Message from the President 4

Message from the Founder Donor 5

At a glance 9

Strategic approach 12

Geographical presence 13

Innovations 17

Health and Wellness Centres 18

Operational outcomes 19

Outreach in 2018 20

Success stories 21

Way forward 22

Awards 23

Partners 24

Auditor’s report 25

It has been a pleasure to observe LEHS transform in the last four years from one program in one state to eight programs across fi ve states providing quality primary healthcare to a population of over 140 million in the most underserved areas. I am a fi rm believer in innovation and technology-solutions in addressing real- life challenges. LEHS leaders and staff resonate with the same spirit and this has been a catalytic force leading to the progress we have made this far.

Our ‘Digital Health & Wellness Center’ model, for example, incorporates today’s cutting-edge technologies and processes, making this an incredibly valuable solution that supports and accelerates Government of India’s priorities underlined in the National Health Policy 2017 for delivering quality primary healthcare to the remote and underserved populations. When scaled, this model alone holds the potential to reach over 400 million people in the next two years. Continuing on this path of innovation, we can achieve Universal Health Coverage in no time.

My congratulations to team LEHS for its achievements and for the hard work they continue to put into this important initiative.

Lords Education and Health Society (LEHS) works towards improving the quality and access to primary healthcare services for the underserved communities in India. LEHS is implementing the healthcare models through partnerships with state governments, international agencies and the private sector through Public Private Partnerships (PPP) model. This is achieved by appropriately introducing promising healthcare innovations in the public health system - to build an equitable, innovation-led and evidence-based quality healthcare system.

Lords Education and Health Society (LEHS) is the fl agship program of Lords Education and Health Society (LEHS) - a non-profi t organisation established in 2003 under the Indian Society Registration Act, 1860.

Alignment with Government Initiatives and Demonstrating Best Practices sadfs

In 2018, LEHS made a strategic shift in its approach. As the National Health Policy 2017 (NHP, 2017) implementation was initiated at the center and state levels, LEHS made a shift from being an ‘implementing organization’ to assuming an ‘advisory role’ and further as a ‘thought leader’. The organisation provided technical support to the State Governments in setting up of the Health and Wellness Centers (HWCs). As the innovation partner, LEHS has been instrumental in setting up of the National Innovation Unit (NIU) at the National Health Authority (NHA) to support the Central Government to roll out the PM-JAY- Ayushman Bharat Scheme.

Congruent with the Gol mandate, LEHS is committed to demonstrating scalable, replicable and innovative health system

strengthening solutions across Ayushman Bharat - Health and Wellness Centers (HWC) and the PMJAY (Pradhan Mantri Jan Arogya Yojana).

LEHS as part of its intervention in Rajasthan, successfully transformed several low performing primary health centers and their associated sub-centers into technology-enabled and innovation led centers. The learning’s of this project were applied to the next strategic partnership as the Knowledge Management partner of the Delhi Mohalla Clinics. These projects proved to be stepping stones for the much larger advisory role in Rajasthan and Madhya Pradesh.

Thereon, innovative healthcare models were implemented in Public-Private Partnerships with various state governments, international agencies, and private sector players.

Inception of LEHS

In 2015, LEHS curated a unique innovation-led model to transform the underperforming Primary Health Centres (PHCs) to performing centers in Rajasthan by signing a 5-year Memorandum of Understanding (MoU) with the Government of Rajasthan. The facilities were taken up on Public- Private Partnership mode located in remote areas, with diffi cult terrain, high levels of poverty and poor health indicators.

LEHS is currently managing 31 Primary Health Centres (PHCs) in Rajasthan (7 urban 24 rural) under the Public Private- Partnership in 14 districts of Rajasthan.

• Technical Support Unit, National Health Mission, Government of Rajasthan: A TSU was set up with an agreement with the Department of Information Technology Govt, of Rajasthan for implementing electronic health records at fi ve PHCs (both rural and urban) in Rajasthan.

• LEHS partnered with NHM for Universal Health Coverage: LEHS signed a Memorandum of Understanding (MoU) with the National Health Mission, Government of Rajasthan with a broader goal of setting up a TSU to achieve Universal Health Coverage. The TSU supports the state government in program design and implementation and management of HWCs.

• The pilot for specialist consultation (gynecology) through telemedicine at PHC Bhadoti of Sawai Madhopur district supported by Aditya Birla Finance Limited (ABFL) was conducted as one of the key innovations in the fi eld of public health to provide such services through telemedicine.

