Kennedy presentation

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Duncan Maru's Harvard Kennedy presentation

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  • Stress the “success” of being approached by the gov’t for collaboration – this slide should really just be “a few months after opening the clinic, we were approached by the government and local community, and offered to join in a public-private partnership to re-open the Bayalpata Hospital
  • Stress the importance of our philosophy in how we approach our work
  • 50,000 patients to date
  • Kennedy presentation

    1. 1. Building Health Systems in Rural Nepal:<br />The story of Nyaya Health<br />Duncan Maru, MD, PHDCo-Founder and President| Nyaya Health<br />Harvard Kennedy School, February 17, 2011<br />
    2. 2. Outline<br /><ul><li>Introduction to Achham
    3. 3. Birth of Nyaya Health
    4. 4. Current services provided by Bayalpata Hospital
    5. 5. Challenges
    6. 6. Key features of the NGO
    7. 7. Next steps
    8. 8. Panel Discussion</li></ul>1<br />
    9. 9. Where We Work: Nepal – Achham District, Far Western Region<br />
    10. 10. Achham District, Far Western Region, Nepal<br />
    11. 11. Achham District, Far Western Region, Nepal<br />
    12. 12. Achham District, Far Western Region, Nepal<br />
    13. 13. Achham District, Far Western Region, Nepal<br />
    14. 14. Achham District, Far Western Region, Nepal<br />
    15. 15. Achham, Nepal<br />250,000<br />population of Achham<br />0<br />number of allopathic doctors in Achham before Nyaya<br />6+<br />hours in bus to reach the nearest operating room<br />14<br />hours in bus to reach the nearest intensive care unit<br />6% & 54%<br />Female and male literacy rates, respectively<br />1 in 125<br />deliveries results in the mother’s death<br />64<br />number of stillborns for every 1,000 live births<br />>80%<br />of men migrate to India for work; over 7% return with HIV<br />99.5%<br />of babies are born in homes and cattle sheds<br />50¢<br />average daily per capita income in Achham<br />60%<br />60%<br />of children are chronically malnourished<br />8<br />
    16. 16. Nyaya Health Snapshot<br /><ul><li>Founded in 2006; public-private partnership with Nepali Ministry of Health & Population in 2009</li></ul>Social justice-oriented mission: <br /><ul><li>To provide free community-based healthcare in rural Nepal that strengthens the Nepali Ministry of Health’s public sector
    17. 17. To develop and disseminate effective strategies of healthcare delivery in resource-poor settings throughout the world</li></ul>9<br />
    18. 18. Public-Private Partnership<br />We operate services that aim to bolster the public sector at three levels:<br />Referral-level: Government hospital<br />Primary care level: Government health posts (clinics)<br />Outreach level: Government community health workers<br />
    19. 19. SanfeBagar Primary Health Center<br />Sanfe Bagar Health Center: After<br />Sanfe Bagar Health Center: Before<br />11<br />
    20. 20. Bayalpata Hospital<br />12<br />
    21. 21. Bayalpata Hospital<br />
    22. 22. Bayalpata Hospital<br />Infrastructure development and capacity building, not care provision alone<br />Government collaboration: Government partnership contract for 5 years signed June 2009 – June 2014<br />Currently one of the highest levels of clinical care in the Far West (2 million people)<br />50,000 patients seen to date<br />
    23. 23. Bayalpata Hospital<br /><ul><li>All health care services free of charge:
    24. 24. Inpatient & Outpatient services
    25. 25. 24-hour emergency and obstetric services
    26. 26. Laboratory & Pharmacy
    27. 27. Radiology: X-Ray & Ultrasound
    28. 28. HIV, TB treatment programs
    29. 29. Malnutrition treatment (RUTF)
    30. 30. Ambulance services
    31. 31. Community Health Worker (CHWs) services
    32. 32. Telemedicine
    33. 33. 2011 Expansion Plans:
    34. 34. Comprehensive surgical suite
    35. 35. Solar energy
    36. 36. Expanded CHW network
    37. 37. Teaching hospital status</li></li></ul><li>Key Challenges<br />Human resources<br />Supply chain management<br />Energy systems<br />Telecommunications<br />Community relationships, outreach<br />Public sector relationships<br />
    38. 38. Nyaya Health: Unique Features<br /><ul><li>Collaboration with the Government
    39. 39. Managed by a volunteer Board of Directors, 29 full-time employed Nepali staff and many volunteers around the world
    40. 40. Over 99% of all funds used directly in Nepal
    41. 41. Transparency
    42. 42. Prioritizing the most marginalized</li></ul> Staff:<br /> 70% achhami<br /> 60% female<br /> 35% dalit<br /> Patients:<br /> 65% female<br />17<br />
    43. 43. Next Steps<br />Continued Renovations<br />18<br />
    44. 44. Next Steps<br />Next Steps<br />Surgical Services<br />Quality Improvement<br />Implementation Research<br />19<br />
    45. 45. Next Steps<br />Next Steps<br />Solar Power<br />20<br />
    46. 46. My Personal Vision for Bayalpata Hospital<br />
    47. 47. Acknowledgements<br /><ul><li>The staff of Bayalpata Hospital & the people of Achham, Nepal
    48. 48. The volunteers and individual donors of Nyaya Health
    49. 49. The Nepali Ministry of Health & Achham District Health officials: Dr. Deepak Gaylal, Mr. SailendraShrestha, Mr. JhanakDhungana
    50. 50. Harvard School of Public Health Global Health Forum and Nepal KoYuwa
    51. 51. Institutional Supporters: Abbot Laboratories, AMD and the Open Architecture Network, America Nepal Medical Foundation (ANMF), BWH COE in Quality and Safety, Buddha Air, Cents of Relief, Child Health Foundation, CIWEC Clinic (Menlha Nursing Home), Ella Lyman Cabot Trust, EquityEditors Association, Ford Foundation, Frederick Lovejoy Foundation, Google Grants, Nepal Ministry of Health and Population (MOHP), New Aid Foundation, Partners in Health, QBC Diagnostics, Quidel Corporation, Singapore Internet Research Center, Ten Friends, The Hunger Site, The International Foundation, The Shelley and Donald Rubin Foundation, Until There's a Cure Foundation, UpToDate, William Prusoff Foundation, Yale University</li></li></ul><li>Bayalpata Hospital 2010 <br />
    52. 52. Challenges: Facilities-Based Deliveries<br />
    53. 53. Challenges: Transportation Infrastructure<br />
    54. 54. Finances<br />

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