Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Tiyatien Health 2012 Annual Report

563 views

Published on

Taking on the challenge others deemed impossible, Tiyatien Health has continued to provide quality health care through our Frontline Health Worker model. From continuing to strengthen our model to introducing our new site in Konobo, Tiyatien Health has accomplished much this year. Read this report and reflect on the progress and innovation of this past year.

  • Be the first to comment

Tiyatien Health 2012 Annual Report

  1. 1. Tiyatien Health A: PO Box 426133, Cambridge, MA 02142 M: info@tiyatienhealth.org W: www.tiyatienhealth.org T: @tiyatienhealth Tiyatien Health is a 501(c)(3) nonprofit 2012 corporation and a Massachusetts public charity.
  2. 2. TIYATIEN HEALTH IS PIONEERING TABLE OF CONTENTS INTRODUCTION NEW MODELS Letter from the Executive Director Last Mile Villages Our Model 4 5 7 OF HEALTH TWENTY-TWELVE FHWs 2012 National and Global Impact 10 11 DELIVERY Philip Collins: The Road to Recovery 13 Konobo and Strategic Plan for Scale 15 Honors and Publications 17 FOR LIBERIA’S FINANCE AND LEADERSHIP Financial Review Board and Partners 19 21 LAST MILE CONTACT Back Cover VILLAGES.1 2
  3. 3. President Bill Clinton recognizing Tiyatien Health’s Commitment To Action at the 2012 ClintonGlobal Initiative, with Medic Mobile and Liberia’s Minister of Health and Social Welfare,Honorable Dr. Walter Gwenigale (far left). Dear Friends, We are often told it is "too expensive", "too difficult", or even "impossible" to deliver health care to women and children living in remote, last mile villages, where the danger of falling sick is greatest and the chance of accessing treatment is lowest. But, having grown up in a country formerly written off as hopeless, I can tell you that those who say, “It cannot be done," can be proven wrong. Coming out of decades of civil war, Liberia, my home country, suffered a deadly HIV epidemic. Weafus Quitoe, Alphonso Mouwon, and Raj Panjabi Sick people in rural areas were written off as unreachable and left to die without treatment. In response, Tiyatien Health (TH) and the Liberian Having grown up in a country Government joined forces to launch the country’s formerly written off as first rural HIV/AIDS treatment program in 2007. At the time, some called the idea hasty and unwise. hopeless, I can tell you that Yet earlier this year, TH and the Ministry enrolled the program’s 500th patient, and 19 other sites those who say, “It cannot be around the country now use our model for treating done," can be proven wrong. HIV/AIDS. This year, TH faced another seemingly impossible challenge.  The Liberian Government invited TH to bring comprehensive health care to women and children in Konobo District. In Konobo, a district sixteen hours from the capital, mothers would have to walk up to two days to access care. It was a place where no organization would go.   After months of assessment and planning, TH did what others had deemed “too difficult” and launched “…this work on systems building…in the end will our program in Konobo. Today, women and children in Konobo are receiving quality care from frontline health workers for the first time in history. In the next five years we hope to hire 300 more frontline health workers to cover Konobo and provide care to 150,000 people in several other remote districts.  have the biggest impact on whether people live Our goal is to one day create a national network of frontline health workers that will serve all 1.5 million of the women and children without access to care in my country. or die in large numbers.”   I want to thank all of you who have joined us in creating an unprecedented standard of care for Liberia’s last mile villages. As you read this report and reflect on the progress of the past year, I hope you will consider contributing to Tiyatien Health. Together, we can continue to save lives and make the impossible possible. — President Bill Clinton on Tiyatien Healths Dr. Raj Panjabi groundbreaking work in rural Liberia Co-Founder Executive Director3 4
