Optimized Social-Technical Intervention Protocols for National Healthcare Services Forecasting

Universal healthcare management is a challenge globally, with many countries having significant limitations on operating and maintaining healthcare systems. Emerging economies are faced with more challenges in this regard. India, for example, is home to large populations, low service costs, and a very diverse service offering. An ambitious national healthcare program, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) plan, for the economically challenged, was introduced to “leave no one behind,” moving to a needs-based healthcare model. The ambitious plan seeks to provide services at scale on a national health basis, funded by both national and state governments. This ambitious plan, like many global health initiatives, has significant challenges, most especially operational challenges. As a result, the Sri Sathya Sai Institute of Higher Learning (SSSIHL) in India embarked on a collaboration with the Johannesburg Business School (JBS) to address this challenge through designing intervention protocols to optimize the healthcare service forecasting. The two [SSSIHL and JBS] institutions saw an opportunity for developing the application of optimization techniques, and ensuring awareness among Indian beneficiaries about the scheme, benefits, and procedural intricacies at various stages is critical to success. Their work focused on the awareness levels of beneficiaries of the AB-PMJAY scheme in the Anantapur District of Andhra Pradesh. The team analyzed data from 8000 rural families using a novel expert model that generates actionable forecasting by deploying three models in sequence to explore and identify gaps related to awareness of enrollment procedures, treatment protocols, and claim reimbursement processes.