This was another example of an approach to increasing access to diagnostic and clinical services in underserved areas in the developing world. The model of using a commercial relationship to leverage both demand and supply of a health service sits fine with me, but to then extend the individual benefits to the service provider and service user to a greater social benefit on any appreciable scale seems a far stretch to me when related to family planning services in this example. I appreciate the fact that the idea here is to increase individual access to family planning services in a setting where individualized care delivery is being promoted, especially in India where there is a complex history of controversies over various kinds of family planning interventions at the population level. I’m not convinced however, that this particular model is realistic in it’s market niche in this case.  The costs of the initial investment for the franchise owners and primary clients (young women in both cases here) seem very high. Likewise, there are tons of externalities beyond just the logistics and costs of setting up an ICT intervention of this scale.

The article that accompanied Terri’s presentation highlights 3 key areas in the conceptual framework of telemedicine that this kind of ICT enterprise model should address: assuring the availability of services, assuring the quality of services, and assuring use. This pilot project’s results have not convinced me (so far) that these are being met. Although an interesting approach to a really important problem – access to quality care at affordable prices in rural areas – I’d be interested in seeing how/if this is scalable and what the actual family planning/population health level indicators show about impact on targeted outcomes so far.