An Introduction To Community-Based Healthcare In Developing Countries

The Cooperative Society Newsletter
November 2017, Issue 6
by E.G. Nadeau

community based health
Community health workers in Kenya

The major challenges facing access to healthcare in Africa and other developing countries include: a shortage of doctors and other health professionals, a high percentage of people living in rural areas, and a shortage of funds for services and treatments.

As a result, many people die prematurely from causes that are often easily and inexpensively prevented or treated. For example, in Sub-Saharan Africa:

  • In 2015, the average life expectancy at birth was 60 years compared to a world average of 72 years.[1]
  • In 2013, there were 510 maternal deaths per 100,000 live births compared to 16 such deaths in developed countries.[2]
  • In 2015, out of every thousand children, 86 died before they reach the age of five. This compares to 6 child deaths per 1,000 in developed countries.[3]
  • HIV/AIDS killed 1.6 million people in 2013 – 75% of all HIV/AIDS deaths in the world that year – although the survival rate for people with HIV/AIDS has gone up dramatically in the past few years because of the availability of antiretroviral drugs.[4]

Clearly, the number of preventable deaths in Sub-Saharan Africa and some other developing countries remains far too high. However, there are a lot fewer of them than there were just 15 years ago. A significant reason for this is the United Nations Millennium Development Goal Program that has helped many countries to reduce premature deaths by 50% or more.[5]

This program began in 2000 and ended in 2015. It was replaced by the UN Sustainable Development Goal Program which began in 2016 and will continue through 2030.[6] The new program has ambitious goals to reduce these mortality rates much further. Below, I briefly describe a healthcare project that could serve as a model for reducing mortality in the years ahead.

A few years ago, I conducted research on a community healthcare initiative in Kenya coordinated by the National Cooperative Business Association (NCBA), a US-based organization that provides international development assistance.

Five main things struck me about this program:

  • Community health workers, selected by their fellow villagers, received training to address basic health needs. As a result, scarce health professionals served as secondary resources rather than primary ones for local healthcare.
  • There was an emphasis on self-reliance at the village level, both in terms of healthcare planning and implementation.
  • The program operated at a very low cost per village resident.
  • Village initiatives were designed to be sustainable after NCBA staff left.
  • In just a few years, the program expanded to include several thousand villages and millions of local residents.

This kind of community-based healthcare model has the potential to save millions of lives in Sub-Saharan Africa and in other regions of the world between now and 2030 – especially if it is promoted through the UN Sustainable Development Goal Program, international health assistance programs, and healthcare ministries in developing countries.

If you’d like to learn more about lessons from the community healthcare in Kenya, Click Here

[1]https://data.worldbank.org/region/Sub-saharan-africa; https://data.worldbank.org/indicator/SP.DYN.LE00.IN

[2]http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf

[3]http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf

[4]http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf

[5]http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf

[6] http://www.undp.org/content/undp/en/home/sustainable-development-goals.html

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