I think Joel’s question and your response raise interesting issues about the most cost-effective ways to meet (at least more of) the health-care needs of people in places too small/remote to support a ODH health center. I can think of three general possibilities:
One, improve transit for bringing sick people to a center, such as by providing a bike (with small pedicab trailer) for a trusted community member to lend out to those needing to transport friends or family members to an ODH or other health center. The obvious problem there is that the bike might disappear or be diverted to other uses.
Two, create some sort of lightweight stationary version of ODH health centers for communities that cant support a full one—employing a part-time, non-nurse community health worker with a sharply limited scope of practice (e.g., malaria, pneumonia and diarrhoea in under 5s).
Three, put a nurse on a motorbike with a small trailer to create a mobile, semi-lightweight version of an ODH health center (e.g., two hours a day in each of three locations, with two hours of transit time). The cost per patient would obviously be higher than ODH’s model due to lower patient volume per nurse, travel expenses, and likely higher facility costs per patient.
I suspect all of those require more donor subsidy per patient than ODH’s current model. The potential advantage would be that the treatment provided may be even more counterfactual than what ODH currently provides.
I think Joel’s question and your response raise interesting issues about the most cost-effective ways to meet (at least more of) the health-care needs of people in places too small/remote to support a ODH health center. I can think of three general possibilities:
One, improve transit for bringing sick people to a center, such as by providing a bike (with small pedicab trailer) for a trusted community member to lend out to those needing to transport friends or family members to an ODH or other health center. The obvious problem there is that the bike might disappear or be diverted to other uses.
Two, create some sort of lightweight stationary version of ODH health centers for communities that cant support a full one—employing a part-time, non-nurse community health worker with a sharply limited scope of practice (e.g., malaria, pneumonia and diarrhoea in under 5s).
Three, put a nurse on a motorbike with a small trailer to create a mobile, semi-lightweight version of an ODH health center (e.g., two hours a day in each of three locations, with two hours of transit time). The cost per patient would obviously be higher than ODH’s model due to lower patient volume per nurse, travel expenses, and likely higher facility costs per patient.
I suspect all of those require more donor subsidy per patient than ODH’s current model. The potential advantage would be that the treatment provided may be even more counterfactual than what ODH currently provides.