The Design, Operations, and Feasibility of Primary Healthcare service Delivery through Mobile Medical Units

Background: Mobile medical units supplement and complement the existing public and private health sector in provision of basic primary healthcare services by reaching the last mile. They serve the underserved populations having accessibility challenges in rural and peri-urban areas. However, little evidence exists regarding experiences with such programs. This paper describes the design, operations,  and feasibility of running a doctor-led mobile medical unit program in low-resource settings in India. Methodology: Program documents and routinely collected data over four years (July 2015 to May 2019) were analyzed. We present a private sector supported mobile medical unit program model, scope of services, routine operations, and distribution of health morbidities among program beneficiaries in two north-eastern states of India. Findings: Mobile medical units are designed to provide preventive, basic diagnostic, curative, and referral services. Close coordination with government frontline health workers, ensuring uninterrupted doctors availability, supply chain management of drugs and consumables, and information technology-driven data capture are the core program elements. A total of 113,966 beneficiaries (Males 43%; Females 57%) made 206,976 visits (first time visits 55%; repeat visits 45%) during the reference period. Of all visits, young beneficiaries (<19 years) utilized the program services the most (34%), and elderly (≥60 years) the least (12%). Program beneficiaries sought consultations for non-communicable disease (45%), minor ailments (40%), communicable diseases (9%), and reproductive and child health-related conditions (6%). Non-communicable disease-related consultations were higher (48%) in Assam compared to Arunachal Pradesh (35%) (p=0.03). Conclusions: Delivery of basic primary healthcare services through the mobile medical platform is feasible in low resource settings. Such platforms improve health access and equity to bridge the last-mile health service delivery gaps, especially for people suffering from common illnesses. Recommendation: Careful economic evaluations of mobile medical unit based services are required before scaling them elsewhere. Key Words: Mobile Medical Unit, Primary Care, SPARSHA