Rohini Kalvakuntla works in the India office for ACCESS Health International. She manages the Public Private Partnerships Project and ACCESS Health’s involvement with the Center for Health Market Innovations. We talked to her recently when she was in New York, to find out more about the work she’s doing in India and how she remains passionate and inspired, despite the challenges.
ACCESS Health: You started working with ACCESS Health International in 2012. Why did you want to join the team?
Rohini Kalvakuntla: I had heard a lot about ACCESS Health International from a number of different people and it was amazing how they all talked about one thing: making healthcare innovations and good practices accessible to all the key players. This is so important. So much progress is happening in terms of improving healthcare, but the people who should know about what’s being done to improve healthcare aren’t always aware. This means that people are constantly reinventing the wheel. I wanted to work with ACCESS Health so that I could help people better understand good practices and support governments in advancing their own healthcare systems.
ACCESS Health: What does this look like in practice?
Rohini Kalvakuntla: One of the big projects I work on for ACCESS Health is managing the Public Private Partnerships Project, which brings public and private sector players together to strengthen healthcare systems in India. Last year, one of our big projects was helping Rajasthan develop a policy framework around how governments engage with the private sector around healthcare: What are the mechanisms to engage the private sector? How can it work most transparently? What are the financing mechanisms? We started by fostering dialogues between the public and private sector, bringing them to the same table so they could talk openly about the challenges and opportunities that existed in working with each other. These conversations happened at the state and district levels, so everyone felt they had a say in what the policy would eventually look like.
Those initial conversations have led to real change in Rajasthan. Prior to our involvement, public private partnerships were not particularly transparent and there was generally a lack of trust between both parties. But now the state is very able to articulate how it wants to engage the private sector in healthcare and the terms of that engagement. There have been a lot of fruitful initiatives that have stemmed directly from our initial dialogues and others that have begun more recently, based on the new basis of trust and transparency.
ACCESS Health: What has been the biggest challenge in your work?
Rohini Kalvakuntla: I think the biggest challenge is just knowing how difficult it is to move the needle. In India, we have huge out of pocket expenditures for healthcare and we need more social funding to reduce these out of pocket payments. But even though this is clearly understood, even by government, it’s still very difficult to generate the political will necessary to make such a significant change. One thing this has taught me is how important it is to find champions within the government who understand the issues and are willing to do the hard work with us to increase our odds of winning and creating lasting change. In an odd way, this challenge is also very motivating because it pushes us toward more and more innovative solutions – if our initial approach isn’t working, what else can we try to finally make things work?
ACCESS Health: What else motivates and inspires you?
Rohini Kalvakuntla: It’s really the need. In India, the need to build responsive and sustainable healthcare systems has never been more obvious or urgent. Having a weak healthcare system can have crippling effects, especially when you consider the current rise in chronic diseases, changing demographics and an aging population, and increases in infectious disease outbreaks like Zika or the avian flu. In Hyderabad where I work we had a swine flu outbreak a couple of years ago that nearly broke the healthcare system – we were completely unprepared for that kind of an outbreak. When you experience this need for high quality but affordable healthcare so intimately, it inspires you to keep working despite the difficulties. There is no greater motivation than to think that you’re working for a purpose and that you are ultimately contributing to something that makes human societies better. By looking at everything from that angle we can figure out what is important, what we need to prioritize, and keep ourselves driven toward the end goal.