Wharton Around the Globe: Assessing Care Delivery in Assam, India

Contributors: Alomi Parikh WG’20, Kerianne Fernandez WG’19, Caleb Flint WG’20, and Shannon Ridge WG’19
To learn more about Alomi, Kerianne, Caleb, and Shannon, click here.

 

colorful-1974699_1920.pngThrough the Wharton Global Health Volunteers (WGHV) organization, Wharton students have the opportunity to participate in service-oriented healthcare consulting projects. These projects allow students to use and develop their skill sets through experiential learning and impact healthcare in the developing world. This past winter break, four WGHV members worked with Makunda Christian Leprosy & General Hospital in Assam, India, (makunda.in) to develop an impact assessment of their work providing healthcare in a low-resource setting.

There is a shortage of care for patients in resource-poor populations such as that which Makunda Hospital serves. Most healthcare is out-of-pocket, and one hospital admission can leave a family in poverty. Providing healthcare to local residents in resource-poor settings can be challenging to do in a sustainable manner. Makunda Hospital has developed a unique model, the “Makunda Model,” that allows it to provide care to many outpatients and inpatients in need of healthcare services in a remote region of northeastern India. It has developed approaches to maintain sustainability in spite of seeing patients with limited resources, and, additionally, has created educational and agricultural businesses in the local community. The hospital sees more than 100,000 outpatients, admits more than 13,000 inpatients, performs more than 5,000 inpatient procedures, and delivers over 5,000 babies each year. 

25 years ago, the doctors responsible for reopening the hospital created a 30-year strategic plan, including phases of stability, local expansion, and distant impact. The Wharton Global Health Volunteers group was asked to conduct an impact assessment of the work done by the hospital thus far.

check-up-clinic-dentist-1170979.pngIn order to evaluate the impact this model has had in the past 25 years, we conducted an assessment that included: 1) observing Makunda’s facilities and operational practices, 2) conducting in-depth interviews with Makunda employees, patients, community members, and competitive hospital administrators, and 3) analyzing financial documents and hospital statistics. The ability to travel to the site of the hospital and experience first hand the way the model was implemented in day-to-day practice was extremely enlightening and essential to the outcomes of our project.

We found that Makunda Hospital’s focus on poor-centric strategies, cost management, and continuous improvement has enabled it to generate revenue and retain healthcare professionals in a way that leads to sustainable patient care. Pricing based on ability to pay, equality in services offered, mission-driven employees, and a culture of continuous process improvement have allowed for continued provision of quality care to the local population. We described key areas of impact, takeaways for other hospitals in low-resource settings, and broader implications. We furthermore suggested key areas to focus on during development of the next 30-year strategic plan.

This project has been a rewarding learning experience for our team. It enabled us to learn about innovative provider models and think critically about providing care in different settings. We would like to thank our alumni for making this trip possible.

 

Contact Alomi at:
alparikh@wharton.upenn.edu

Contact Caleb at:
flint888@wharton.upenn.edu

Contact Kerianne at:
kerianne@wharton.upenn.edu

Contact Shannon at:
sridge@wharton.upenn.edu