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The Self-Medication is another huge problem that PeS team faced. Most of the people in Rajasthan villages are using self-medication through a retailer, traditional healers, or private practitioners. Villagers depended on traditional home remedies based on folk models of the body, illness, and healing.

The traditional healers, who are the first point of contact of patients in olden days, will use ayurvedic model of medicine to heal patients by balancing the body’s three humours (wind, bile and phlegm) through herbs, massage and exercise. These healers created an illusion towards the allopathic medicines in the villages. They used to tell that because of allopathic medicines, the body system will get hot, when compared to natural remedies. This portrayed as side effect of allopathic medicines. And this is believed to have negative long-term consequences.

On the other hand, few of the healers had begun to combine allopathic treatment in their prescriptions of better result. Many patients believe that modern medicine was more effective.

Private Doctors, are more in number than traditional healers. These doctors are nurses, who work beside a practitioner and saw patients, with no educational training. Some of them are compounders who had worked with doctors in the city and learned the trade but returned to their home towns. These doctors used to inject Steroids and IV saline/drips to restore energy.

These steroids give immediate palliative effect to relieve the patient from pain and made patients feel energetic. After injecting steroids, patients are more likely to return to work and tell family and friends about their experience. Steroids are banned in India. But due to the faster and instant effects the patients often criticized the sahayakis for not administering the steroids. The villagers do not known the negative impacts of frequent usage of steroids.

Most of the villagers are poor. Their income may not to be sufficient for their single meal per day. So the charge to the doctor is, most likely, an additional burden to the. The private doctors charge the patients according to their economic situation. They also asked them to pay later or provided barter service. No other healthcare option – neither the PeS nor the Public system – offered that flexibility.

The public hospitals will charge the patients less than the traditional healers or private doctors. But the problem is that these facilities are very far from their villages. Villagers are not to use it because it was often closed or inconvenienced the patient who had to travel to get care.

In the system the piramal created to cure every villager, everything is going well but patients are not interested to come for cure. Sometimes there is not patient visited the sahayika. But to run the system each sahayika need to get at least 3 patients per day. This results in loss for the piramal system.

The Sahayikas referred parients to other providers with needed facilities for severe cases. A tenth of the time, PeS referred patients. For some complex cases, the PeS was not a useful first visit. This resulted in some patients, especially those who believed that the new service should be a one stop solution to badmouth PeS. Few patients did not want to wander between hospitals. They needed a single place to get cured. These doctors advised the villagers not to visit the PeS centres, claiming that they were not delivering the care needed. Some of the patients are admonished or even threatened to withhold care. Some of them warned patients to be wary that PeS might eventually leave the village.

Many of public practitioners were known to run parallel private practices. By making the public service inefficient, they funnelled patients to their offices where clients paid a small premium to receive faster, more attractive care.

The piramal e-swasthya had thought of other options which are already failed by other initiatives. Doctors camping in the villages were not scalable due to high attrition rates. Few doctors are not willing to travel 6 hours in van every day to serve thousands. And medical care is on-demand service.