{"id":13928,"date":"2025-06-28T06:52:12","date_gmt":"2025-06-28T06:52:12","guid":{"rendered":"https:\/\/www.smilefoundationindia.org\/blog\/?p=13928"},"modified":"2025-07-01T13:24:46","modified_gmt":"2025-07-01T13:24:46","slug":"telemedicine-for-equitable-healthcare-in-rural-punjab","status":"publish","type":"post","link":"https:\/\/www.smilefoundationindia.org\/blog\/telemedicine-for-equitable-healthcare-in-rural-punjab\/","title":{"rendered":"Telemedicine for Equitable Healthcare in Rural Punjab"},"content":{"rendered":"\n

Over 65% of India\u2019s population lives in rural areas, but healthcare infrastructure and personnel remain disproportionately urban-centric. Punjab\u2019s rural communities, home to ~17.9 million people, face a 20% shortfall in health sub-centres, fewer Primary Health Centres (PHCs) than needed, and a huge gap in Community Health Centres (CHCs).<\/strong> As a result, each rural sub-centre in Punjab serves on average 6,258 people (vs the national norm of 5,000) and each PHC covers 45,000 people (vs norm 30,000). These shortages are compounded by severe workforce gaps \u2013 for instance, rural CHCs in Punjab have only 55 specialist doctors<\/a> against 336 required (over 80% vacancy).<\/p>\n\n\n\n

Many facilities also lack basics like electricity and water: in 2023, 299 of Punjab\u2019s 2,857 rural sub-centres had no electric supply and dozens lacked running water. This infrastructure deficit undermines service quality and deters healthcare utilisation, especially among vulnerable groups (women, children, the elderly). It reflects a broader inequity. <\/p>\n\n\n\n

Globally, 56% of people in rural areas do not have access to essential health services<\/a>, contributing to worse health outcomes and avoidable mortality. Bridging these gaps in accessibility is crucial for India\u2019s commitment to Universal Health<\/a> Coverage (UHC) and health equity.<\/p>\n\n\n\n

Telemedicine has emerged as an effective solution to the rural healthcare crisis, by breaking geographical barriers and bringing medical expertise virtually to underserved areas. India\u2019s national telemedicine platform eSanjeevani<\/strong> exemplifies this potential \u2013 since launching in 2019, it has facilitated over 34 crore (340 million) consultations<\/a> as of Feb 2025, connecting remote patients with doctors and specialists. <\/p>\n\n\n\n

During the COVID-19 pandemic, telemedicine proved indispensable in maintaining care continuity in remote regions. The Government\u2019s two-pronged eSanjeevani system \u2013 AB-HWC (Ayushman Bharat-Health and Wellness Centre) for provider-to-provider consultations via Community Health Officers (CHOs) at rural clinics, and OPD for direct patient-to-doctor online visits \u2013 has helped ensure availability, accessibility and affordability of healthcare across India. However, leveraging telehealth at scale also requires robust digital infrastructure, training, and community trust. Studies indicate that without adequate training and protocols, telemedicine referrals can be sub-optimal, and limited digital literacy or connectivity in rural areas remains a barrier. Addressing these challenges is essential to realise telemedicine\u2019s full impact. <\/p>\n\n\n\n

Punjab, with relatively high mobile penetration and improving broadband reach, is well-positioned to benefit from telehealth innovations \u2013 provided the rural clinics are upgraded with power supply, internet, and skilled staff. This is the context in which Smile Foundation\u2019s telemedicine initiative in Moga district, Punjab, was conceived as a public-private partnership model to strengthen rural primary care delivery.<\/p>\n\n\n\n

Smile Foundation telemedicine initiative in Moga, Punjab<\/strong><\/h2>\n\n\n\n

Moga, Punjab<\/strong> \u2013 identified under India\u2019s Aspirational Blocks Programme for its lagging health indicators became the focus of a telemedicine-led healthcare strengthening project in 2023-24. Smile Foundation, in collaboration with the Health Department of Punjab, and corporate partner SBI Cards, launched a comprehensive telemedicine initiative to bolster primary healthcare in Moga\u2019s rural<\/a> blocks. This model builds on Smile Foundation\u2019s prior success in Nuh (Haryana)<\/a>, adapting it to local needs in Punjab. <\/p>\n\n\n\n