• Impact of sustained quality health services in Rajasthan saw an average out-patient of rural PHCs surging from 924 per PHC per month in 2014-15 to 1700 in 2018-19. From July 2015 to June 2018, Primary Health Centers (PHCs)/SCs that off er OPD services and were being managed by LEHS|LEHS, saw a total of approx. 20, 00,000 patients and 13,000 institutional deliveries.

• Health & Wellness Centers (HWCs): Seven technology- supported HWCs are operational and have provided medical consultations to clients through the telemedicine system.

Progress of key indicators for Rural PHCs with LEHS’s intervention

DELHI-NCR: Healthcare at Doorstep

Aam Aadmi Mohalla Clinics (AAMCs), Delhi

LEHS has been supporting the Government of NCT of Delhi as its Knowledge Management Partner to the AAMC initiative/program for ensuring quality primary healthcare services at the doorstep (within their locality) of the people of Delhi. Presently 187 clinics are functional with 96 clinics in rented premises and the rest functional from portacabins.

919,501 medical consultations were provided to 628,198 patients (unique count) with 43:57 ratiosof male and female benefi ciaries availing the services.

HARYANA: Community Healthcare Pehal Clinic/NCR (Chakkarpur, Gurugram)

Pehal Project is an integrated community development program for the underserved population living in Gurugram. Supported by United Way Delhi and itscorporate partner, Carrier India, LEHS curated an NGO-led model of SMART Clinics thataim to combine innovation, management effi ciencies, and resources to enhance client satisfaction and increase sustainability through improved cost recovery measures. The clinic has impacted 2,420 benefi ciaries.

Pehal organized a mega screening camp for NCD screening in collaboration with AIIMS, New Delhi and screened 410 visitors.

UTTAR PRADESH: Improving Urban Health Seeking Behaviour

LEHS is implementing a vector-borne disease eradication program called ‘Strengthening Urban Behaviour around Health’ (SUBAH), a community-based dengue prevention and control project carried out in Gorakhpur. The program is in alignment with the National Vector Borne Diseases Control Program (NVBCP), supported by GSK Consumer Health Care Limited.

In order to measure the impact of this program, LEHS rolled out a state-of-the art technology for early detection and treatment of dengue. Data management and reporting systems were strengthened within the existing Government Management Information System (MIS). LEHS also developed a comprehensive Geographical Information System (GIS), which can be easily mapped, for Gorakhpur and in return help identify dengue hotspots. These spots can be tracked over a period of time to analyze the impact of various interventions made in the district.

Madhya Pradesh: Technical Support Units

LEHS works as a technical support unit providing Health Support, Policy Advocacy & Scaling Innovations in Bhopal, MP. The key area of work has been around the Non-Communicable Diseases and maternal health under the gamut of RMNCH+A activities. LEHS provides technical support to the National Urban Health Mission, Government of Madhya Pradesh with the Urban Health Coordination Committee (UHCC). LEHS team undertook gap analysis of UPHCs and other urban public health facilities which helped the NHM offi cials-Principal Secretary (Health) and Mission Director in restructuring the action plan. LEHS also facilitated an assessment for Kayakalp Initiative in Bhopal and Jabalpur districts to enable the health centres to comply with the eligibility criteria and getting rewarded for demonstrating high level of cleanliness, hygiene and infection control facilities.

Assam: Strengthening Primary Healthcare Delivery

LEHS partnered with the Amalgamated Plantation Pvt. Ltd. (APPL) Foundation

A pilot nutritional support program for pregnant women (PW) was started in collaboration with Amalgamated Plantations Pvt. Ltd. (APPL) Foundation to improve maternal and child health outcomes in the tea garden estates in upper Assam. A study was conducted to promote safe motherhood which covered 700 pregnant women.

LEHS facilitated eHealth records of the population for referral reporting and to enable continuous care. Additionally, LEHS extended support to pilot it in approximately 100 health facilities across rural and urban health centres.

LEHS’s innovation-led primary healthcare delivery model includes the identifi cation, nurturing, and certifi cation of promising healthcare innovations and the facilitation of their introduction into allows public healthcare to reach the last mile, while encourages and supports the innovators.

Biotechnology Industry Research Assistance Council (BIRAC) and LEHS entered into a Validation Partnership Agreement (VPA) with an aim to Identify

and assess promising need-based; high- potential innovations (via active mapping/listing) prioritize them and demonstrate their technical worthiness for scale- up. public health systems. This

• Indian Council of Medical Research (ICMR) and LEHS entered into a partnership to envision the development of sustainable healthcare solutions in India by identifying and leveraging the most promising innovations in primary healthcare.

