The initiative was launched with the objective of providing primary health facilities to people living in remote areas of the state. These MMUs provide the same facilities as those provided by a basic hospital and it is planned to have one MMU per district.
The Government of Bihar decided that the best approach towards operating these MMUs was through a Public Private Partnership. A budget of Rs.1,656,000 for the year 2009-10 was allocated to the Arogya Rath program under the National Rural Health Mission. A fixed budget of Rs.468, 000 was allocated to be paid to each MMU.
Three organizations were selected to undertake the project: Spake Systems (14 MMUs), Jagran Solutions (12 MMUs) and Jain Studios (12 MMUs). Currently, 16 MMUs are run by Jagran Solutions, covering 200 villages and over 13000 patients.
The responsibilities of the private partners are as follows:
- Provide the requisite vehicle, equipment and software
- Install, operate and maintain appropriate GPS facility
- Technical manpower to run the MMU and provide medical services
- Technical back up for maintenance of the system
- Ensure quality standards
- Provide detailed reports and maintain database of MMU services as per the proformas provided at the time of signing of the contract, or as issued by the SHSB from time to time
A second vehicle should accompany the medical van; this second vehicle is used for the purpose of carriage of the medical personnel and it is also to be used as an ambulance for transporting patients in the case of an emergency.
The manpower required for the program is to be provided by the private agency. Each MMU is accompanied by the following: 1 doctor, 1 nurse, 1 pharmacist, 1 operation theatre assistant, 1 x-ray technician, 1 lab attendant, 1 Auxiliary Nurse Midwife (ANM) and 1 driver. The MMUs are able to attend to about 120 patients per day.
The MMUs are equipped with 33 life-saving drugs, which are issued free of cost to patients in need. They are also equipped with various medical tools and facilities as well as normal ambulance appliances.
The following services are provided in the MMUs:
- Referral of complicated cases
- Early detection of tuberculosis, malaria, leprosy, kala-azar and other locally endemic communicable diseases as well as non-communicable diseases such as hypertension, diabetes and cataract cases.
- Minor surgical procedures and suturing
- Anti-natal checkup and related services
- Promotion of institutional deliveries
- Immunization clinics
- Treatment of common pediatric illnesses, diarrhea, pneumonia, respiratory tract infections, sexually transmitted diseases
- Family planning services - counseling for spacing and permanent methods, distribution of contraceptives
- Investigations like hemoglobin, urine examination for sugar and albumin, clinical detection of tuberculosis