2019 Annual Report (5)

follow-up and continued care, and counseling. Both of Possible Health?s hospitals see upwards of 150,000 patient visits,
6,000 surgical procedures, and 2,000 inpatient visits annually. Bayalpata Hospital sees between 400- 600 patients per
day. The Schooner Foundation?s past funding has been instrumental in helping Possible Health refine their integrated
healthcare delivery approach, evaluate its impact and lay down the strategy and foundation to scale their solutions.
Following the 2015 earthquake that devastated much of Nepal, Possible initiated work in Dolakha to bring its work to the
region. Possible designed and implemented a professionalized community health worker program to make healthcare
more accessible to remote communities. This is also where Possible developed NepalEHR, the first-of-its-kind electronic
health record to improve efficiency in care delivery and establish a culture of data use for decision-making among
healthcare providers and managers. We saw firsthand how CHWs used a smartphone app to gather information on their
mobile phones. Each rural household has been labelled with a small blue house number attached to the
house(untraditional and uncommon for many of these communities) for identification purposes. To date this information
has been housed in a separate database. In the coming months, the app and database will be synched with the
NepalEHR system,a large milestone in the organization.
During the course of the multi year Schooner Foundation grant, Possible began an evaluation of their professionalized
Community Health Worker (CHW) program, in collaboration with the Nepal Ministry of Health. Prior to this professionalized
CHW model, some of the duties of the CHWs were performed by community health volunteers, mostly women who were
nominated by their peers to serve their community. We were able to meet some of these volunteers during our site visit.
By professionalizing the role of CHW, Possible has taken a commendable step in gender equity in Nepal by providing
these women financial stability and empowering them within their community.
Once completed, the study will demonstrate what the impact of a professionalized CHW network supported by strong
facilities has on reproductive, maternal, newborn and child health (RMNCH) outcomes. Data collection for the study is
expected to be completed by July 2019, and Possible hopes that the evidence generated will strengthen the case for a
professionalized and paid CHW cadre to be deployed through the public health sector in Nepal to support the
Government?s mandate of healthcare for all.
INTEGRATED HEALTHCARE DELIVERY APPROACH AND IMPACT
Possible Health?s integrated healthcare delivery approach is a direct response to the gaps they have observed as a public
sector provider. Specifically, Possible has identified the following five components as essential to quality, equitable and
effective healthcare:
I. Home-based care by community health workers for proactive, longitudinal service delivery;
II. Technology and systems-based enhancements at the facility level to alleviate the quality gap in public health
facilities;
III. Systems for data collection, aggregation and utilization to enable providers and program managers to identify and
adapt to shifting needs and service gaps;
IV. Value-based healthcare principles to improve financial risk protection for people accessing care while reducing
overall health system costs; and,
V. Patient-centered healthcare focused on longitudinal care of patients and families.
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