LEHS launched technology-enabled HWCs in coherence with Indian Public Health Standards (IPHS) 2012 Guidelines. The HWC model addresses preventive, promotive, basic curative and rehabilitative healthcare needs catering

to a population of 3,000 to 50,000. The model signifi cantly reduces Out-of- Pocket Expenses (OOPE), by providing a complete package of services, including preventive, early diagnosis, basic curative and redressal.

Madhya Pradesh10 technology-enabled Health and Wellness Centers have been established in three priority districts of Bhopal, Jabalpur, and Vidisha in Madhya Pradesh. The centers have 1,726 medical consultants (general and specialist) empaneled for telemedicine. Average visitors per center increased from 55 in October 2018 to 127 in December 2018.

AssamLEHS added Assam as a priority state and six healthcare centers were transformed into technology and innovation-led smart clinics to off er comprehensive primary healthcare services to the tea garden communities.A comprehensive Clinic Health Management System (CHMS) in partnership with Amalgamated Plantations Pvt Ltd (APPL) was developed and deployed. 53 Urban Primary Health Centers (UPHCs) were transformed into technology enabled Health and Wellness Centers. LEHS Technology enabled HWCs include Swathya ATM, Medicine Vending Machine, Medical Teleconsultation, online registration, basic vitals, patient records, and diagnostics.

RajasthanAn average out-patient of rural PHCs increased from 924 per PHC per month in 2014-15 to 1,700 in 2018-19. From July 2015 to June 2018, Primary Health Centers (PHCs)/SCs that off ered OPD services treated approx. 20,00,000 patients and conducted 13,000 institutional deliveries.

Uttar PradeshLEHS piloted the NHA-NHM collaborative HWC PMJAY initiatives in Gorakhpur. These centers were made operational in remote areas to allow early case reporting and management of anti-larval measures to prevent dengue from spreading in the communities. A comprehensive Geographical Information System (GIS) was developed to map dengue hotspots; track them over a period of time and analyze the impact of various interventions made in the district.

Capacity building trainings conducted for doctors, paramedics, and pharmacists laying emphasis on clinical evaluations, treatment interventions, signs, symptoms and prevention of dengue through CME in Varanasi, Allahabad, Mirzapur, and Faizabad.

In Uttar Pradesh, LEHS conducted regular outreach activities in close

coordination with fi eld service providers such as ASHA, ANM, AWW

MPW, and malaria fi eld workers to sensitize

ommunities on prevention measures for

dengue and its widespread.

LEHS designed and rolled out a

behaviour change campaign in

Uttar Pradesh to advocate and

make community members understand the importance

of prevention and precautions in quality healthcare.

LEHS conducted Yoga wellness modules for the rural population in various districts in Madhya Pradesh. A cervical cancer training along with hands-on training for lab technicians was also conducted.

In Rajasthan, LEHS signed a fi ve-year MoU with the Government of Rajasthan to transform under performing health centers and establish a high-quality primary healthcare delivery system. Under a PPP with the state government the program

covers 14 districts covering 32 rural and urban PHCs that serve 0.65 million people.

Population directly and/ or indirectly covered by

LEHS support

LEHS Partners with NHM for Universal Health Coverage: An MoU was signed with the National Health Mission, Government of Rajasthan with the goal of setting up a TSU to achieve Universal Health Coverage and to support the state government in

program designing; implementation and management of HWCs.

An MoU was signed with the Department of Information Technology Govt, of Rajasthan for implementing electronic health records at fi ve PHCs (rural and urban)

in Rajasthan.

Shaping the Future of Healthcare through Artifi cial Intelligence

• By 2020, LEHS programs aim to reach 10 million underserved people with quality healthcare services in partnership with the governments of Rajasthan, Madhya Pradesh and Uttar Pradesh among other states.

• LEHS aims at bringing dramatic changes in the delivery of Primary Healthcare introducing Artifi cial Intelligence in the PH delivery system.

• LEHS would take up advisory roles and functions to help the government in fulfi lling its millennium development goals to achieve a Healthy India.

• Our prime initiative - Scale Rajasthan (2015-20) will help achieve the evolution of Smart Clinics by making signifi cant leaps in its operative model and seamlessly taking it to other states. The organization will work towards the creation of state-of-the-art diagnostic labs at district hospitals and community health centers with linkages at the primary health centers enabled by private partners.

Demonstrate and launch low-costhealthcare innovations

• LEHS will continue to make sustained eff orts to identify innovations to address key needs and gaps within the public health system and scale them up.

LEHSBuilding No. 24 (3rd Floor), Okhla Industrial Estate Phase III

New Delhi -110020