HealthRise customizes local partnerships to improve healthcare systems around the world.
The South African mother knew her baby was ill. So as any mother would do, she took her daughter to multiple clinics and hospitals, hoping for a diagnosis. In a region that has been grappling with an HIV epidemic for decades now, where 4 in 10 people are HIV-positive, the child was tested over and over for HIV. She almost fell into a coma before she was correctly diagnosed with type 1 diabetes. 1,2
It can be challenging to diagnose non-communicable diseases like diabetes, within health systems that have been built in response to infectious diseases to provide episodic care.
The Medtronic Foundation developed the HealthRise program to address the need for integrated, quality care for all conditions. The program is a five-year, $17 million global effort to help improve access to care for underserved populations in Brazil, India, South Africa, and the United States. It was created to help countries reach the World Health Organization's goal of lowering premature death from non-communicable illnesses such as diabetes and cardiovascular disease by 25 percent by the year 2025.1,3
“The needs of these countries are different, the health systems are different, and the particular make up of what constitutes an underserved population is different,' says Jessica Daly, Senior Portfolio Lead at Medtronic Foundation. “But many of the solutions cut across context, and can offer lessons to a global community hungry for evidence about what works.'1
In Minnesota in the United States, for example, a HealthRise assessment found that 90 percent of people in more affluent zip codes have their diabetes, hypertension and other chronic diseases under control, as compared to only 60 percent of those in lower income areas. To combat this disparity, efforts are being made in three counties to improve quality of care and disease management through a more personalized approach, taking care closer to home. One intervention involves community healthcare workers from the local Somali community going into homes to help link patients to primary care, as well as social programs that can address possible obstacles to care, such as access to healthy food, lack of childcare, and transportation. 1,4
In a region like India, the challenges are different. In the two districts where HealthRise is focused, initial disease identification is a big issue. Approximately 60 percent of people with hypertension and close to 25 percent of people with diabetes have never been diagnosed.5 Strengthening the health system to be able to diagnose more patients earlier is a high priority in these districts, as is building up the capacity to accommodate the healthcare needed for newly diagnosed individuals. Empowering patients in self-care and community-based peer support groups is also critical.1
While individual programs may be tailored to a country's particular barriers to care for underserved populations, HealthRise uses the same general approach regardless of location. In each country, the program seeks to empower patients and strengthen the existing healthcare systems — especially frontline health workers.1,8 It works with governments at the local, state/district, and national levels to accomplish this. Partnerships have been set up with local entities and programs are designed with the input of stakeholders, key opinion leaders, and government experts. They are guided along the way by country advisory committees of experts and will be evaluated by an objective third party to assess impact. 1
By the time the project ends in 2018, the goal is for the programs to be sustainable, and to expand into other areas to improve diagnosis, management, and control of diabetes and cardiovascular disease at greater scale. With such a variety of countries, unique challenges, and different approaches to overcoming barriers to care, the HealthRise program offers a valuable opportunity to test different types of models and determine which are the most successful — valuable information for future efforts aimed at further reducing the devastating impact of diabetes and cardiovascular diseases.1
Interview with Jessica Daly, Senior Portfolio Lead at Medtronic Foundation