feedback from them.”
ACT Grants is now actively working with governments in 8 states across India, and in conversations with more. Another ACT Grants member, who is working with the Haranya and West Bengal governments agrees that getting the attention of the nodal person within the government is tough, but once achieved can be the key to unlocking the door to better impact. “Government brings scale — instead of going after six hospitals, if I can work with one Commissioner, there is instantaneous impact. One thing we also realized was not to take for granted that what worked in one state would work in another. We needed to be responsive to each government’s specific needs.”
Another ACT Grants team representative, who is managing the process with Maharashtra and Tamil Nadu further explains, “We believe, without government buy-in you cannot create a large and scalable impact. The idea is to work together with the governments because they have access to resources that we don’t have and we can offer them solutions that they don’t have time to find — we were able to catalyze change through pilots and proof of concept so the government can see the impact. They did not have the time to manage these solutions but they needed them, so that’s where we played a key role.”
Short turn-around times were also part of the challenge. Given the nature of the pandemic and how rapidly it is spreading, speed and agility becomes important and ground-level execution with the same mindset is crucial.
“One of our biggest impacts, our USP actually, has been through remote ICUs,” He continues. “Wherever we have introduced this idea, governments have picked it up, especially once we were able to show proof of concept. Many times the officers or Ministers request deployment themselves.”
Dr. Dileep Raman, Director, Cloudphysician team, an ACT Grants grantee company that provides remote ICUs, says, “We are working with ACT Grants to expand to more cities and districts. Our priority remains to build capacity and deploy our solutions in places that need it. So far, we have been deploying our solution in districts of Karnataka and Mumbai. We see more districts and non-metro areas in need of ICU capacity as the situation dynamically changes over the next few months. We anticipate that COVID-19 is going to start surging in smaller tier 2 and tier 3 cities which are not as adequately resourced as urban centers and we hope to continue to help them in the coming months.”
The ACT Grants representative also describes how seemingly small insights were also important. “For remote ICUs for example, sometimes our challenges were just getting basics in place like working sockets, stable electricity, or computers. Something like that could take weeks because of the amount of paperwork required. So what we decided to do was devise a standard checklist that we gave to local officials, and only once those needs were met, we would fund that deployment. We also realized that instead of using email, Whatsapp was a more efficient platform to communicate more quickly. For example in Nasik, the CEO Zilla Panchayat, Lina Bansod, was very responsive to us, and she helped us form a Whatsapp group with her team. Things were done very quickly after that.”
Manik Mehta, a volunteer with Step One, a grantee company of ACT Grants, concludes, “While we are all volunteering, it is actually the government’s responsibility to help its citizens, and our hope is to help because it is a huge undertaking. ACT Grants has helped us give us more visibility in front of governments, especially at the city level. We were able to work with Pune city because of their support. Ultimately we all have to remember that we are on the same side — we want to see COVID defeated.”
As of August 30th, the collaborative efforts of team Step One and their volunteers have reached more than 3 million citizens across the country, with more than 500,000 teleconsultations. The team has successfully collaborated with 14 states and 5 cities so far and going forward, this month Step One aims to sign up four more states and six cities that are on the higher side of Covid cases in the country.
In a recent chat with Yourstory, ACT Grants Spokesperson Mekin Maheshwari said that working with multiple governments has been a great learning experience for everyone associated with ACT Grants.
Edited by — Sneha Banerjee