Mohalla clinics have often been referred to as the “first line of defence” in Delhi's primary healthcare system. The scheme elicited a mixed response with its inception in 2015 at Peeragarhi, West Delhi. Based on the successful model of mobile vans or mobile medical units (MMU), the clinics have gone from
106 in 2016 to
519 in 2022. These clinics were developed to deliver quality primary healthcare services to bridge the gap in healthcare delivery between regions and classes, based on a zero-cost model by providing free consultations, drugs, diagnostics, and pathological tests.
Incorporating evolution
Mapping its course from 2015, the clinics continue to undergo regular changes and improvements in their design to be more people-friendly for better access and inclusion. The Centre for Civil Society published one of the
first reports in 2016, trying to analyse the workings of these clinics. It described how people were unaware of the locations of such clinics but showed a positive response to the assured provision of doctors, medicine, and diagnostics. Between
September–October 2016, when Delhi saw dengue and chikungunya outbreaks, these facilities came through and became a vital passage point for patients to get examined and complete lab tests. This was viewed as a significant achievement for mohalla clinics and relieved the emergency in the city.
Between September–October 2016, when Delhi saw dengue and chikungunya outbreaks, these facilities came through and became a vital passage point for patients to get examined and complete lab tests.
The Tata Institute of Social Sciences (TISS) noted in
its case study (2017) the high satisfaction rate of free treatments. However, it was stressed that the frequent change of doctors at select clinics was a concern. In 2019,
ID Insight observed that individuals were becoming more aware of the location of these clinics, demonstrating the growing popularity that these clinics gained among the public. This was further supplemented by the
Centre for the Study of Developing Societies, Lokniti, which stated that 31 percent of respondents had either themselves or someone from their household visited mohalla clinics at least once in the last five years. According to
Lahariya (2017), there are design characteristics in these clinics that are sought in any health system, such as the possibility to eliminate untrained practitioners; decongestion of higher-level health facilities, making experts available for individuals who need them; and providing efficiency in healthcare delivery. This factor is what makes these clinics popular, accessible, and an idea that is now being replicated by many other states.
The pandemic and clinics
The COVID-19 outbreak crippled even the strongest healthcare systems across the globe. A similar situation was witnessed in India, with an overworked healthcare system striving to make ends meet. Unlike the previous dengue or chikungunya infections in Delhi, the COVID-19 waves posed significant hurdles to the system, with even mohalla clinics facing intense pressure. The Delta variant saw the city struggle with shortages of essential medicines, oxygen, and hospital beds.
In Delhi, during the first wave of COVID, the clinics played a critical role in ensuring the delivery of important primary healthcare services. While larger institutions and hospitals had ceased providing outpatient consulting services, mohalla clinics continued to do so. Despite struggling with a lack of safety equipment and salary payment delays, these facilities played a crucial role as access points for many people to gain healthcare services, as well as providing COVID-19 testing services.
Unlike the previous dengue or chikungunya infections in Delhi, the COVID-19 waves posed significant hurdles to the system, with even mohalla clinics facing intense pressure.
Doctors and healthcare workers responding to a global health crisis—trying to protect individuals, families, and communities in adversity with limited resources, a lack of personal protective equipment (PPE), and other equipment—found themselves vulnerable in the fight against COVID-19. Panic caused by misinformation was the primary cause of violence against healthcare personnel. In these times, the Delhi administration should have used the accessibility of these clinics to communicate information to not only alleviate panic and terror among the populace but also to combat misinformation.
Following the example of other governments' rapid response to the pandemic, several mohalla clinics in Delhi began offering COVID-19 laboratory testing services. Many of the personnel stationed at these clinics have been valuable in carrying out different COVID-19-related duties, such as
testing people working in the wholesale market. This suggests that the mohalla clinic's staff could be a great addition to the city in times of medical need.
Conclusion
Primary healthcare services (PHC) are provided through community clinics with physicians, nurses, and other health team members for every 2,000-7,000 people in various
countries. In India, however, there is one urban PHC facility per 50,000 people. As a result, the establishment of mohalla clinics in Delhi expanded the availability of healthcare facilities with physicians fivefold. The locations for these clinics were likewise chosen in underprivileged communities to broaden the availability and accessibility of healthcare services for the poor and underserved. This suggests that providing health services tailored to the needs of the population and closer to the people might enhance utilisation and draw them back to government healthcare.
Women, children, the elderly, migrants, and individuals who previously had no access to free healthcare services at government institutions are seen to be accessing these clinics. This helps in addressing the imbalances in healthcare that are latently fostered in our communities.
The locations for these clinics were likewise chosen in underprivileged communities to broaden the availability and accessibility of healthcare services for the poor and underserved.
According to the paper by
Soumyajit Das, Satvinder Singh Bakshi, and Seepana Ramesh (2021), the pandemic and subsequent countrywide lockdown resulted in a significant decrease in hospital attendance for non-emergency cases. At the same time, India had a
500-percent growth in teleconsultation across all specialities, with
80 percent of consumers being first-time users. Telemedicine can be a solution in India—and other developing nations where remote healthcare delivery is hampered by infrastructure and labour shortages—with mohalla clinics playing an essential role to adapt and integrate them. Such clinics do not need to be staffed by a medical expert for telemedicine practices to be successful. Alongside physical wellness, focusing on mental healthcare, which remains unexplored, should also be prioritised.
By offering outstanding community-level primary healthcare outside of New Delhi and across India's metropolitan regions, Aam Aadmi mohalla clinics can fill a critical need. Models comparable to these are being tested in
Gujarat, Jharkhand, Karnataka, Madhya Pradesh, and Maharashtra. COVID-19 saw these mohalla clinics develop their distinct approaches to addressing the city's health crisis. The rapid response system, which is characterised by prompt health consultation, is what keeps them valuable and convenient in the lives of those communities who require them the most. These clinics are the country's first of their kind, and their ongoing impact evaluations will help us accomplish objectives that will improve our services.
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