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Nyaya Health Provides Free Healthcare in Rural Nepal
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3. Where We Work 250,000 population of Achham 0 number of allopathic doctors in Achham before Nyaya 2 number of allopathic doctors in Achham hired by 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 50% of men migrate to India for work; over 7% return with HIV in 1,000 children don’t survive past the age of five 83 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
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6. Achieving Nyaya Health’s Mission in Achham Mission #1: Build Healthcare Infrastructure Mission #2: Develop a Scalable Model
Annotations in the Notes section for each slide follow and should guide the presenter as to the key points meant to cover throughout the presentation. Title slide; introduction.
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Nyaya's first project in Achham was the Sanfe Bagar Primary Health Center, which: COVER POINTS ON SLIDE
Bayalpata hospital is the big next step that Nyaya is taking to build the health system in Achham. The hospital is slated to open in 21 June, 2009. COVER POINTS ON SLIDE
Nyaya Health's two key missions are complementary of each other. Together with local communities and the Nepali government, Nyaya is working to build a health care system for the Achham district. In parallel, and directly through our experiences in this setting of severe deprivation, we aim to provide a model that other providers can utilize in expanding access to health services in similar areas affected by remoteness, poverty, isolation and war.- The rest of the presentation will be structured in two parts, as per Mission #1 and #2.
This slide is an outline of the aspects of Mission #1 Building Healthcare Infrastructure we will now discuss.
Nyaya uses data and regular evaluation to drive our services improvements and expansion. Providing data-driven health care is a key component of Nyaya's efforts to ensure its services are directly responsive to the needs of our patients, incorporating both their quantitative and qualitative feedback. COVER POINTS ON SLIDE Some details: The initial Nyaya Rapid Health Assessment was overseen be co-founder and epidemiologist Dr. Duncan Maru in April, 2007. The RHA covered the essential aspects of health infrastructure available to the communities served by the future Sanfe Bagar Medical Clinic http://wiki.nyayahealth.org/CommunitySurveys
Constructing effective healthcare facilities requires planning and community involvement. COVER POINTS ON SLIDE
Human resources form the core backbone of a health system. Additional point re: physicians: In Nepal, the overall physician: citizen ratio is 1 in 70,000; in Kathmandu, the capital city, that number is 1:5,000. In Achham, prior to the arrival of Nyaya Health, it was 1:500,000
COVER POINTS ON SLIDE Additional point re: Continuing medical education (CME): Expatriate physicians and other experts are critical to our CME efforts. Nyaya has established relationships with external universities to improve our overall delivery of care. The broader focus is to build the skills and competencies of the local staff on-site who form the foundation of the Nepali health system.
Telecommunications is an integral component to Nyaya's ability to offer health care services in the rural and impoverished Achham district. Both our clinical and administrative capacities are reliant upon consistent and reliable communication technologies. COVER POINTS ON SLIDE
Nyaya Health takes a pragmatic approach to energy that we believe can be used effectively by other rural providers. The flow diagram describes how each system component of Nyaya's current energy system relates [quickly review flow diagram]. Most importantly to the Nyaya energy system are the key factors of affordability and conservation. As we expand services to Bayalpata Hospital, and as financing permits, we aim to add on more costly, but ultimately more environmentally friendly, solar power solutions, which can be incorporated into our current system. DISCUSS PHASED IMPLEMENTATION AND SCALE-UP OF ENERGY PROGRAM AS OUTLINED
Water is plentiful in Achham; water access and safe water, however, often are not. At our hospital site at Bayalpata, Nyaya has worked out an agreement for reliable water access provided for free by local community members in a partnership to benefit the larger community. In the past, Nyaya has used in the electric water filters based on reverse osmosis technology to effectively filter our clinical water supply. At the new hospital site, we will deploy a system that couples the electric water filters with on-site chlorine production units that are being procured through a collaboration with Antennae Technologies and Environmental Camps for Conservation Awareness. Additionally, excess chlorine will be distributed via our community health workers to local communities to educate the public about the importance of clean water, at the same time decreasing significant morbidity and mortality caused by water-born diarrheal illnesses.
Nyaya Health operates in a region where patients often have to walk over four hours to access our services. Roads and cell phone towers are minimal. To achieve screening and follow-up, we utilize community health workers who meet the patients in their own villages, enhancing the quality of our care and accessibility to our patients. Background: http://wiki.nyayahealth.org/CHWs
This slide is an outline of the aspects of Mission #2 Developing a Scalable Model we will now discuss.
The wiki is the core technology behind our collaborative and transparency objectives. COVER POINTS ON SLIDE
The Nyaya Health Blog is another component in our efforts to share our work with key stakeholders, including other organizations working in similar situations, as well as the lay public and our supporters. The Blog offers stories of our work, our patients, and our challenges, in a journal-esque format.
To effectively provide the services our patients need, and to implement them in the most effective, efficient, and cost-effective manner, Nyaya relies on rigorous data monitoring, continued evaluation, and consequent programmatic revision. Furthermore, to ensure continued critical feedback and collaboration amongst our colleagues and supporters, all of our data is available online through our wiki in easily accessible format. COVER POINTS ON SLIDE This page provides an overview of Nyaya's data strategies: http://wiki.nyayahealth.org/DataManagement
Nyaya Health has all financial information publicly available on our wiki to ensure full transparency. Our team has extensive experience in the non-profit sector, and a key compomnent of Nyaya's mission is to advocate for increased transparency throughout the global health community. Nyaya's wiki offers us an easy and readily exportable model to achieve further transparency in this type of work.
COVER POINTS ON SLIDE INCLUDING IMPORTANT CHALLENGES/NEXT STEPS - This is a good place in the presentation for an updated slide discussing particular needs.
We appreciate the opportunity to present at your conference, and are excited to work with you more in 2009. Best wishes - The Nyaya Health Team