Describe the critical need your solution addresses.

In materially poor countries with few resources to dedicate to health care, combined with factors that increase barriers to care such as isolation, war, and language/cultural differences, there is little hope that fully-staffed clinics and hospitals will be built in the near future, or that existing services will be improved and expanded to meet daily health care needs.

Explain your initiative in more depth and its stage of development.

Too often in our world, individuals have to travel long distances, through conflict zones, spending money they do not have, on the chance that an existing hospital or clinic would treat them with respect, in their native language, and actually meet their health needs. The fact that the members of many of these communities may lack formal education does not, however, mean that they cannot be empowered to learn the skills necessary to become the health care providers for their communities.

Concern America has developed a successful “Health Promoter Practitioner” model in which community members are trained to be the primary health care providers in their own communities and the regions where they live. Once trained, these Health Promoter Practitioners can competently diagnose and treat patients, administer a wide range of medicines, and perform surgeries (e.g. tendon repairs), all within a local system that comes from and responds to the needs of the community members. Concern America's four-year Practitioner training program, a model developed by the organization over the past 20 years and unparalleled in its quality of instruction and accessibility to individuals with little formal education, trains lay practitioners whose resulting depth of knowledge, skills, and ability to provide health care are comparable to the work of physician assistants and nurse practitioners in the U.S. As a result, in villages located hours away from health care centers and whose residents earn less than $2.00/day, high-quality, low-cost health care is a reality, saving and sustaining innumerable lives, using few resources.

Concern America’s Health Promoter Practitioner model has proven extremely successful in various countries in Latin America. In an effort to bring the model to many more communities/regions, organizations, and governments throughout the world, Concern America and its field team members who implement the Health Promoter Practitioner model on the ground (all medical professionals with many years of experience in the field) are writing a “Manual” that can help western-trained medical professionals understand this primary health care model and replicate it around the world. The writing of the Manual has already begun, is estimated to take three more years, and will be a major contribution to the field of primary health care worldwide.

How does your strategy and approach respond creatively and comprehensively to key issues?

Concern America’s Health Promoter Practitioner model is a breakthrough in the provision of primary health care in economically impoverished communities located in remote regions. Some of the reasons include: (1) the model does not rely primarily on doctors or nurses for direct care, or the construction/staffing/equipping of new and expensive clinics and hospitals, to meet the primary health care needs of people currently without such services; (2) the model draws upon the wisdom, creativity, and deep-rooted commitment of helping one’s community of the local community members themselves; (3) the Health Promoter Practitioners emerge as local leaders who are at the center of creating local health infrastructure and systems; and (4) these health care/community leaders become the voices of their people who actively work to change the root causes of the lack of health care in their regions by working with governments to improve health policies and the quality of care given in area health centers/hospitals.

Specifically, the Health Promoter Practitioner model effectively responds to the key issues in the following manner: SOCIAL: Provides essential health services that are of high quality AND affordable, while building trust in regions often healing from civil conflicts, devastating poverty, etc. CULTURAL: The Practitioners are of the very people they serve, respecting their culture’s health care beliefs and cultural norms, while providing care in their own native language(s). ECONOMIC: Providing primary health care is possible and affordable for families living in extreme poverty. ECOLOGICAL: Families receive the vast majority of their health care without leaving their villages; community clinics are often powered by solar energy and have a low-impact on the environment; the model follows an integrated approach in which the Practitioners are also trained to build potable water systems, fuel-efficient stoves, and other environment and health-related efforts. TECHNOLOGICAL: Even without the most advanced machines and technology, 90% of primary health care needs can be successfully met in one’s village, all with a low-cost set of “essential” medicines (World Health Organization designated) and equipment [thermometer, stethoscope, otoschope, blood pressure cuff (sphygmometer), suture materials, scales, watch, field microscope, and birth kits].