Post on 12-May-2015
description
Nyaya Health 2010
Nyaya Health: A public-private partnership
to develop healthcare in rural NepalJhapat Thapa, Medical Director
director@nyayahealth.org
Nyaya Health 2010
Who We Are
2
Mission: 1) To expand healthcare capacity in rural Nepal2) To develop a scalable model of healthcare delivery
in resource-poor settings.
501(c)(3) organization founded in USA in 2006 Public-private partnership with Nepali Ministry
of Health & Population. Managed by a volunteer Board of Directors and
employed Nepali staff Over 99% of all funds used directly in Nepal
Nyaya Health 2010
Where We Work: Nepal – Achham District, Far Western Region
Nyaya Health 2010
Where We Work
4
250,000 population of Achham
0 number of allopathic doctors in Achham before Nyaya
10+ hours in bus to reach the nearest airport and operating room
1 in 125 deliveries results in the mother’s death
64 number of stillborns for every 1,000 live births
99.5% of babies are born in homes and cattle sheds
50¢ average daily per capita income in Achham
60% of children are chronically malnourished
14 hours in bus to reach the nearest intensive care unit
6% & 54% Female and male literacy rates, respectively
50% of men migrate to India for work; over 7% return with HIV
60%
Nyaya Health 2010
First stage: Sanfe Bagar Primary Health Center
Opened for service April 6, 2008
Served over 17,000 patients between April ’08 and May ‘09
Services included: Outpatient department 24 hour emergency services Maternity suite with 24 hour-
obstetric services Diagnostic laboratory Pharmacy
14 all-Nepali staff
All services completely free
Nyaya Health 2010
Second stage: Transition to Bayalpata Hospital
The Hospital was constructed by Nepali government 30 years ago but never came into operation
Nyaya Health has renovated and opened the services in June 2009 in collaboration with Nepali Ministry of Health. Ministry of Health & Population to take over Bayalpata Hospital in 2014
Nyaya Health 2010
Current Services: Bayalpata Hospital Services include (all free):
Adult and pediatrics Ambulatory services. 24-hour emergency and obstetric services. In patient services. Laboratory & Pharmacy. Community Health Workers (CHWs) Ultrasound services. ART and DOTS clinic Ambulance services. Ambulance services.
2010-2011 Expansion: X-ray service. Surgical suite for emergency C-
section and general surgery. Expansion of inpatient and maternity
ward. Solar energy
Nyaya Health 2010
Achieving Nyaya Health’s Mission in Achham
Mission #1: Build Healthcare InfrastructureMission #2: Develop a Scalable Model
8
Nyaya Health 2010
Mission #1: Build Healthcare Infrastructure
Key components: Needs assessment Clinical Facilities
Development Human Resources:
Recruitment Human Resources:
Continuing Medical Education
Telecommunications Reliable energy Clean water
9
Nyaya Health 2010
Building Healthcare Infrastructure: Needs Assessment
Needs assessment is a key component of delivering locally effective community-driven healthcare services
Rapid health assessment, 2007 Reviewing clinical service data Community health worker
surveys
10
Nyaya Health 2010
Building Healthcare Infrastructure: Clinical Facilities Development
Nyaya Health incorporates principles of social justice and community-driven development into all design processes
Facilities designed to enhance patient dignity and healing
Sanfe Bagar Health Center: Before
Sanfe Bagar Health Center: After
Nyaya Health staff participate in the process, further developing human resource capacity
Local community members engage in the process through voluntary and paid engagements
11
Nyaya Health 2010
Building Healthcare Infrastructure: Staff Recruitment
Focus on local talent
Open, advertised process
Structured and qualitative components to the interview
Salaries on par with the Nepali government
Opportunities for career advancement
12
Nyaya Health 2010
Building Healthcare Infrastructure: Continuing Medical Education
Developing new competencies among staff is key to building health systems.
Strategies include: Reviewing evidence-based clinical
protocols Ultrasound data reviewed by Yale. On-site clinical consultants. Computer literacy
13
Nyaya Health 2010
Building Healthcare Infrastructure: Telecommunications
Reliable telecommunications system is central to our ability to deliver:
Quality medical care. Logistics planning. Telemedicine. Fundraising.
14
Nyaya Health 2010
Building Healthcare Infrastructure: Community Health Workers
Community health workers play critical roles in ensuring timely access to essential medical care
Effectively deliver care in rural regions with little access to transportation
Provide follow-up care of chronic conditions
Help raise awareness and educate their fellow citizens
Offer continual feedback to Nyaya about community needs and concerns
Phased scale-up of CHW network
1. Outreach
2. Medical adherence support
3. Paramedical services
15
Nyaya Health 2010
Developing a Scalable Model: Nyaya Health Wiki
Wiki is an searchable repository of: Management policies and contracts Clinical protocols clinical data Clinical engineering details
All pages viewable to the public
A forum to share lessons-learned from our patients in Achham with organizations in similar settings around the world
http://wiki.nyayahealth.org
16
Nyaya Health 2010
Developing a Scalable Model: Nyaya Health Blog
Staff and volunteers write journal-type stories to share and reflect on our programs
Forum for discussing: Patient cases Clinical operations details Organizational challenges and successes
Colleagues throughout the world can use these experiences to guide their own work and provide us with feedback or questions http://blog.nyayahealth.org
17
Nyaya Health 2010
Developing a Scalable Model: Data Monitoring
Effective healthcare must be driven by data monitoring and evaluation
Collaboration between Nepal- and US-based data team is critical: Monthly uploading and analysis Public access to enhance
collaboration and transparency in the global health community
Revision of programmatic design and protocols according to regular data evaluation
http://wiki.nyayahealth.org/DataManagement
18
Nyaya Health 2010
Developing a Scalable Model: Financial Transparency
Nyaya’s wiki offers ready accessibility to: Line-by-line expenditures Month-by-month budgets summaries Timeline of expenditures Accounts balances
Benefits More engaged donors Organizational culture of honesty
and openness More effective management
http://wiki.nyayahealth.org/Budget
19
Nyaya Health 2010
Nyaya Health – Bayalpata Hospital celebrates 1st Birthday
• Whole community was invited
• Tree planting as a symbol of sustainable development and a green future.
Nyaya Health 2010
Nyaya Health and Yale New Haven/Waterbury Hospital
Started off by Yale Medical Students
Several residents from Yale have rotated at Bayalpata Hospital
Future program for interested residents to rotate at the hospital.
Hospital equipment donation
Nyaya Health 2010
Nyaya Health –
Nyaya Health 2010
Thank You! Questions?
23
135 College St, Suite 323New Haven, CT 06510, USAPhone: +1.724.986.5050Fax: +1.630-604-8615
info@nyayahealth.org http://www.nyayahealth.org http://wiki.nyayahealth.org
http://blog.nyayahealth.org
Bayalpata Hospital, Ridikot VDCAchham, Nepal
Phone: 977-94-690-404 (Achham)Phone: 977-9845236035(KTM)