Digital Healthcare and a Social Business Model to Ensure Universal Health Coverage (UHC): A Case Study of Bangladesh

Poverty, Rurality and Disability are three major vulnerabilities to deliver quality healthcare services and ensure universal healthcare coverage (UHC). Disruptive technologies and a social business model can deliver healthcare services to non-UHC communities in a faster, affordable and sustainable manner. This chapter of the book investigates the status of UHC in Bangladesh, categorizing out of coverage communities. Kyushu University and Grameen Communications have developed an affordable, user-friendly, and sustainable digital healthcare delivery system, which we call Portable Health Clinic (PHC). A community-based micro healthcare entrepreneur can take the PHC to visit an elderly person, pregnant woman, or person with disability at their doorstep, and provide real-time primary health services connected to licensed healthcare professionals. Annual health checkups are a long-standing institutional practice in Japan, but not as prevalent in emerging countries including Bangladesh. Small organizations cannot afford a health center at their premises, thereby remaining out of coverage of healthcare services. Health insurance is not prevalent, which exposes not only well-being but savings or assets to risk in catastrophic situations. Regular health checkups are known to provide an early alert of any diseases, which can reduce health risks, save medical costs and increase productivity. We categorize five different rural and urban communities in which PHC pilot studies have been carried out over the last 12 years. We have designed five different delivery models and evaluated their financial sustainability, as well as social impact. This chapter describes this experience and identifies major challenges with the purpose of ensuring that UHC approaches can assimilate advanced technologies, mainstream them in national healthcare policy in the country, and train healthcare workers.