  4. 4. AT TIYATIEN HEALTH, WE GO THE LAST MILE. 400 million people across the African continent go their entire lives without seeing a health worker. Nowhere is this crisis worse than in rural Liberia, where people in remote, last mile villages must walk up to two days to reach a health facility. These villages, communities, and people have been written off as too far and too difficult to reach. Where others have turned away, Tiyatien Health has pushed forward. Tiyatien Health believes that health is a human right, no matter where you live. By building a new model of frontline health workers, Tiyatien Health is providing high-quality, comprehensive health services to the most remote corners of Liberia.5 Two Tiyatien Health workers make the journey to a village in Konobo District, one of the most remote and least accessible locations in Liberia. 6
  5. 5. 21ST CENTURY FRONT LINE HEALTH WORKER < a professional health delivery network, door to door > STATUS QUO Around the world, people are dying in last mile villages because they live too far from hospitals and clinics. In response, Tiyatien Health is pioneering a 21st century Frontline Health Worker to bring health care directly into these villages. RECRUIT EQUIP MANAGE OUR IMPACT TH has modernized FHW recruitment with TH equips FHWs with the tools to deliver FHWs are supervised by nurses who a 5-step algorithm that assesses each unprecedented home-based services, taking ensure high-quality care through close candidate’s success in preliminary training full advantage of modern, handheld management and performance and hires only the most qualified. diagnostics and mobile health platforms. evaluations. Frontline Health Workers, professionally t r a i n e d a n d e q u i p p e d, p r o v i d e a n TRAIN INTEGRATE INCENTIVIZE unprecedented array of home-based services. TH rigorously trains FHWs to provide life- By integrating FHWs with the public health TH provides FHWs with performance- saving care for the top five killers of system, FHWs receive clinical support and based incentives which set delivery With this model, every person, no matter how women and children, using robust seamlessly refer patients to clinics for targets and reward the most successful. far from a facility, has access to high-quality curricula and one-on-one coaching. advanced care. health care.7 8
  6. 6. IN 2012, DELIVERED AND AS A RESULT 23 RECRUITED 22,715 92.9% EQUIPPED HOME VISITS ⇧ 34% TRAINED OF PATIENTS INTEGRATED MANAGED AND INCENTIVIZED + SURVIVED FRONTLINE HEALTH 1,713 AND STAYED IN CARE WORKERS DOT DOSES PER MONTH ⇧ 9% EACH MONTH FHWs 2012 THIS YEAR, TH NEARLY DOUBLED THE NUMBER OF CHRONIC 127 CARE PATIENTS SEEN BY FHWS BY MODERNIZING MANAGEMENT FHW Patients PRACTICES AND SETTING AMBITIOUS DELIVERY TARGETS FOR ⇧93% EACH FHW. TH ALSO INCREASED THE FREQUENCY AND DEPTH OF TRAININGS, EXPANDING THE ILLNESSES THAT FHWS ARE 3,643 Chronic Care EQUIPPED TO TREAT. WITH A REVAMPED CASE-FINDING Clinic Visits APPROACH, WE ENROLLED MORE EPILEPSY AND MENTAL HEALTH ⇧102% PATIENTS, WHO NOW REPRESENT MORE THAN ONE-THIRD OF ALL PATIENTS UNDER FHW CARE. ADDITIONALLY, ALONGSIDE THE MINISTRY OF HEALTH AND SOCIAL WELFARE, TH IMPROVED THE 99% Treatment LOCAL HEALTH FACILITY’S CAPACITY TO RESPOND TO PATIENTS Adherence IN NEED OF ADVANCED CARE. THE ZWEDRU CHRONIC CARE CLINIC AT MARTHA TUBMAN MEMORIAL HOSPITAL HAS EXPANDED INTO A NEW FOUR-ROOM FACILITY AND TH HAS LED 95% FHW QUALITY IMPROVEMENT INITIATIVES IN MATERNAL AND Retention NEONATAL HEALTH CARE.9 10
