The problem: lack of affordable healthcare
In Nepal, 10 million people don’t have access to quality healthcare.
Imagine an expecting mother who arrives at a facility in time to give birth — and it’s the first time she’s ever been seen by the physician. For many people in last-mile communities in Nepal, this is the reality. The nearest medical facility might be a five hour walk away, or an exorbitantly expensive jeep ride.
The solution: integrated healthcare
Possible is developing a model for integrated healthcare that is customized for low-resource settings and delivered at the local level. The goal: a patient wouldn’t have to travel outside of their community for essential health services, regardless of condition (such as mental or maternal health) or type (i.e. preventive versus curative).
How Possible works
Possible starts with the belief that system-wide improvements — as opposed to silver bullet solutions — are required for changing the health outcomes of entire populations. More and more, there is a global consensus reinforcing the need for integrated, people-centered primary healthcare systems that reach last-mile communities without financially burdening families.
Possible has been developing these systems improvements for over a decade. Key components of their healthcare model include:
- High-quality, interconnected facilities that deliver essential services, support training of healthcare workers, and are places of learning and healing.
- Community health workers who proactively identify conditions, longitudinally deliver care, and link communities, households, and individuals to facilities. (This includes care delivered in an individual’s home.)
- Linked digital systems for frontline workers, including supply chain, billing, operations, patient tracking, population management, and quality improvement tools.
- Affordability, with minimal point-of-care fees to encourage timely access to care and offer financial protection to families.
Let’s continue with our expecting mother example. As opposed to having to travel to a medical facility hours away, pregnant women in Possible’s catchment areas are visited by Community Health Workers (CHWs), who conduct antenatal screenings and anticipate complications long before a patient’s due date. In the field, a CHW enters patient data using a smart phone, which is integrated with patient records at the facility level, so that health workers across sites can access information for accurate diagnosis and treatment.
Possible operates in some of the most underserved communities in Nepal, including Achham, once an epicenter of both the HIV epidemic and civil war; and Dolakha, a remote district whose infrastructure was ravaged by the 2015 earthquakes. They work at the direct delivery and policy level, with a vision of scaling to serve all 30 million people in Nepal through government adoption. They hope their model can be adapted to other low-resource settings experiencing similar constraints.