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    • Women's health

    How hard to reach are the 'hard to reach'?

    It's simply a question of prioritization, say delegates at the Partners' Forum on maternal, newborn, and child health.

    By Jessica Abrahams // 13 December 2018

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    Dawn on the border of the Juma Reserve in the Brazilian Amazon. Photo by: Neil Palmer / CIAT / CC BY-NC-ND

    NEW DELHI — When aid groups finally make their way into “hard-to-reach” communities, they often find Coke bottles, political merchandise, and soccer jerseys there. All of which raises the question, “Are they hard to reach, or are we just not prioritizing to reach them?” as Gogontlejang Phaladi, founder of advocacy group Pillar of Hope, put it onstage at the Partners’ Forum on maternal, newborn and child health in New Delhi, India, this week.

    “Because it’s important for [the private sector] to sell Coca-Cola in those far-away rural places, they do make an effort. So why is it we can’t do that with health care services, information, and commodities?”

    — Gogontlejang Phaladi, founder, Pillar of Hope

    When the global development community talks about the “hard to reach,” they mean, “they don’t have resources to reach those people because they are disadvantaged” — either geographically, because of the area in which they live, or because they are part of a marginalized group — Phaladi, a youth representative from Botswana, told Devex after the session. “But for me, it’s just an excuse to not put in effort or go the extra mile to reach them …”

    “If they are hard to reach, we should not be finding soda bottles there, we should not be finding political campaign T-shirts and merchandise there. But because it’s very important [for politicians] to reach them during the political period, they do reach out to those people. Because it’s important for [the private sector] to sell Coca-Cola in those far-away rural places, they do make an effort. So why is it we can’t do that with health care services, information, and commodities?”

    “It’s not actually that they are hard to reach; they are easy to reach, we’re just not prioritizing to reach them,” she added

    David Imbago Jacome, a doctor from Ecuador who works on family planning with indigenous communities in the Amazon rainforest, agreed to an extent. Some of the communities he covers are a two-hour river ride away from his base, yet he isn’t provided with transportation to reach them, he said — a situation in which more resources and prioritization would clearly make the difference.

    But these groups can also be hard to reach in the sense that it is often the first time that health or development services have been extended to them, meaning the work is more intensive and progress is slower.

    “Often, when we talk about hard-to-reach areas, really we just need to think about different ways to reach those areas,” said Carla Blauvelt, Malawi country director with VillageReach, an NGO that helped to create a telephone service offering health care support to those living in rural areas. “So there might be transport challenges but then there are mobile networks, so people can call in … You have to find different, innovative solutions,” she said, rethinking the access challenge.

    “I lived in South Sudan before, and there are actually really hard-to-reach areas in [parts of the] country without roads … But they’re still able to, there are certain groups and certain organizations that do reach those communities … It’s really about putting in the effort.”

    Editor’s note: The reporter traveled to New Delhi with the support of the World Health Organization and the International Center for Journalists. Devex retains full editorial independence and responsibility for this content.

    • Humanitarian Aid
    • Global Health
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    • Innovation & ICT
    • Ecuador
    • South Sudan
    • Botswana
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    About the author

    • Jessica Abrahams

      Jessica Abrahams@jiabrahams

      Jessica Abrahams is a former editor of Devex Pro. She helped to oversee news, features, data analysis, events, and newsletters for Devex Pro members. Before that, she served as deputy news editor and as an associate editor, with a particular focus on Europe. She has also worked as a writer, researcher, and editor for Prospect magazine, The Telegraph, and Bloomberg News, among other outlets. Based in London, Jessica holds graduate degrees in journalism from City University London and in international relations from Institut Barcelona d’Estudis Internacionals.

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