Transforming rural healthcare delivery through technology and integrated care
Over 400 million people worldwide lack access to basic healthcare. In rural communities, health facilities are often out of reach and the lack of affordable, quality care leads to poor health outcomes and often catastrophic financial burden. This is true for 12 million people in Nepal where pregnant women go through pregnancies without access to prenatal care or the support of a trained health provider during childbirth; infants risk dying of preventable conditions such as diarrhea, malnutrition, pneumonia, and congenital surgical conditions; and adults are subject to Chronic Obstructive Pulmonary Disease, which if left untreated, can lead to severe shortness of breath and poor quality of life.
Possible, a non-profit healthcare organisaton operating in Nepal, believes that everyone, including the rural poor, deserves quality healthcare without financial hardship. They designed a model that is not driven by fee-for-service and provider-centric, but that it is rather patient-centric and targets the major drivers of morbidity and mortality. As such, their model not only does provide patients who require specialised care with free services in two government hospitals, but also trains Community Healthcare Workers (CHW) to meet patients in their homes and screen for pregnancy, infant malnutrition, and Noncommunicable Diseases at critical moments in their health.
Key to their model is an Electronic Health Record (EHR), which Possible has successfully implemented in a rural, low-resource setting. Healthcare providers use mobile phones technology to enter and access a patient’s medical history, prescriptions, and lab results, wherever they are, from hospital to home. Real-time access to the EHR helps caregivers identify high-risk patients, and accurately diagnose and deliver care across a patient’s lifetime. Take Apsara, a 24-year-old woman who lives in Nandegada and met with a CHW after being pregnant for the sixth time. Her previous five pregnancies resulted in her babies dying within two months of delivery. The CHW counseled Apsara around prenatal health, diet and behavior. She is now scheduled for a hospital delivery. For patients like Apsara, regular monitoring and birth planning are key to a safe pregnancy.
Through a unique cost-share partnership with the Nepal government and the momentous National Insurance Act introduced in October 2017, which Possible helped influence, they are on the path toward scaling their model and helping make healthcare a reality for many who have been left out. To date, Possible has witnessed dramatic results through its model, including a rise in safe institutional births from 30% to 93% in the catchment areas where it serves. Possible proves how it is possible to envision a future where everyone, regardless of location or income, can walk together and be guaranteed quality healthcare as a human right, not a privilege.