Establishing Reliable Healthcare Systems
Empowering Local Communities in Building a Reliable Healthcare System
We are working on creating a healthcare delivery system tailored to rural areas by utilizing the power of "community" and "technology," with a focus on ensuring access to essential healthcare in regions facing a shortage of medical resources.
By implementing a system operated by local residents, we aim to establish an affordable and sustainable mechanism for reliable healthcare that can be relied upon by everyone.
Empowering Local Communities in Healthcare Delivery
Community-Based Care
Community health workers, employed from within the community, utilize the dedicated smartphone-based questionnaire app, "ASHAConnect," to visit and provide care to pregnant women, children, and individuals with lifestyle-related illnesses. By having locals involved, we create an environment where the workers can connect closely with the community residents.
Facility-Based Care
When facing difficulties, we encourage individuals to seek care at nearby healthcare facilities. To ensure access to a certain level of healthcare without the necessity of traveling to distant medical institutions, we are working on improving the healthcare delivery system.
In Nepal, patients generally take a paper copy of their medical records home, and medical facilities only have basic ledgers. However, only 10-20% of patients bring back their records during follow-up visits. Consequently, healthcare providers often find themselves starting from scratch with each consultation. To address this issue, we are leveraging technology to create an environment where patients can maintain their health information while ensuring that essential data is stored at medical facilities."
Leveraging 'Technology' to Support Healthcare Delivery
We are developing a smartphone-based interview app, "ASHAConnect," for community health workers and an electronic health record software, "NepalEHR," for healthcare facilities. Additionally, we are working on constructing a "Common Database" to integrate and store data acquired from ASHAConnect and NepalEHR. By combining these technologies, we aim to facilitate the expansion of healthcare services and provide regionally optimized health and medical services."
ASHAConnect
A smartphone-based questionnaire app designed for community health workers employed from the local region
Common Database
A storage system for the data recorded in ASHAConnect and NepalEHR
NepalEHR
Electronic Health Record (EHR) software designed for healthcare facilities, storing treatment and diagnostic histories as data
ASHAConnect
The smartphone-based interview app 'ASHAConnect' for community health workers is designed to address three areas: maternal and child care, infant care, and lifestyle disease care. Even in regions with limited access to healthcare facilities, it allows for home visits to individuals in need of care, providing basic healthcare services.
The app enables community health workers, who may not have extensive medical knowledge, to conduct appropriate guidance and identify risks through the interview process. By following the app's instructions during the interview, prompts for medication, lifestyle improvements, and recommendations for seeking medical attention are displayed. Additionally, the app allows for the management of educational content for community health workers and tracking of patients who need to be visited.
What ASHAConnect can do:
- Record home visits and interviews
- Manage activities
- Detect risks and issue alerts
- Provide health education for community health workers
Educational content includes:
- Lifestyle and environmental improvements
- Medication guidance
- Information on lifestyle diseases
- Preparation for childbirth
- Family planning, etc.
NepalEHR
NepalEHR, designed for healthcare institutions, is a software that allows recording patient diagnoses, treatment information, and other details in the form of electronic health records (EHR). In regions with limited medical data, this software is used for clinical consultations in healthcare institutions and remote medical services in rural areas, facilitating the consolidation of patient information. To ensure usability in environments with unstable power supply, appropriate setups are implemented, and the adoption of this software in healthcare institutions is being promoted. Additionally, it enables collaboration with medical institutions and pharmacies, making it possible to prescribe medications based on electronic health records.
Common Database
We are working on developing software that integrates and visualizes data from ASHAConnect and NepalEHR, using a unified ID assigned to individuals as the core. Additionally, we have initiated the development of dashboards for project administrators and local authorities to manage and utilize. By analyzing the integrated data through statistical dashboards in the Common Database, we aim to provide region-specific healthcare services.
Actual Activities
Community Health Workers (CHW)
These are paid health workers employed from within the community. They regularly visit pregnant women, those who have recently given birth, and patients with non-communicable diseases related to lifestyle. Using ASHAConnect, they check health statuses and provide counseling.
Regular training is conducted to ensure the health workers has the necessary knowledge. Well-informed health workers contribute to health education and encourage medical visits in the community. Currently, we have employed 12 people in the Rajapur district and 17 people in the Gadawa district, providing daily care to around 800 patients in the region (as of October 2023).
Activities of Community Health Workers
Information Gathering
Visits to medical institutions and communities to gather information.
Patient Listing
Compiling a list of patients, including pregnant women, infants, and those with lifestyle-related diseases.
Initial Visit
Conducting the first visit to understand the patient's health status.
Advisory
Consulting with project managers or specialists for care policies once a month or as needed.
Regular Visits
Monthly home visits to check health status, provide guidance, and refer patients to medical institutions if risks are identified.
Introduction of Healthcare Information Management Software
We have introduced healthcare information management software to address challenges such as 'patients forgetting or losing their paper records when returning for a follow-up visit' and 'lack of proper storage of information in medical institutions, leading to an inability to understand the current status.' Simultaneously, we leverage the current benefits of 'patients being able to retain their own health information' by implementing healthcare information management software.
While some large hospitals in Nepal use electronic health records (EHR), small-scale healthcare facilities in rural areas do not have such systems in place. Therefore, we work closely with the operations of small healthcare facilities in rural areas, customizing the software to create an environment for the electronic management of medical information.
By effectively managing medical information through optimized software, we contribute not only to the improvement of healthcare quality but also to reducing the workload of healthcare facility staff.
Additionally, since we provide patients with printed records, they can easily convey their medical history to healthcare professionals at other institutions when seeking medical care.
ID for Health and Medical Services
In Nepal, where there are many instances of identical names within communities and uncertainty about addresses and birthdates is common, we have assigned a unified ID (HealthConnect ID) to individuals. Under the supervision of Japanese experts, we have created ID cards for use in health and medical services. These ID cards are planned for distribution to all households in the project implementation area, and approximately 30,000 simplified cards have already been distributed (as of August 2023).
Related Content
Health Education
Commitment to Solutions
About Nepal
