IXL Social Enterprise Case Studies Chronic Diseases October, 2013 | Page 9
Improving Chronic Disease Care in Slums by 2019
information safely and privately.23 This means doctors have to diagnose and treat patients with
imperfect and incomplete information.
Do doctors have the right incentives? Corruption often develops because incentives aren’t
properly aligned. Doctors need to be incentivized to provide the best care for patients, rather than
finding the quickest way to move slum dwellers and other poor patients out of the hospital.24 All
players along the value chain need to be incentivized to price treatment and medicine fairly, offer
care extensively, and ensure the highest level of quality to all people.
Are people held accountable? Because of a lack of transparency, holding corporations, clinics
and medical practitioners accountable for their actions is at best difficult. In 2001, pharmaceutical
companies in the private sector came under tremendous scrutiny for their policies and pricing
models on life-saving HIV and AIDS medication.25 This pressure for transparency, however, has
not been equally applied or sustained around the world. Governments, middle men, and black
market dealers all have their own reasons to manipulate the system. A study in Pakistan slums
has shown that only 24 percent of corrupt medical practices come from doctors while 70 percent
comes from other hospital staff.26
Cannot find it
A 68-year old slum dweller, Bharat
Tiwari, is disappointed because doctors
at a government-funded hospital in New
Delhi have deferred a surgery needed to
treat his heart ailment and told him to
return in two months. Such delays are
not unusual at the overstretched facility.
Bharat and his family were hoping that
surgery could reduce the high drug costs.
His son says the 100 spent every month
on his father’s medications adds up to a
quarter of the family income. Now Bharat
and his family will just have to wait.
Can I find it when I need it?
Can I get there? Weak infrastructure means that frequent trips to clinics or hospitals can be too
costly for individuals and families. A survey in India found that 14 percent of respondents were
dissatisfied with the distance they had to travel to receive care. 17 percent were dissatisfied
because of the hours care was available and 35 percent were dis ͅѥ͙