Maternal Care for a Healthier Society

Delivery Room in Achham

This year, Tufts’ GlobeMed chapter has committed to raising money to improve the quality of maternal care provided for the people of Achham by the interventions of Nyaya Health. Since pregnancy is a perfectly normal condition in a healthy woman’s life, and many women will give birth at least once in their lifetimes, it makes sense to direct the attention of a medical facility in this direction.

The value of meticulous prenatal and perinatal care is impossible to overstate; an improvement in the monitoring and treatment of expectant mothers lays the groundwork for the raising of healthy children and the development of a healthier society. As a chapter, it is our hope that the improvement in resources generated by our fundraising efforts allows the medical team at Bayalpata Hospital to provide the expectant parents of Achham with the best care possible.

Presently, Nyaya Health provides for the implementation of routine prenatal and delivery services, including tests for anemia and HIV, standard delivery with the assistance of a qualified midwife or physician. There are also provisions for dealing with relatively common peripartum complications such as pre-eclampsia, obstruction of labor, and breech deliveries.

With increased funding, Nyaya Health is looking to increase the number of services available to pregnant women, specifically in the realm of administering preventive care and treating minor complications during delivery. The medical team hopes to further limit maternal mortality and ensure that as many births as possible occur healthfully and without harm to mother or baby.

A Dialog with Data

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From January 2012 to June 2012, 54% of the patients seen in Bayalplata Hospital came from village development communities (VDCs) within the Community Health Program’s “catchment area.” The graph below depicts the frequency of ER cases based on VDC. Note that the VDCs in red are ones that are not part of the current catchment area.

Data can tell a story. It can tell you about people’s lives, about your own life. It can tell you about a country, or a community or a business. It can tell you a great deal about how to best serve a population, and about the factors that impact a person’s health. At Globemed at Tufts, we believe that data has the power to make a difference, you just need to step back and take a look.

This post is the first part in a series called “Dialogue with Data” on what the data that Nyaya Health collects is telling us. The series is written by the Globemed at Tufts data team which has the privilege to review some of the data that Nyaya collects in order to find any patterns or trends that might exist. Each week another post will be published that will attempt to tell a story about Nyaya and their patients.

We’ve learned something from looking at this data, we hope you will too.

What does every human deserve?

It’s a simple question with some very complex answers. Our mission is to inspire people to turn these answers into solutions. Come to our advocacy event co-sponsored by Tufts Engineers without Borders for a panel of global health experts who have worked with organizations like GlobeMed, Partners in Health, The Millennium Campus Network, and Nyaya Health.

Join us this Friday at 4:30pm in Robinson 253 to learn about how to turn our ideas about the basic and not so basic things every human deserves into action.

Data + People = Change

The above video describes the Medic Mobile initiative being implemented in Bayalpata Hospital. Medic Mobile in Nepal is intended to serve as a model for other countries. Through the input and retrieval of data via mobile phones, Medic Mobile can help provide information about essential public health services among community health workers, and improve these services through the availability of this data. Watch the video to learn more about this powerful movement.

Caring for Children

Recently, in an effort to increase visibility and attain more data necessary to continuously improve their standards of care, the Nyaya Health members at Bayalpata Hospital began collecting data specifically focusing on the admittance and treatment of young patients. The hope is that the collection of these facts and figures will allow the organization to progress in its treatment of this especially susceptible population.

While certain challenges arose throughout the process of data entry—a difficult task to accomplish efficiently without computers—the physicians and health assistants pressed on. When keeping paper records was found to be unsuitable, the health assistants at the hospital were given the opportunity to practice using laptops, as they would for data entry in the future, which, fortunately, made the whole process much smoother and more effectual.

These efforts show a cognizance of and sensitivity to the reality of health care procedures not found in many health organizations. The consistent implementation upon evidence-based programs is laudable and will surely contribute to Nyaya Health’s continued success in its ultimate goal: furthering the cause of equity in global health care.

This specific direction for the gathering of data is only the beginning. As Nyaya Health’s director of data and evaluation, Jackie Pierson, wrote in a blog post on her organization’s website, “Future programs and services will be revised based upon the data we gather in this initial phase.”

Please Support Nyaya Health in the Chase Community Giving Contest!

