Hussain H. Bandukwala, a management and technology consultant writes about Heartfile’s exciting Health Financing initiative  that enables healthcare providers to request funds on behalf of their patients. Hussain has an avid interest in mobile technologies and their role in improving healthcare, education and finance in developing countries. He currently resides in Toronto, Canada, (you can follow him on Twitter @parwaaz03)

Health insurance is either mandated or completely accessible in most developed countries. In Pakistan, however it is still a luxury. Given the current structure of health insurance in the country, only a select few are able to reap its benefits, while those who really need it – laborers living below poverty line – are far from it.

Majority of Pakistan’s workforce is employed in the informal sector and therefore, does not have access to health insurance. Yet, households in this category face high healthcare costs that forces them to spend their savings, sell their properties, borrow heavily and on occasion, give up their basic needs. Some choose to forego treatment altogether.

While the government provides primary healthcare to the poor, high-cost care is not a top priority. Furthermore, the processes involved to access funds allocated for healthcare are time consuming, inefficient, and lack accountability. Heartfile, an Islamabad-based NGO founded by Dr. Sania Nishtar is taking it upon itself to drive this issue to the top of Pakistan’s healthcare agenda.

Heartfile launched its Health Financing initiative in March 2010, enabling healthcare providers to request funds on behalf of their patients to cover treatment expenditures. These funds are disbursed from Heartfile’s health equity fund, which in turn is supported by grants and donations from trusts, charitable funds, corporations, individual donors, and crowd-funding.

Using its proprietary web- and mobile-based technology platform (built by Valentia Technologies), Heartfile facilitates submission of funding requests online or via SMS. This efficient form of request intake is followed by thorough measures to validate the legitimacy of the requests. Amongst other activities, this includes telehealth assessments with patients, and running a cross-check with NADRA, Pakistan’s national ID card system, to verify that the requestors are indeed below the poverty line. According to Dr. Nishtar in an interview, the funds are released within 72 hours of the request, which is a much faster turnaround time compared to the distribution of government’s funds.

Once the funds are allocated, Heartfile uses necessary checks and balances to make sure that the funds are used appropriately. It maintains a history of funds utilization and reports it to donors as requested. Donors can register online to donate, and have complete control on where and how they want their contributions to be used (based on disease and demographic profile of the patients).

Heartfile Health Financing counts The Rockefeller Foundation amongst its major donors, whose funds are being used to help patients at the Pakistan Institute of Medical Sciences (PIMS). When Judith Rodin, President of the Rockefeller Foundation, was asked in a recent interview about social innovation that has gone to scale, she cited Heartfile’s tremendous progress to date:

“… Heart File decided to crowd-source the stories across the world through mobile technology. We’ll SMS this person’s story and we’ll ask people using mobile finance to make contributions to his healthcare, which they are now doing and then they SMS back to the philanthropist whether it’s $.05 or $5.00 or whatever, how he’s healing and how his family’s doing. Well when you think about that, you think about what philanthropy is going to be in this new kind of environment as well. The innovation is really just accelerating at an extraordinary pace…”

Dr. Nishtar is leading the donation efforts by pledging all royalties from her book Choked Pipes. She believes that Pakistanis by nature are philanthropic but that this trait is dormant because of their lack of trust in the proper use of funds. Given the accountability and transparency that Health Financing offers, Dr. Nishtar hopes that the people of Pakistan will rise to the occasion and offer their help in raising health funds for the poor and needy.

Health Financing has been launched as a pilot project in 3 hospitals in Islamabad and Rawalpindi, and according to Dr. Nishtar, they will expand their reach to 5 hospitals by the end of 2011. The pilot has also been restricted to limited medical specialties and will eventually grow to other areas based on need and funding. Since its inception, Health Financing has been able to round up many success stories and it has also been instrumental in the relief efforts for the flood that devastated Pakistan in July 2010.

Developing countries have usually been very innovative in introducing grass-root efforts to cater to social needs. They have particularly been impressive in leveraging telehealth and health advancements to implement effective solutions. In addition to incorporating these elements within its core offering, Heartfile’s mHealth Financing program meshes a unique health reform with tried and tested financing mechanisms that can be scaled across Pakistan, as well as to other developing nations. Given Dr. Nishtar’s authority on healthcare policy in Pakistan and across the globe, Pakistan’s healthcare agenda is in safe hands.

Have you donated to Health Financing? If so, what do you think about it? If not, will you consider contributing to it? How else do you think mHealth/telehealth can improve healthcare in Pakistan?

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