  7. 7. "Tiyatien Health is the only organization looking at how to bring HIV care into the community from the clinic. We all need to learn from them to bring this model to the whole country." - Dr. Ivan Camanor, Executive Director, National AIDS Commission, Republic of Liberia GOING BIG CHANGING THE WAY THE WORLD DOES VILLAGE HEALTH NATIONALLY 1.3 million Tiyatien Health partners closely with Liberian policymakers to improve community-based services throughout the country. TH helped the National PARTNERING FOR SCALE In April 2012, TH completed the first phase community health workers serve AIDS Control Program adopt our monitoring and of a two-year national project to replicate evaluation system for home-based services as their patients around the world, but national database. Additionally, TH was invited onto our FHW model for HIV/AIDS patients across the country. In partnership with the the steering committee to help write the 2011-2021 many are poorly trained and Liberian National Health Plan. Liberian Ministry of Health and Social Welfare (MoHSW) and the Global Fund, asked to volunteer, resulting in nineteen health facilities launched TH’s sub-par performance. By sharing package of training and supervision to treat people living with HIV. These FHWs kept our best practices nationally and GLOBALLY more than 94% of HIV patients alive-and- in care each quarter, more than tripling the globally, Tiyatien Health is TH has worked with the Clinton Global Initiative, national baseline rates of 28% (MoHSW modernizing community health USAID, and Partners In Health to share and scale data, May 2011). lessons from community health worker models. worker practices around the world. TH’s work has also been brought into the 19 57,894 94% classroom, as part of new global health curricula at HOME ALIVE AND PROJECT Harvard Medical School and Massachusetts General SITES VISITS IN CARE Hospital.11 12
  8. 8. Whatever it takes. Philip Collins and his road to recovery Philip Collins, one of THs FHWs and a former patient, embodies TH’s mission and philosophy through his deep commitment to providing for sick and impoverished communities. This June, Philip was in a devastating motorbike accident that threatened his life and ability to continue serving his patients in Liberia. In March of 2007, Philip laid emaciated in his village, dying of AIDS. Fortunately, that same month, TH and the Liberian Ministry of Health opened Liberia’s first rural HIV clinic in Zwedru, and Philip became one of the country’s first patients to receive antiretrovirals outside of the capital. Philip survived because of his treatment, going on to thrive as a community leader and a vocal advocate for patients like himself. Upon the recommendation of his Frontline Health Worker, Philip joined a support group for HIV and soon became one of the group’s leaders. Seeing many patients who needed nutritional and economic support, Philip and the group built a farming cooperative that now provides for its members and their families. Philip trained to become an FHW in 2009 and now provides the same life-saving care that he received to over 500 pateints every month. This year, Philip found himself once again fighting for his life and beyond the reach of medical care. Returning home at dusk, Philip was in a motorbike accident in which he suffered multiple, life-threatening open fractures. His injuries required intensive orthopedic surgery that was unavailable in Liberia. “In caring for the Around the world, the Tiyatien Health community mobilized to get Philip the sick and