The democratisation of digital health in rural Bangladesh

Around 20% of the people in Bangladesh were already living under the poverty line in 2019 and it is estimated around 17.5 to 20 million people have become newly poor in the country due to the on-going pandemic. Already struggling to make ends meet with insufficient income, quality healthcare is therefore, often viewed as a luxury by many. Thus, health financing is a crucial aspect in ensuring the reach of quality healthcare services to the rural and poor people.

The ‘Free Health Cashback’ feature of Digital Healthcare Solutions (DH) enables various marginalised and people living under or close to the poverty line to access quality healthcare services with minimal cost. People can apply for cash against the Free Health Cashback using the Digital Hospital App or website through this feature. They simply need to upload images of relevant documents such as medical tests, treatment, prescriptions, etc., and get cash against expenditures (such as diagnostic tests, COVID-19 isolation, maternity costs, hospitalization) in their mobile wallet within a certain period. 

The sudden onslaught of the COVID-19 pandemic has reversed the country’s steady poverty reduction trend, which took place for over two decades due to various government initiatives. Furthermore, a significant loss of jobs and livelihoods had also led to large effects on food security as per the Bangladesh Development Update by World Bank. Therefore, access to quality healthcare has become quite difficult, in some cases luxury for the existing and newly poor people who are already struggling with other necessities like food.

Even before the pandemic, given the large population and limited healthcare infrastructure, and high costs in the private sector, access to quality healthcare services wasn’t easy for the underprivileged. Even with the increased expenditure on health being at just over 5% of the budget for FY21, it was still less than 1% of the total GDP. Furthermore, due to the centralized nature of the economy, people from the rural areas would often have to incur high costs to commute to the large cities for health check-ups and doctor consultations. Therefore, for a large section of the population, health was only a priority when it was a matter of life or death or severely affected their livelihoods. More often than not, minor health issues would always be neglected, which would become serious health issues and push the already poor into further poverty due to substantial health expenditures.

The Free Health Cashback of DH has been introduced as a solution to this issue as Micro Health Financing. By subscribing to a package of DH, anyone can apply for the Free Health Cashback against their health expenditures. To make it more accessible to all, DH has also introduced its very own app available in the Play Store. People can apply for the Free Health Cashback by uploading the images of all the relevant documents and receiving the money in their mobile wallet for valid claims. Exemption of physical document submission expedites and facilitates access to healthcare services. 

The app is available in both Bangla and English and has been designed in a way that anyone can easily use it. The app also provides doctor consultations via Call, Chat, and Video Call with experienced MBBS and Specialist doctors at a very affordable cost, which can be accessed from anywhere with a mobile network. Furthermore, all patient data is stored digitally for future reference with utmost importance to the privacy and confidentiality. DH also complies with ISO 27001:2013 which is recognized as the global standard for information security.

To introduce people to this service and app, the field team of DH has been operating in the rural areas of Bangladesh, where they provide hands-on training in the local markets, community gatherings (Uthan Boithok) on how to use the app and access these services. Community health workers work relentlessly to introduce and explain the benefits of the services in rural areas. DH has also been using local pharmacies and agent banking services to drive awareness of these services. 

Since its inception in 2015 as Telenor Health and eventually acquired by Grameen Telecom Trust in 2019, DH (a social business) has paid out nearly $1 million in Free Health Cashback and has also conducted over 1 million doctor consultations. A significant portion of these have been given free of cost to various marginalized people through initiatives with partner NGOs, INGOs, government bodies, etc., DH also has a base of nearly 6 million subscribers. Digital Healthcare Solutions (DH) is a Social Business venture of Grameen Telecom Trust, chaired by Nobel Laureate Professor Muhammad Yunus.

Due to this innovative feature introduced by DH, many people now have the confidence and ability to access quality healthcare whenever needed without worrying about the cost. At highly affordable prices, people not only get to consult with doctors from the comfort of their homes anytime but are also getting financial support for diagnostic tests, COVID-19 isolation, maternity costs, hospitalization for various health issues, and free life insurance including family members.