doctHERs: How professionally marginalised, home-restricted female doctors can provide Lady Health Worker-Assisted Telemedicine in Urban Slums & Remote, Rural Communities...

NAYA JEEVAN

[ 391 Votes ]

Pakistan

Organization Type: Civil Society | Category: Internet for Development

Project Summary

doctHERs is a novel healthcare marketplace that connects home-restricted female doctors to millions of underserved patients in real-time while leveraging technology. doctHERs circumvents socio-cultural barriers that restrict women to their homes, while correcting two market failures: access to quality healthcare and women's inclusion in the workforce. doctHERs leapfrogs traditional market approaches to healthcare delivery and drives innovative, sytems change. For example doctHERS can access urban/rural patients through mobile and internet enabled technologies/vídeo-conferencing • Trained, trusted community Nurses/ Health Workers/Midwives assist DoctHERS in assessing patients at ‘point-of-care’ using diagnostic tools which create a new ‘healthcare value chain’ • doctHERs can work across the healthcare sector: operate 24/7 tele-healthlines, conduct medical/claims reviews, contract services to health plans (PPOs, health insurance companies), promote health/wellness coaching and trainings via web, IVR-enabled health modules or SMS-enabled localized health messaging.

Over the past 18 months, doctHERs has provided ICT-enabled telehealth services in Sultanabad, an urban slum of 250,000 lives in Karachi which is inhabited by marginalised migrant workers. Over the past 6 months, doctHERs has opened 3 community-based clinics and 1 retail pharmacy clinic to cater to the unmet needs of informal workers and marginalised communities.

Background

70% of 2013 medical school graduates in Pakistan were women, yet only 25% are currently practicing medicine due socio-cultural constraints that exclude them from the workforce. In the same Pakistan, 95% of women living in poverty can not access affordable, quality healthcare and have never seen a qualified female doctor. Stuck in this status quo, millions of marginalized women face unnecessarily high maternal-child mortality/morbidity, sadly in the presence of a surplus of under-utilized but qualified female doctors who have historically been unable to reach them. The silver lining to this cloud is that the country has 85% penetration of access to mobile & internet technology. Given the significant demand-supply mismatch between female doctors and patients in underserved communities, it behooves us to question how can we leverage the full potential of information and communications technology to bridge this gap?

Justification

There are 3 specific reasons why our organisation initiated this project:

(i) we wanted to retain highly talented female medical staff in our own organisation who otherwise would have taken an extended leave of absence to have children or spend additional time with their families, etc.

(ii) we recognised that this supply-demand mismatch (market failure) would continue unless we innovated an ICT-based solution to bridge the health human resource gap.

(iii) We are committed to gender equality (60% of our senior management are women) and doctHERs is very much aligned with our core philosophy and mission to promote the socioeconomic inclusion of women as a fundamental right.

This project nominated to the ISIF Asia award because…

doctHERs is the first ICT-enabled model anywhere in the world (that we are aware of) that specifically and exclusively integrates home-based female medical health providers who have otherwise been excluded from the health workforce. In addition, it provides skills-training and gainful employment for community-based lady health workers (LHWs), community midwives and nurses in remote, rural communities and connects them to urban-based doctHERs via telemedicine in a manner which creates significant impact and tangible value for end-users/beneficiaries.

Team

One of the co-founders of doctHERs, Dr. Sara Khurram, spearheaded the project management team that has implemented the doctHERs project. doctHERs has collaborated with an ICT tech partner (Tech-4-Life) that has expertise in telemedicine. In addition, doctHERs has collaborated with a grassroots-level, community-based organisation (Sustainable Development Initiatives) to launch a nurse-assisted telemedicine clinic in an urban slum (Hijrat colony) in Karachi, where women residents were not previously able to access quality healthcare.

Objectives

(i) Connect home-restricted female health professionals to marginalised communities (especially women and children) who lack access to quality, affordable healthcare

(ii) Train and Capacitate community-based nurses/midwives and Lady Health Workers on how to provide communities in urban slums and remote rural areas with access to doctHERs via smart phone or tablet-assisted video consultation.

(iii) Expand the network of doctHERs to ~500 home-based female physicians who are re-integrated into the workforce.

(iv) Expand the provision of quality primary care to ~36000 patients (and 24000 female patients/year) in communities which have historically been deprived of this right.

Technical details and contribution to innovation

ICT-enabled video-consultation with peripheral remote diagnostic instruments connected to a telemedicine software platform that links to the video.
ICT-enabled 24/7 Telehealth (healthcare delivered via mobile phones)
Electronic Health Records (of patients visiting clinics or using doctHERs)
ICT-enabled Clinical Management System

Activities

(i) Conduct preventive health workshops delivered by video for 5000 urban slum dwellers
(ii) Provide 7500 patients with high-quality primary care - 600 complete
(iii) Establish a telemedicine-equipped Community Health Center in Sultanabad - Complete
(iv) expand network of doctHERs clinics to 10 - 4 complete

Outcomes

Telehealth-facilitated OB/GYN consultations have led to 70+ safe hospital deliveries • 500 lives have been saved by providing them with access to life-saving interventions/surgery

Additional impacts include:

(i) a network of 25 female doctHERs have been re-integrated into the workforce

(ii) 5 Monthly health surveillance screenings have yielded detection of 3 cases of cancer, 15 cases of hepatitis and 32 cases of cardiovascular risk in the target population...

Publications and dissemination efforts

• PBS Newshour
http://www.pbs.org/newshour/bb/world/jan-june11/pakistanhealth_05-23.html
• Christian Science Monitor
http://www.csmonitor.com/World/Making-a-difference/2011/0328/In-Pakistan-Asher-Hasan-brings-innovation-to-health-care-cost-at-1.80-per-month
• Forbes
http://www.forbes.com/global/2010/0719/creative-giving-asher-hasan-health-care-native-son.html
• Fast Company
http://www.fastcompany.com/1690237/five-innovators-heading-cgi-naya-jeevan-doctors-rx-micro-insurance
• Stanford Social Innovation Review
http://www.ssireview.org/articles/entry/hmo_for_the_poor
• Center for Health Market Innovations
http://healthmarketinnovations.org/program/naya-jeevan?display=izpb
• Foreign Policy Magazine
http://afpak.foreignpolicy.com/posts/2012/07/11/the_doctor_isnt_in

Awards and distinctions

2014: VISA Innovation Award 2013: GE/Changemakers Innovation Award - Women Moving Work in MENA 2013: Rockefeller Foundation Centennial Innovation Challenge 2012: G20 Financial Inclusion Challenge Award 2012: Wall Street Journal Asia Innovation Award Finalist 2011: WEF/Schwab Foundation Asia Social Entrepreneur of the Year

Website

http://www.njfk.org and http://www.docthers.com

YouTube movie about the project

http://www.youtube.com/watch?v=Iol8AFLDYT8

profile or page from the organization or project leader

https://www.facebook.com/nayajeevan

profile from the organization or project leader

N/A

profile from the organization or project leader

N/A

Project Representative

Dr. Ashar Hasan

Project Representative on

http://www.linkedin.com/profile/view?id=7200652

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