EQUIP-HWCs

Ayushman Bharat Health and Wellness Centers (AB-HWC), a.k.a. Ayushman Aarogya Mandirs (AAMs), play a crucial role in delivering a comprehensive range of primary healthcare services at the community level, aligning with the principles of universal health coverage. But implementing these services faces several challenges including infrastructure issues, limited resources, and lack of trainings. There is a need to accelerate the progress towards the programme goals by identifying existing challenges, incorporating the best practices, and developing context-specific strategies within the existing resources to make the AAMs fully functional. The challenges and bottlenecks include sub-optimal continuum of care, difficulties in IT-enabled teleconsultations, issues with training, competencies, and teamwork among Community Health Officers/Mid-Level Healthcare Providers, ambiguity in roles, lack of infrastructure, human resources, and inadequate drugs and diagnostics. The delivery of CPHC through AAMs rests substantially on the institutional mechanisms, governance structures, and systems created under the National Health Mission (NHM), as well as on the overall work culture and adherence to the core values. Thus, understanding and addressing these issues and other determinants is crucial.

Overall Objective

This three-year Implementation Research (IR) shall identify, co-develop, implement, and optimize context-specific health service delivery models for the 12 CPHC services through AAMs.

Study Objectives

• To assess the current functioning of AAMs in delivering 12 expanded range of CPHC services.
• To identify the context-specific barriers and facilitators and their influence in the demand and delivery of 12 expanded range of CPHC services through AAMs.
• To co-develop, implement, and iteratively refine contextualised strategies to improve the equitable coverage and quality of the 12 expanded CPHC services through AAMs.
• To assess and evaluate the functioning of AAMs, coverage, and quality of CPHC services achieved through the model.
• To document the model characteristics and evolution, health system inputs, model adoption and its fidelity through observed improvements in AAM functioning.
• To develop improved guidelines/IR toolkits for implementing CPHC services, training modules, and modules for capacity building of AAMs.

Effect of Source Credibility on the Adoption and Valuation of Risk Mitigating Services: Field Experiment on Cervical Cancer Screening

Cervical cancer is the second most common cancer in India among women between the age of 15-65 years, resulting in a mortality of 77,348 in 2020. According to the CDC, as many as 93% of cervical cancer cases could be prevented through screening and vaccination. Though India has a national screening program for cervical cancer, only 1.9% of women between the age of 30-49 years have ever undergone a screening test (NFHS 2021). The two most common barriers to adoption cited are lack of awareness among consumers and limited access to affordable screening services (Basu et al. 2006). Consumers’ adoption and valuation of risk mitigation services depends on their risk perception of the eventualities. In this context, risk communication plays an important role in the formation of risk perceptions, inducing risk evaluation, and consumption of risk-mitigating offerings, thus making this a marketing problem. Further, consumers’ perspective of whether a service is “affordable” makes this a core pricing problem.
In this research, the authors Anima Nivsarkar, Prof Prakash Satyawageeswaran, Prof Vedha Ponnappan and Prof Sundar Bharadwaj investigate risk communication strategies that can improve awareness of and impact the valuation of risk mitigation services and, therefore, their adoption.

Impact Of Influencers and Microfinance in the Adoption and Valuation Of Subscription-Based Services

Out-of-pocket expenditure (OOPE) on healthcare exacerbates the vulnerability of low-income populations, at a point in time when they are already distressed, forcing families to go without medical care, delay care seeking, or borrow against meager assets, resulting in a debt trap. Over 381 million people (4.9% of the worldwide population) were pushed into extreme poverty due to OOPE in 2019 (UN 2023). Due to its importance, the United Nations brought health financing under Sustainable Development Goal 03 (UN 2023). Research suggests prepayment mechanisms such as subscription or insurance as options to remove price as a barrier to service in emergencies and to offer predictability of payment schedule to an uncertain eventuality (Cherla et al. 2021; Mint 2022). Understanding how marketing can promote the adoption and enhance the value perception of prepayment mechanisms, such as subscriptions, is vital to reducing OOPE-related catastrophes.
Healthcare, similar to insurance or warranty, caters to unpredictable eventualities-based usage, which induces several challenges in consumer demand for subscriptions. A subscription to the service is based on the consumer’s expectation of future use, which is uncertain and also it involves an upfront payment for a long duration service. In the low and middle income countries LMIC context where liquidity is a significant constraint for the poorer segments, paying an upfront fee for future services is another critical barrier due to “present bias”. Given these challenges, identifying factors that motivate consumers to overcome their uncertainty and present bias to subscribe to an uncertain future healthcare service is an important marketing question.
In this research, the authors (Madhur Mohan (UGA), Vedha Ponnappan (IIM Udaipur), Prakash Satyavageeswaran (IIM Udaipur), Raghunath Rao Singh (UT Austin)) examine the impact of marketing levers that can help overcome the aforementioned challenges, improving consumer’s adoption and valuation of a healthcare subscription. Our exploratory discussion with organizations working in the healthcare domain and patients confirmed that (a) uncertainty of usage and trust in the organization, and (b) severe liquidity crunch are the two most significant barriers to the uptake of a subscription service.