poor, we best care the world had to offer. With help from dozens of supporters, the Brigham and Women’s Hospital, Partners In Health, Spaulding Rehabilitation can save the world.” Hospital, and the Ray Tye Medical Aid Foundation, Philip traveled to Boston for -Philip Collins, FHW multiple operations performed by leading orthopedic surgeons. Months later, Philip is now walking – a feat that we all feared would never be possible after his accident. He is eager to return to Zwedru this January to share with others the same compassionate care- giving that he witnessed firsthand in Boston. According to Philip, “In caring for the sick and poor, we can save the world.”13 14
  9. 9. THE ROAD (1) 2012 { PILOT (2) PROVE Pilot a comprehensive FHW primary care program in the most (3) SCALE 2014 { Partner with government to replicate the AHEAD 2014 challenging district [Konobo] and prove dramatic increases in survival 2017 Konobo model to 10 priority districts. The district of Konobo is home to the most remote villages in West Africa’s 46% 12% 300 150,000 largest rainforest, which until now have of women have lost of women give When Tiyatien Health partnered with the been written off as unreachable. The a child to disease birth in clinics Liberian government to establish the first HIV district’s only health facility is inaccessibly far for most 225 112,500 treatment site in rural Liberia, TH did what others had said was impossible, with far residents, and Konobo’s women and children have 6 hours 11% average travel of children better results than were ever expected. some of the worst health time to clinic immunized 150 75,000 indicators in the country. In 2012, Tiyatien Health launched a strategic planning process by consulting patients, In two years, we plan to provide primary 75 37,500 staff, and partners around the world. The process culminated in a five-year strategic care for 100% of Konobo residents plan to spread our model and scale our by building a new health system with 0 2012 2013 2014 2015 2016 2017 0 ideas. Frontline Health Workers at its core. # of FHWs # of People Served15 16
  10. 10. PUBLICATIONS ‣JOURNAL OF GLOBALIZATION AND HEALTH, AN ANALYSIS OF LIBERIAS 2007 NATIONAL HEALTH POLICY: LESSONS FOR HEALTH SYSTEMS STRENGTHENING AND CHRONIC DISEASE CARE IN POOR, POST-CONFLICT COUNTRIES (OCTOBER 2011) ‣PLOS MEDICINE, COMPARATIVE PERFORMANCE OF PRIVATE AND PUBLIC HEALTHCARE SYSTEMS IN LOW- AND MIDDLE-INCOME COUNTRIES: A SYSTEMATIC REVIEW (JUNE 2012) ‣XIX INTERNATIONAL AIDS CONFERENCE, AN ANALYSIS OF LIBERIAS NATIONAL HEALTH POLICY AND HIV/ AIDS PROGRAM: LESSONS FOR HEALTH SYSTEMS STRENGTHENING AND CHRONIC DISEASE CARE IN POOR, POST-CONFLICT COUNTRIES (JULY 2012) HONORS ‣THE MULAGO FOUNDATION, 2011-2012 RAINER ARNHOLD FELLOWSHIP ‣HARVARD GLOBAL HEALTH DELIVERY PARTNERSHIP, SUPPORTED INITIATIVE ‣USAID COMMUNITY HEALTH WORKER EVIDENCE SUMMIT 2012, INVITED EXPERT ‣ECHOING GREEN, 2011-2012 FELLOWSHIP PRESS ‣CLINTON GLOBAL INITIATIVE 2012, GLOBAL HEALTH WORKFORCE COMMITMENT CLUSTER, HIGHLIGHT BY FORMER PRESIDENT BILL CLINTON (09/25/12) ‣WALL STREET JOURNAL, MASIMO ANNOUNCES $1 MILLION COMMITMENT TO ACTION WITH THE CLINTON GLOBAL INITIATIVE TO SOLVE MATERNAL MORTALITY & ANEMIA (09/25/12) ‣UNHCR NEWS, GIVING BACK: LIBERIAN HEALTH WORKER CARES FOR DISPLACED IVORIANS. (12/22/11) A Frontline Health Worker performs a basic health assessment, one of17 the first steps towards providing care. 18
