Science in the Triangle

IntraHealth International is a nongovernmental organization that works to make it easier for people to access high quality health care throughout the developing world. IntraHealth is based in Chapel Hill, with offices and programs in Africa, Latin America, Asia, and the Middle East.

On Thursday, April 22, IntraHealth celebrated its 30^th anniversary. I spoke with Laura Hoemeke, IntraHealth’s director of strategic communications, about IntraHealth’s work and the challenges in providing health care in the developing world.

What are the problems that people working in health care face in the developing world?
Many health care problems faced in the developing world are the same issues faced throughout the world. People want access to good, affordable care, whether it’s for themselves, their children, or their parents. Health workers want access to the necessary knowledge, skills and materials to do a good job—and education to continue learning.

Much of our IntraHealth’s work focuses on basic family health care, or maternal and child care, which are very important issues around the world. Another interesting issue that everyone is looking at in the developing world is the emergence of chronic diseases, which we’ve traditionally associated with developed countries, but that are also becoming an issue throughout the world as people live longer and the population ages.

New technologies are also an issue. These can be as simple as a tool that allows a one-time injection that can be used for family planning, insulin injections, or other purposes. These are very simple things that because of either price issues or access haven’t gotten out. We think of technology that supports health workers will also have an impact in the future. For example, having a health worker do an online course to get education, or use technology to allow a health system better track data, so that not only a regional health system, but individual health workers, can use that data.

Can you define the term “health worker”? Why do you use this term rather than say, “doctors and nurses”?
For us, the term describes anyone who’s offering health care, or supporting the overall health system. In the states you don’t’ really say “I’ve got an appointment with my health care worker.” But worldwide a lot of health care is given not only by doctors and nurses, but by a whole cadre of health care workers. For us this term include doctors and nurses, but also technicians, hospital directors, or community health workers, who in many countries who are very vital in getting health care out to where people live.

What sort of projects is IntraHealth working on at the moment?
Our largest project is Capacity Plus. It’s a global project, supported by the U.S. government, that supports and strengthens health workers. This will include looking at things like planning for what a country needs in terms of its work force, strategies for motivating and maintaining health workers, and motivating and training health care workers.

We’re working on making a lasting difference. Training, for example, shouldn’t be a one-shot deal. We’d rather see training as continuing education, or something that helps each health worker better fit into the system where he or she is working.

So this project includes helping health workers develop planning, or help figure out not only how many doctors and nurses a country needs, but also find out what the performance of those health workers and how can that performance be optimized. We’re also doing lots of work with technology.

IntraHealth’s mission focuses on providing “sustainable and accessible” health care. Can you tell me why these issues are important in the developing world?
The word “accessible” means different things to different people. But for us, it means that health care should be there and be of good quality. I think too that this fits in with a broadening definition of what a health care worker is. In some countries, especially in rural areas, there aren’t hospitals or doctors that people are able to get to. So if you don’t bring health care closer to where people live and are, it isn’t accessible.

Making health care accessible also has connotations related to specific services and finances. So it can mean figuring out what services are that people need figuring out what people can pay and health care. In Rwanda, for example, we were very involved in supporting the country’s nationwide health care program called mutuelles. This program lets people buy a membership card every year, and that gives them access to a certain number of services. It’s been really successful, and in many areas, almost 90% of people are covered. That financial barrier is gone, so people aren’t afraid to go to the hospital when they are sick.

Making health care “sustainable” really plays on our desire to work with country governments to make sure that our health efforts and improvements have lasting benefits, rather than going away once our work ends. We work to ensure that whatever technologies or systems we have are developed in collaboration with a country’s ministry of health and that they then become part of that country’s policy framework. If you don’t do this kind of work with a local governments and in-country partners, none of it will be sustainable in the long run.

Read IntraHealth Global Health blog and follow IntraHealth on Twitter.