They are community-based. They stay.
They are a permanent program serving a population of 220,000 residents. Their commitment to stay and deliver services is the basis of their bond with the communities. This deep trust is reflected in their programs: every year community members call us with thousands of referrals.
They take care to the patient’s doorstep.
It is their poorest patients who can least afford the time, cost and energy of traveling to health facilities. In their TB program, they challenged the orthodoxy that a poor patient must travel 3 times a week to a health center to get her drugs. They decided to go to their patients’ homes instead. A decade later, their approach is now accepted as mainstream. When they receive word that a patient might be sick, they make a house visit. In their maternal and newborn health (MNH) program, they perform ante-natal checkups at home when pregnant women are unable to visit health facilities.
They invest in women.
Their teams are local. They believe in female community health workers (CHWs), and have made significant investments to strengthen them in their catchment. A persistent, appealing myth is that more technical training for CHWs transforms health outcomes. In their experience one must start instead with addressing the deep disenfranchisement, misogyny and loss of agency that CHWs face in public health institutions and their communities. They have advocated for fair wages for CHWs, they offer round-the-clock field support, have created a career path, and given voice to their aspirations.
They strengthen public health institutions.
They believe that public health institutions (PHIs) have a central role in the care of the rural poor. All their work is through PHIs. In both TB and MNH, they have significantly strengthened the PHI’s ability, and transformed the community’s view of public health. They are not ideologues. They seek private avenues for their patients when PHIs prove inadequate.
They never leave a patient behind.
Their patients and families know that They will not leave their side, often literally, until they are well. Their dedicated local staff endure long hours of travel and hospital stays to ensure that patients get proper care. Newborns born in isolated hamlets are taken to neonatal ICUs. Those suffering from TB and HIV are taken to district-level referral facilities. Their resources may limit us, but their principles do not.
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