If you live in a rural community in India and someone in your family is dying, you might sell your buffalo and travel two thousand kilometers to save that person’s life. But when it comes to basic health services, unless those services are available in your village, you may never receive preventative care.
In communities that live in the periphery, inexpensive and widely accepted services that most of us would recognize as fundamental rights—family planning, antenatal care, blood pressure screenings, simple diagnoses, and immunizations—are not being delivered.
Communities are clamoring for these services; the need is very strong. There are enough health resources to do a reasonably good job in delivering them. And yet, too many people are going without basic medical care because the supply side and the demand side somehow do not connect.
Something is very wrong, and it’s a puzzle we have to crack. We need solutions that are in line with the enormity of the challenge.
This week, I am in Oxford, England at the 2013 Skoll World Forum, a gathering of nearly 1,000 influential social entrepreneurs and thought leaders. I am excited to hear about the work and ideas of the people in this community, people who are tackling some of the world’s most pressing problems and creating positive change. Gatherings like this foster the kind of interdisciplinary and interconnected approach that can catalyze meaningful and lasting change in people’s lives.
While I often think about catalyzing change in terms of health services and health systems, an interconnected vision and solution is critical to tackling any problem. In every community, there are three key questions. First, how can you make what’s already there better? Second, how can you discourage existing systems that are not functional? And third, once you tackle the first two questions, how can you continue to improve?
My organization, World Health Partners (WHP), uses innovative market-based approaches to improve the quality of rural health care. We are creating a complete service delivery ecosystem, which connects informal rural health providers to qualified doctors and provides people with access to a wide range of critical health services and products, in part through telemedicine.
We have three years of full scale programming experience under our belts, and we are currently working in 10,000 rural villages. By the end of 2014, we will be in 40,000. This means thousands and thousands of Indians living in rural and remote places will be able to get the kind of basic health services that they need and that are their right.
How do we do this?
We recognize that large resources are available in every country, however remote, however poor. The most obvious resources are the ones we are already familiar with, such as private sector hospitals and public sector facilities. We look at how to use the available resources in the private sector to supplement the public sector.
We look, too, for other resources that are hidden, fragmented, or easy to miss—such as informal health care providers. These are people who may lack medical and technical skills but have strong relationship skills and empathy for the community. They always live within the communities, provide round-the-clock care, and offer credit, which is vital in agrarian economies where incomes are cyclical.
Then we work to design a large-scale architecture that can combine the individual strengths of each sector—public and private, formal and informal—to best meet a community’s needs. What we’ve found is that, surprisingly, many of these sectors strengths are complementary, can work together, and lead to greater efficiency and sustainability.
When it comes to working in unorganized environments, a flexible framework with a certain amount of latitude is critical. This is how we draw our strategies. We work our way up from the bottom.
Scale is also a critical element. Reaching under-served communities that are poor and large in number is our highest priority. We approach this like any other business, we generate high volume and critical mass so we can reduce the cost to the clients and they can get the basic health services that they need.