1. Rethinking Public Health A Social Enterprise Model for Birthing Stations www.umeedsey.org Saving Lives at Birth through Strengthening Community based Structures and Referral Linkages

2. Teaching Hospital DHQ Hospital THQ Hospital 100,000 Population RHC 10,000 Population BHU/ CMW/ LHV 1000 Population LHW Family Healthcare Levels

3. Tertiary Care (Rehabilitation) Specialist (Consultant) General Practitioner Lady Health Visitor Community Midwife Lady Health Worker Triage Cost

4. Primary HealthCare Tertiary HealthCare Secondary HealthCare Civil Dispensary Community Midwife/ Lady Health Visitor Lady Health Worker Basic Health Unit Rural Health Centers Tehsil Level Health Facility District Level Health Facility Private Hospital Facility Tertiary Level Hospital Facility (Complex) Referral – Pregnant Women Referral – Complicated Cases Referral – Acute Diseases Lab Tests/ Gynecologist Referral – Emergency Cases Referral – Special Cases Referral – Complicated Cases KEY

5. APP Developed Register Pregnant Women (If not registered by LHW) Monitor Symptoms (Antenatal Record, Physical Examination) Refer Complicated Cases to RHC (Gynecologist) (Basic EmOC) Refer Emergency Cases to Comprehensive EmOC. (DHQ/ Teaching Hospitals) APP Developed Register Families Monitor Acute Symptoms Family Planning Growth Monitoring Refer Patient to GP Refer Pregnant Women to CMW/ LHV Pharmacy Lab Tests Comprehensive EmOC Referral (Emergency Cases) Basic EmOC Referral (Emergency Cases) Prescription Lab Tests Pharmacy Slips Discharge Summary Patient Admission Referral 1 2 3 Lab Tests Pharmacy Slips General Practitioner (Available At) BHU RHC THQ DHQ Private Hospital Private Clinic Specialist (Consultant) (Available At) RHC (Gynecologist) THQ DHQ Private Hospital Private Clinic Hospital (Panel Hospital Category) RHC THQ DHQ Private Hospital 1 23 Electronic System EMR HIS M-Health Information System

6. Micro Health Franchise Model Project Name: UmeedSey high quality care to mother and child www.umeedsey.org

13. Franchisor will Provide: 1.Birthing Station 2.Life Saving Drugs, Birthing Toolkit (Complete) 3.Smart Phone 4.Emergency and Transportation Services 5.Referral Doctor (Expert Advice) 6.Branding/ Awareness Campaign 7.On going Trainings Supply Chain System Financially Sustainable Franchisor

14. CMW Coverage – Our Goal 25% Market Share PKR 14000 40% Market Share PKR 22400 55% Market Share PKR 30800 70% Market Share PKR 39200

15. Innovation in MNCH Care System Mobile App CDSS EMR M&E Supply Chain Billing & Insurance

16. Mobile Application Add New Patients Patient Details Past Obstetric History Genetic/ Family History Surgical Medical History Calculates EDD Remembers Patients Gestational Week Show Patient List with Real Time Status Alerts Reminds CMW on pending Information Antenatal Visit Record 9 Lab Tests

18. http://umeedsey.org/opendata.aspx

19. CMW Trainings

20. LHW App Anemia Diarrhea diseases Intestinal parasites Acute respiratory infections tuberculosis Malaria Primary eye care Scabies AIDs and hepatitis Monitoring/Vaccinations of Babies Under 5 CMW App Anemia Gestational diabetes Pre-eclampsia (Toxemia) High blood pressure Eclampsia Hyperemesis gravidarum Placenta previa Placental abruption Preterm labor Miscarriage Multiple pregnancies Fetal problems LHW (Promotive healthcare - FP) CMW (Skilled Birth Attendant) Doctor (Referral Center) MNCH Triage

21. Register Families Common Ailments Growth Monitoring Immunization Family Planning Births/ Deaths Supplies LHW Community 1000 Persons LHW Role

22. LHW Monthly Report

23. LHW MIS (Excel Based)

24. 1 Month Delay Delay in transfer of Information (2 Months) EDO Health Office Monthly Report Hard Copy Directorate of Health LHW MIS (Excel) Soft Copy LHW Community 1000 Persons LHW Register Data Record Keeping Decisions & Planning LHW Program Story Board

25. LHW Community 1000 Persons Data Decisions & Planning Directorate of Health LHW MIS (Web Based) Real-time Data Transfer EDO Health Office Daily Report

26. LHW App Register Families Family Members WASH Symptoms Screening AnemiaDiarrhea Intestinal Parasites Acute respiratory infections TuberculosisMalaria Primary eye care ScabiesAIDsHepatitisMedication Growth Monitoring ImmunizationFamily Planning Poverty Score Card LADY HEALTH WORKER APP (Developed)

27. Register Families Helps in Collection of evidence based data Average Family Size Birth/ Death Reporting System Identification of Unregistered citizens Symptoms Screening Early DiagnosisDisease Burden Reduced Cost of Healthcare Identification of community health practices Growth Monitoring Identification of Chronic Disorders Nutritional Status Immunization Record PolioMeaslesHepatitis BDiphtheriaPertussisTetanusTuberculosisPneumonia Family Planning Contraceptive Disbursement Pregnancy Rate Population Growth Rate Poverty Score Card Update of PSC NADRA/ BISP Targeted Benefits/ Subsidies

28. LHW Enterprise Revenue Streams LHW Data EPI CMW/ LHV Referral Fee Selling of Health Insurances Medicine Others

29. Franchisor Management System Desktop/Web App Features Internet/ Wireless Network Settings Managing Referrals and Emergency Transport Health Statistics Reports Supply Chain Management System Accounting and Payroll Health Worker/ TBA Capacity Building Training Program Indicators Monitoring and Evaluation Reports

30. THANK YOU! Any Questions?