2019 Annual Report (5)

strong history with key milestones in its development. It also has strong and
strategic global partnerships, ensuring that it stays abreast of the latest
thinking in the field.
The ratio of doctors to patients in Nepal is 1:10,000 and Clinical Health
Worker to patient is 1:778. Possible Health has diversified leadership with
decision making authority. 50% of their leadership are women, and most of
the leadership is from Nepal. The Physicians, staff, and leadership are all
highly educated, committed and skilled. Dr. Santoush Kuman Dhungana
(Provincial Director) is excellent. He will be moving the U.S, but a search has
already begun in Nepal for his replacement. Dr. Santoush will continue to
remain involved with Dr. Duncan Maru. We also met with SP Kalopunee, the
executive director who is very capable and worked in Government Relations
for many years. Ghaurav Tiwari, director of operations is also noteworthy.
Dr.Mandeep Pathak, the Orthopedic surgeon is highly skilled and relocated
with his wife to Achham. Dr. Bikash Gauchan is a Heal Fellow placed at the
hospital. I will have the opportunity to learn more about his work with
Possible when I meet with him at his U.S HEAL graduation in June. Link to
the Staff Bios
Possible Health grows and retains leaders, and demonstrates upward
mobility of its staff. The organization has a commitment to professional
development and capability building, including sending fellows to
opportunities including Global Health courses at Harvard, etc. They have a
Board and Advisory Council both in Nepal and the U.S. Particularly
noteworthy is that Possible Health implemented a Gender Equity and Social
Inclusion Committee (GESI) and hired a dedicated staff person, Subeksha
Poudel (Senior Manager of Communications and Gender Equity and Social
Inclusion). The committee and staff are working on many issues related to
Gender Equity and Social Inclusion, including the elimination of the practice
of Chhaupadi, where girls and women are banished to huts during
menstruation and are at risk of being bitten by snakes, raped, or death as a
result of smoke inhalation by burning cookstoves.
Possible demonstrates excellent reporting and impact data, a defined growth
and sustainability plan, and excellent Indicators of success and Impact. They
are strongly aligned with the Schooner Mission in Global Health. They are a
trustworthy and transparent Partner.
The Electronic Record System is unprecedented. It has customized templates, tracks wait times, number of visits,
treatments, lab results, hospital beds, patient flow and is linked to the billing systems. Even the pharmacy is kept up to
date so the doctor or nurse cannot prescribe a drug that is unavailable onsite. One of the practices we were particularly
impressed by was the Continued Medical Education Modules (CMEs) which took place every day for the staff. In addition
Possible uses Objectives Key Results OKRs and 360 reviews.
The Community Health Worker Model is moving from pilot to scale. As it scales up in other municipalities, the government
is covering some of the costs.
In the next five years Possible hopes that the national health insurance will cover 65% of their operations. There will be
municipality and ward financing, vertical programs and supply chains, government HR, and basic healthcare.
In 2019 Possible adopted a new structure. This evolution to on the ground leadership has led to more accountability and
stronger participation. The new federal structure of the country allows Possible to negotiate at various levels of
government.
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