GlobeMed at Tufts partner organization, Nyaya Health (www.nyayahealth.org), is an international NGO founded by Yale medical students in 2008 to improve access to health care in the remote, rural Achham district in Far West Nepal. Nyaya Health’s mission is to realize the right to health care by delivering transparent, data-driven health care for Nepal’s rural poor. Today, in partnership with the government, Nyaya operates out of Bayalpata Hospital in Achham to provide free, community-based care. They employ Community Health Workers andCommunity Health Worker Leaders to reach community members in 9 counties in Achham.
Nyaya Health has entered the Chase Community Giving contest, and we need your votes to win the $250,000 grand prize to expand our work to 5 clinics in rural Nepal. Expansion to these clinics will strengthen the Community Health Worker Program by increasing access to care. Please vote at http://bit.ly/votefornepal, and SHARE this image telling your friends why you are voting to make progress possible in Nepal.

We are a Network.

Last weekend I had the privilege of attending the 5th meeting of the Clinton Global Initiative University. CGIU, brought together over 1000 student leaders and professionals who are commitment to making a difference in the world.

At the conference, I had the pleasure of connecting with Maya Cohen, the executive director of Globemed as well as a number of other members of the Globemed National Team. I was also able to speak with members of other Globemed chapters such as the GW and Columbia Chapters.

One of the main topics we discussed was how we can really become a network. Globemed has done incredible things since its founding. It has spread to nearly 50 chapters across the country, engaging hundreds of students, and raising tens of thousands of dollars for a wide range of partners around the world. It is amazing how many people care about the fight for global health equity and who are willing to devote so much time to the cause. However, if we are to truly maximize the work that we are doing, we need to find a way to work together.

Right now, all the chapters know of the existence of other chapter. Chapter presidents have phone calls with other chapter presidents in order to learn from one another. Globemedders attend Hilltops, GROW Training’s, and Summit in order to meet each other in person and to learn from experts in the field. While this is a form of networking, many of these connections have not yet resulted in tangible change.

One of the greatest assets that Globemed brings to the global health movement is the potential to be a network. As students, we don’t have all the knowledge about health interventions. We do not have as much experience as experts, or our partner, which is why we don’t presume to know the answer to every problem. Our partners are the best suited to make a difference in their communities, not us. What we can bring however, is a connection to a much larger network. As college students, we have access to a breadth of different connections ranging from school officers and professors to family members.

Lets say that one globemed member has connections to 5 different resources that can be of value both internally and externally (a potential donor, knowledge of sanitation interventions from class, a professor who works with bed nets, experience with web design, etc…). This one person is connected to the 30 members of their chapter, each of whom has another 5 connections. Now lets say that this chapter’s connections are made available to 50 other globemed chapters in the country, all with their own connections.
With some simple multiplication, that means that a single chapter can connect their partner to 7,500 different resources that may be of use to them. We just need to connect with one another.

In order for the movement towards global health equity to become successful, we need to find a way to take advantage of this multitude of connections. We need to go beyond talking about being a network, to actually being a network that can share resources to one another.

The Tufts chapter is committing itself to this end. Check back soon for the start of new initiatives to make this happen.

Pushing the Envelope: Turning the Impossible into the Possible

On February 29th, our Globemed chapter here at Tufts had conference call with Gregory Karelas, the Country Director of Nyaya Health and Mark Arnoldy, the Executive Director. After some difficultly with the internet connection in Nepal, we able to speak with them over our President’s speaker phone. It was grounding to speak with Gregory, who currently works and lives at Bayalpata Hosiptal in Acham, Nepal. He gave a detailed description of the landscape near the Hospital and shared stories from his day-to-day life as the Country Director. He shared some of the challenges, for example how difficult it is to recruit a permanent to doctor work at Bayalpata Hospital, and some of the recent successes of the organization. In the last seven months, the hospital staff has grown by 25% and on the 25th Nyaya broke ground for its new surgical center. He also reported that this year has seen many more patients than the last, and almost double the amount the hospital saw in two years ago.

It was incredibly inspiring to speak with two men so dedicated to gaining health equity in Acham, Nepal. Gregory explained how government officials frequently question Nyaya’s ability to create a sustainable, yet free clinic, and he pointed out that Nyaya has successfully created a free and growing hospital in five years. “We’re really pushing the envelope,” he said.