Projects That Work: 2013 Winners
The first annual Projects That Work forum took place at the 2013 conference of The Network: Towards Unity for Health (TUFH), which was held November 16-20, 2013, in Ayutthaya, Thailand. The 2013 competition showcased projects that had successfully addressed missions related to the 2013 conference theme, Rural and Community-based Healthcare: Opportunities and Challenges for the 21st Century, for three years or longer. An open worldwide call resulted in 120 submissions from which five projects were selected by an international panel of 13 reviewers. Descriptions of the selected projects follow.
Medical Decision Support Technology to Improve Maternal and Child Health
Primary health care in rural parts of India rests largely on the shoulders of Village Health Workers (VHWs), who are employed in a multitude of vertical health programs run by the government, and whose responsibilities often greatly exceed their qualifications and training. This project is aimed at bettering the antenatal care, postnatal care, and the care of children under five through the use of appropriate decision support technology for VHWs. The protocols for pregnancy, child birth, post-partum, and newborn care from the World Health Organization, the Indian Ministry of Health and Family Welfare, and the National Rural Health Mission in the state of Tamil Nadu were customized to local circumstances and unanimously agreed upon by a panel of expert obstetricians from partnering institutes. Guidelines for the care of children under the age of five were also adapted using Integrated Management of Neonatal and Childhood Illness protocols. An application that runs on mobile phones and handheld devices was developed, which allows the VHWs to enter patient information such as chief complaint, weight of child, blood pressure and hemoglobin level of mother, etc., while interacting with their patients. As a VHW completes the set of questions, the application classifies the patient into a broad diagnosis and generates care recommendations and a checklist of health advice based on the aforementioned protocols. The mobile phone-based decision support technology helps the VHWs in accurately diagnosing their patients, tracking missed investigations and immunization appointments, record keeping, and follow-up services.
Presenter: Saurav Das, Founder/Director, NewDigm Healthcare Technologies, Chennai, India
Longitudinal Clinic/Community Attachment Program for Students
The Longitudinal Clinic/Community Attachment Program for Students (L-CAS) is a medical-education-through-experiential-service-learning initiative that was implemented at the University of Pretoria School of Medicine in an effort to create a more community-oriented learning platform in the primary care setting. Initially L-CAS was only introduced for first-year medical and dental students, but in its second year it was extended to all medical students (years one through five) and to dental students in years one and two. From 2008 through 2010, medical and dental students were linked to one of 51 primary health care delivery facilities in Tshwane, Hammanskraal, Metswedding, and Ekurhuleni North Distric, where they worked as part of the health care team under the supervision of a mentor. In 2011 the program was adapted to move the student exposure from the clinics to the patients’ homes and from curative to preventative medicine. Students gain meaningful experiential learning activities, as well as the chance to reflect on what they have learned academically, and their involvement helps with service delivery and quality improvement. By providing an opportunity for students to practice their skills, interact with patients firsthand and over time, and become part of a health care team, the L-CAS program is helping to cultivate creative, responsible, and productive health professionals and future leaders who will be able to contribute to and improve holistic primary health care delivery in South Africa.
Presenter: Marietjie van Rooyen, Co-Program Developer/Manager, University of Pretoria, Pretoria, South Africa
Point-of-Care Testing Program for Diabetes Management
Type 2 diabetes and its principal complication, renal disease, are responsible for a significant burden of morbidity, mortality, and social and cultural trauma in Australia’s Aboriginal and Torres Strait Islander people. More than 80% of Aboriginal people live in rural and remote parts of Australia, where the disease burden of diabetes is highest, yet access to pathology testing for diabetes management is poorest. The Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS) Program was created to address this problem. Point-of-care testing bridges this gap in health equity by providing a convenient and accessible mode of pathology service delivery for diabetes patients that enables pathology testing to be performed on-site with results available in less than 10 minutes for immediate management and/or change of diabetes treatment. The QAAMS program now operates in more than 175 Aboriginal and Torres Strait Islander medical services and represents the largest national point-of-care testing network in Australia.
Presenter: Mark Shephard, Director, Flinders University International Centre for Point-of-Care Testing, Adelaide, Australia
Student Development Strategy for Primary Health Care of Family and Community
This program has changed the learning methods of the Fundación Universitaria San Martín School of Medicine, through the integration of knowledge about family and community needs pertaining to residents of the Sabaneta and Envigado municipalities. The school has implemented an integrated and eco-systemic student development strategy that includes activities inside community and family health care, incorporating principles of problem-based learning and community oriented medical education as pedagogical strategies. The project is acquiring academic, social, and institutional recognition and is considered a model to replicate in other communities in Colombia and other parts of Latin America.
Presenter: Marco Sosa, Director, Public Health Department, Faculty of Medicine, Fundación Universitaria San Martín, Medellín, Colombia
Community Health and Development Program
The objectives of this university-wide program are to provide learning opportunities in community health and development to community health faculty and students of the university through firsthand service-learning experiences in community based projects; and, while doing so, to assist local governments in rural areas in improving their health systems. Participants include faculty and students of the University of the Philippines Manila’s Colleges of Medicine, Nursing, Allied Medical Professions, Dentistry, Public Health, Pharmacy, and Arts and Sciences, as well as the College of Social Work and Community Development and the College of Home Economics at another University of the Philippines campus. The interprofessional collaborative work has increased faculty members’ understanding of each other’s professions, as well as deepened their understanding of their potential contributions to the development of local health systems. Students have gained insight and experience in rural health work, and health services in participating communities and villages have improved as a result of the program.
Presenter: Elizabeth Paterno, Program Director, University of the Philippines Manila, Manila, Philippines