Increasing access and controlling cost in primary care: A localized approach

India has economic and geographic disparities in access to healthcare, high incidence of infectious diseases and rising rates of chronic diseases. These are outcomes of systemic malfunction of the state healthcare system, an unregulated private healthcare market, inadequate health literacy and lack of consumer awareness. Such irregularities form a vicious cycle of inadequate access, cost inefficacy and treatment ineffectiveness which lead to poor health outcomes in India. The Worker's Health Initiative is a non-profit institution based in West Bengal, India, which runs several clinics throughout the state. The aim of the initiative is to provide exemplary localized solutions to some of these problems. Its first objective is to address economic disparities in access to healthcare through the principle of Rational Use of Medicine. This principle is endorsed by the World Health Organization in view of providing guidelines for therapeutically sound and cost-effective use of medicines by health professionals and patients. The initiative's second objective is to address geographic disparities in access to healthcare by providing outreach and care in isolated rural communities with no access to healthcare. Youth from those communities are trained to dispense basic primary care and health literacy in their own communities. Seasonal outreach camps are also organized in such communities, where rural patients have access to primary care and specialist physicians associated with the organization. The objectives combined also provide an exemplary framework to control infectious diseases like Tuberculosis and manage chronic diseases like Diabetes Mellitus in poor and isolated communities of West Bengal.