Case Study Highlights: Vulnerable Populations
Seven CHMI case studies look to funding and implementation to assist at risk populations
Consider the some of the most vulnerable populations of the world: children, refugees, HIV/AIDS patients and those residing in rural areas. Their needs and lives vary significantly from other groups, resulting in a greater need for access to the health market. In this batch of case studies, seven CHMI profiled programs address this challenge through a variety of means, spanning from using unique funding techniques to different methods of implementation.
Eye care facility Sadguru Netra Chikitsalaya (SNC) of India makes use of the high volume, low cost method of patient care in order to keep treatment efficient. The organization is able to reduce the cost of each procedure they perform by focusing on one operation, such as cataract surgeries. SNC also uses cross-subsidization to help the rural poor that they serve. Those patients that are able to pay the full expense of eye care are expected to, and the extra funds can be transferred to those that are unable to pay for the treatment.
While SNC focuses on assisting the rural poor through cross subsidization, Research, Training and Management (RTM) International of Bangladesh and Vision Centers of South Africa work under a public-private partnership model to fund their endeavors. RTM works with refugees, focusing their efforts mainly within the sphere of maternal and child health. To accomplish their goals of capacity building and improved health awareness, the organization works with many different players, including the government of Bangladesh and other private organizations for both funding and ground support. Vision Centers, which provides eye care to the rural poor, operate within publically funded clinics in order to cut costs for those they serve. This partnership helps strengthen both the public and private health sectors, creating successful outcomes for all who seek care.
Public-private partnerships are only one way to ensure that the vulnerable gain access to care. The Generics Pharmacy provides the cheaper, generic version of medicines through a franchise method, increasing physical and financial access to the medicines throughout the Philippines. Franchise specialization and spreading the costs across franchisees allows for lower cost to each user. Given that the Generics Pharmacy is a for-profit company, each franchisee has a strong incentive to succeed, insuring that the Philippines will have access to generic medicines for a long time to come.
While there are many different funding schemes giving access to vulnerable groups, there are just as many varied implementation schemes. Associacao Saude Crianca works to improve the health of children in Brazil through the entire family. Reaching out to families who have children with repeated hospital admissions, the organization invites them to become involved in their social inclusion program. In addition to providing medical care, family members participate in job training, and utilize educational and legal services as needed. This comprehensive approach has been estimated to have cut re-admission to hospital rates by 66%.
Turma Do Bem, another Brazilian program, also works with children. The program seeks out poor children who had not previously had access to dentistry and gives them care completely free of charge up until their 18th birthday. To end the cycle of poor health and poverty, some patients also find employment through the program by being trained as dental assistants.
Hand picking each patient is a way to reach some, but usually not all of a vulnerable population. Project Masiluleke of South Africa has found a way to expand care, utilizing technology. The almost universal usage of mobile phones has allowed Project M to use text messages to reach one of the most vulnerable groups in the world: those suffering from HIV/AIDS. Aiming to raise awareness and assist those who need it to get treatment, the short, uplifting texts have been found to raise calls to HIV help lines by three times.
These programs show that regardless of the method or funding used, the key is to reach out to these vulnerable populations who most need access to the health market. To learn more about these programs, read each program’s profile in the CHMI database.