The project\u2019s core intervention is the establishment of 12 e-Arogya Telemedicine Clinics<\/strong> at government Health and Wellness Centres (sub-centres) across Moga. Each clinic is equipped with a telemedicine kiosk, digital diagnostics (point-of-care devices), and a Medicine Vending Machine (MVM) for instant dispensing of essential drugs prescribed during tele-consultations. Crucially, the project invested in infrastructure upgrades<\/strong> and identified sub-centres were refurbished along with outfitting of solar power units in them to ensure 24\u00d77 electricity, and providing reliable internet connectivity to support uninterrupted tele-consultation sessions. This approach directly addressed the basic facility gaps, like electricity, that previously hindered digital health services in Punjab\u2019s villages. <\/p>\n\n\n\n

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By December 2023, necessary government approvals were obtained and the telemedicine units were integrated with the national eSanjeevani<\/strong> platform, aligning the project with the Ministry of Health\u2019s digital health ecosystem.<\/p>\n\n\n\n

Capacity-building and community engagement<\/strong><\/h3>\n\n\n\n

Capacity-building and community engagement form a major pillar of the Moga initiative. In partnership with state authorities, Smile Foundation conducted training for local healthcare providers and Frontline Workers. In late 2024, a two-day training for 180 frontline staff (CHOs, ANMs, ASHAs)<\/strong> from Moga\u2019s health centres was held, focusing on management of common Non-Communicable Diseases (NCDs) like hypertension, diabetes, and screening for breast, cervical, and oral cancers. This skilling-up of workers aimed to ensure they can effectively use the telemedicine equipment, triage patients, and promote continuity of care. <\/p>\n\n\n\n

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\u201cStrengthening healthcare at the grassroots\u201d also involved behaviour change communication in the community \u2013 health awareness camps, village meetings, and mobilisation by ASHA workers to increase acceptance of teleconsultation services. The programme specifically targets women and marginalised groups for outreach, in line with Smile\u2019s Swabhiman<\/a> (women\u2019s empowerment) programme.<\/strong> Notably, Dr. Neena Bansal, Senior Medical Officer in Moga, commended the initiative and presented a Certificate of Appreciation to Smile Foundation for its contribution to upgrading rural Health and Wellness Centres.<\/p>\n\n\n\n

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By early 2025, the e-Arogya clinics in Moga have begun offering remote consultations with MBBS doctors and specialists (located at hub hospitals) via eSanjeevani, free medication for patients through the MVM linked to government supply, and routine NCD risk-factor screenings \u2013 bringing primary care delivery that normally required travel to district hospitals directly to villages.<\/p>\n\n\n\n

Improved primary care delivery and health access outcomes<\/strong><\/h2>\n\n\n\n

Though the Moga telemedicine project is in its early stages, it draws from the proven impact of Smile Foundation\u2019s earlier telehealth intervention in Nuh district, Haryana which offers a template for expected outcomes. Nuh, a predominantly rural and socio-economically challenged area (ranked among India\u2019s Aspirational Districts), saw its first Smile telemedicine unit launched in May 2021. By mid-2023, this had expanded to 10 e-Arogya clinics across 8 PHC areas in Nuh, covering a population of about 10 lakh (1 million). The results have been remarkable in enhancing healthcare utilisation and equity. <\/p>\n\n\n\n

In a one-year period (April 2022\u2013March 2023), Nuh\u2019s telemedicine centres facilitated 32,789 doctor consultations for villagers who otherwise face barriers to access. Importantly, over 53% of patients were repeat users (multiple visits), indicating high satisfaction and trust in the quality of care. The telemedicine clinics also integrated NCD screenings into their workflow, leading to thousands being screened for diabetes, hypertension, and other conditions per government protocols, with data reported into the public health system for follow-up. Such integration with the national NCD programme means earlier detection and referral of cases (e.g. identifying hypertensive patients who were unaware of their condition), reinforcing primary care\u2019s gatekeeping role.<\/p>\n\n\n\n

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