  11. 11. FINANCIAL REVIEW Statement of Tiyatien Health’s broad base of grassroots support, major donors, and partnerships contributed to an unprecedented level of support in fiscal year 2012. This increase in revenue was maximized towards program costs as we kept a low 10% overhead. We Financial Activities June 30, 2012 ended fiscal year 2012 with net assets of $289,003, much of which will be spent down during our programmatic launch in the Konobo District. REVENUE Individuals and family foundations $ 363,965 Additional financial highlights include: Foundations and corporations $ 149,036 • Partnerships for our Boston office: In fiscal year 2012, our full-time Boston Gifts in kind $ 214,481 staff grew from one person to a team of four. Investments from the Global Health Corps and the Echoing Green Fellowship covered more than 87% of the Total Revenue $ 727,482 costs associated with these staff, maximizing all donations towards programmatic costs in Liberia. EXPENSES 4% 6% Program Services $ 440,363 5% • In-kind donations: This year, Tiyatien Health partnered with Direct Relief 3% International to send more than $214,000 worth of medicines and supplies to Development $ 20,649 southeast Liberia. In the years to come, our partnership with DRI will allow us to 6% procure the world’s best medicines and equipment, which would otherwise be Management $ 29,833 unaffordable.  Total Expenses $ 490,846 • Advanced financial systems: Our financial systems have matured as our revenue has grown. In fiscal year 2011, we launched a professional Quickbooks Change In Net Assets $ 236,636 accounting system that allows for accrual-based financial tracking and finer Net assets at beginning of year $ 52,367 budget analyses, both of which are crucial for maintaining our commitments to 76% funders and patients alike.  Net assets at end of year $ 289,003 $800,000 $600,000 Tiyatien Health’s Liberian sister organization secured an additional Development Gifts in-kind $154,342 that is not represented in these figures, including major grants Management $400,000 Foundations and corporations from the Liberian Ministry of Health’s Pool Fund and The Global Fund to Programs - Boston Individuals and family foundations Fight AIDS, Tuberculosis, and Malaria. Programs - Monrovia $200,000 Programs - Konobo These figures are prepared from unaudited statements. Programs - Zwedru $0 FY2010 FY2011 FY201219 20
  12. 12. Since our founding, TH has worked in close partnership with the Liberian Ministry of Health & Social Welfare to strengthen the public sector in rural Liberia. Below, TH’s Medical Director, Dr. Jean Bosco Niyonzima, and a government nurse use a new Masimo Rad-57 Pronto (TM) device to conduct a ACTIONAID LIBERIA WE noninvasive hemoglobin screening. BRIGHAM & WOMEN’S HOSPITAL THE DAVID AND ANITA KELLER FAMILY FOUNDATION DHAR LAW, LLP DIRECT RELIEF INTERNATIONAL ECHOING GREEN CAN’T THE GLOBAL FUND TO FIGHT AIDS, TB, AND MALARIA GLOBAL HEALTH CORPS GLOBAL NEIGHBORHOOD FUND GLOBEMED AT UNIVERSITY OF MICHIGAN THE GREENBAUM FOUNDATION CHANGE HANDS TO HEARTS INTERNATIONAL HARVARD MEDICAL SCHOOL INVENEO IRVIN STERN FOUNDATION KANSAS WESLEYAN UNIVERSITY THE THE LESTER FUND LIBERIAN MINISTRY OF HEALTH AND SOCIAL WELFARE THE MASIMO FOUNDATION MASSACHUSETTS GENERAL HOSPITAL MEDIC MOBILE WORLD THE MULAGO FOUNDATION ONE HEART WORLD-WIDE PARTNERS IN HEALTH THE PRAXIS NETWORK RAINER ARNHOLD FELLOWS PROGRAM BY RAMSEY SOCIAL JUSTICE FOUNDATION THE RAY TYE MEDICAL AID FOUNDATION SEGAL FAMILY FOUNDATION STARKEY HEARING FOUNDATION US BOARD LIBERIA BOARD ADVISORY BOARD STILL HARBOR LYNN BLACK, MD, MPH NETUS NOWINE NANCEE OKU BRIGHT, DPHIL OURSELVES. UNHCR EDWARD CARDOZA, MA.MIN EISA HAMOUDA, MD LISA COOPER, MD, MPH UNIVERSITY OF CALIFORNIA - KATHERINE COLLINS, MTS LORENZO DORR PETER EHRENKRANZ, MD, MPH SAN FRANCISCO KIM KELLER, MSC PAUL FARMER, MD, PHD WORLD DANCE SANTA BARBARA JOIA MUKHERJEE, MD, MPH ROBERT LAWRENCE, MD RAJESH PANJABI, MD, MPH PATRICK LEE, MD AMISHA RAJA, PSYD21 LESLIE VENSEL, MD (CHAIR) 22

×