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Partnership Creates Change: Why one-time educational training interventions in primary care are just not enough in rural East Africa 
Dr. Maggie Ehrenfried, PT, DPT 
Development Officer 
LifeNet International 
CCIH Conference June, 2014
LifeNet International transforms African clinics to 
provide quality, sustainable care. 
Life expectancy = 53 years 
14% of children die before age 5 
Maternal mortality 5th worst 
350 doctors for 8.5 million 
BURUNDI
94% average improvement 
in quality of care since 
beginning of partnership 
Less than $ 1 per patient 
annually 
INNOVATIONINCREDIBLE IMPACT 
! 
45 
clinics 
850,000 
patients/year 
6 
denomination 
s
Whenever you enter a town…Heal the sick in it and say to them, ‘The Kingdom of God ahs come near to you.’ 
Luke 10:9
•Nurses make up 50-80% of the health care work force worldwide (PIH, WHO) 
0 
1000 
2000 
3000 
4000 
5000 
6000 
7000 
In Buj 
In Rural 
4728 in Rural /1229 in Bujumbura 
Why Nurses?
Most Continuing Education 
Bujumbura
LifeNet Trains and Mentors
Medical Training
Results in Quality 
94%
Average increase of 42% in pre/post test scores for LN medical training lessons in 2013 
0% 
5% 
10% 
15% 
20% 
25% 
30% 
35% 
40% 
45% 
50% 
Jan-13 
Feb-13 
Mar-13 
Apr-13 
May-13 
Jun-13 
Jul-13 
Aug-13 
Sep-13 
Oct-13 
Nov-13 
Dec-13 
Pre/Post Test Score % Change 2013 
Results in Knowledge
•86% of LN partners increased their patient volume over the course of their LN partnership 
•Patient volume increase in first year of partnership 
•Monthly average Clinic volume: ~1,580 
LN Partner Clinics 
Non-Partners 
52% 
30% 
Results in Numbers
Before 44% After 79% 
Hand-washing
Before 62% After 91% 
Clothes to Newborns
Before 29% After 97% 
Explaining Treatment to Patients
Before 79% After 100% 
Documenting APGAR Scores
Before 21% After 97% 
Infant Resuscitation
Behavior Change 
Trust 
Majority of Staff On- site Trained 
Personalized Training 
Friendship 
Language and Culturally Sensitive Teaching 
Why are we effective?
•Photo 
“Guherekeza”
Growth Goals: Vision 2020 
20MM 
patient visits* 
1,000 
clinics 
Today 
45 Partner Clinics 850,000+ patients* 
* annually
Partnership Transforms Care Walk with us. 
10 Countries 
1,000 Church-based Partner Clinics 
20 million 
Annual Patient Visits
Transforming African Healthcare www.LNinternational.org

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Ccih 2014-accompaniment-healthcare-maggie-ehrenfried

  • 1. Partnership Creates Change: Why one-time educational training interventions in primary care are just not enough in rural East Africa Dr. Maggie Ehrenfried, PT, DPT Development Officer LifeNet International CCIH Conference June, 2014
  • 2. LifeNet International transforms African clinics to provide quality, sustainable care. Life expectancy = 53 years 14% of children die before age 5 Maternal mortality 5th worst 350 doctors for 8.5 million BURUNDI
  • 3. 94% average improvement in quality of care since beginning of partnership Less than $ 1 per patient annually INNOVATIONINCREDIBLE IMPACT ! 45 clinics 850,000 patients/year 6 denomination s
  • 4. Whenever you enter a town…Heal the sick in it and say to them, ‘The Kingdom of God ahs come near to you.’ Luke 10:9
  • 5. •Nurses make up 50-80% of the health care work force worldwide (PIH, WHO) 0 1000 2000 3000 4000 5000 6000 7000 In Buj In Rural 4728 in Rural /1229 in Bujumbura Why Nurses?
  • 10. Average increase of 42% in pre/post test scores for LN medical training lessons in 2013 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Pre/Post Test Score % Change 2013 Results in Knowledge
  • 11. •86% of LN partners increased their patient volume over the course of their LN partnership •Patient volume increase in first year of partnership •Monthly average Clinic volume: ~1,580 LN Partner Clinics Non-Partners 52% 30% Results in Numbers
  • 12. Before 44% After 79% Hand-washing
  • 13. Before 62% After 91% Clothes to Newborns
  • 14. Before 29% After 97% Explaining Treatment to Patients
  • 15. Before 79% After 100% Documenting APGAR Scores
  • 16. Before 21% After 97% Infant Resuscitation
  • 17. Behavior Change Trust Majority of Staff On- site Trained Personalized Training Friendship Language and Culturally Sensitive Teaching Why are we effective?
  • 19. Growth Goals: Vision 2020 20MM patient visits* 1,000 clinics Today 45 Partner Clinics 850,000+ patients* * annually
  • 20. Partnership Transforms Care Walk with us. 10 Countries 1,000 Church-based Partner Clinics 20 million Annual Patient Visits
  • 21. Transforming African Healthcare www.LNinternational.org