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Empowering Youth in Communities through ‘TASK” – The Ambassadors of Sehat Kahani’

Active involvement of female youth in implementing healthcare activities can inculcate emphatic leadership in these future "change agents."

Photo of Dr. Sara Saeed Khurrum
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*Please Upload User Experience Map (as attachment) and any additional insights gathered from Beneficiary Feedback in this field

User Experience Map Journey of a young female while enrolling in ambassador training program.

Why does the target community define this problem as urgent and/or a priority? How is the idea leveraging and empowering community assets to help create an environment for success? (1000 characters)

According to the Pakistan Economic Survey, 23.4% of Pakistan’s population lies below the poverty line. The country also lacks proper access to quality healthcare facilities as seen through the Health Access Quality Index in which Pakistan ranks 154 out of 195 countries. Simultaneously, 49.2% of the population comprises of females and 1/3 consists of youth with most being either uneducated or unemployed contributing to the high disease burden in the community. Since Pakistan is undergoing a health emergency, involvement of the youth is crucial in order to uplift the low income societies and improve the health status of the country. Thus the ‘TASK’ initiative of Sehat Kahani aims to leverage the biggest asset of the community i.e. the youth, above all the females, into undergoing capacity development so as to become ambassadors and thereby allowing the community to become self-sufficient in improving their health status by providing health awareness and collaborating with other networks

How does the idea fit within the larger ecosystem that surrounds it? Urgent needs are usually a symptom of a larger issue that rests within multiple interrelated symptoms - share what you know about the context surrounding the problem you are aiming to solve. (500 characters)

Pakistan is undergoing a health crisis with high rates of maternal mortality (1.78/10000 live births) and infant mortality (52/1000 live births). The underlying socio-demographic factors of this health emergency consists of poverty, low education level particularly of females and unemployment which are also highly prevalent across the country. The idea of ‘TASK’ addresses all these factors via capacity development mechanisms and by fostering the community’s awareness on key health issues.

How does the idea affect or change the fundamental nature of the larger ecosystem that surrounds it (as described above) in a new and/or far-reaching way? (500 characters)

The health crisis exists mostly among females in the community since females are the ones who are most uneducated and unemployed contributing to the disease burden. Thus the idea of ‘TASK’ addresses this issue at grass root level by not only empowering and educating the females in the community but also allowing them to become agents of change to help improve the health outcomes at a larger scale. In the long run, impact will be seen by improving health literacy within the future generations.

What will be different within the target community as a result of implementing the idea? What is the scope and scale of that difference? How long will it take to see that difference and how will it be sustained beyond BridgeBuilder support? (500 characters)

Sehat Kahani already provides access to quality health care through its e-hubs. The idea of ‘TASK’ will allow us to further improve the health status of these marginalized areas via provision of extensive training for the youth and building a sense of community ownership within them. The difference may be visible within 12 months whereby TASK ambassadors will be self-sustained and eligible to provide health awareness to the community after being certified by experts and capable of raising funds.

How has the idea evolved or responded to your user research during the Beneficiary Feedback Phase and any further insights provided if you participated in the Expert Feedback Phase? (1000 characters)

A low-fidelity prototype was conducted at one of the e-hubs. 19 year old Noor belonging to a marginalized community was enrolled in a small training session by a female healthcare provider. After the completion of training, she was asked to provide a short awareness session to females attending the community clinic. The outcome of this pilot was encouraging as the following testimonials came through Female youth: "The training session built my confidence and I feel like I can also be changemaker and give back to the community" Female patient attending clinic: "Such initiatives give me hope that my daughter will not be forced into being a maid like me and she will understand how her health directly contributes to improving the community." The user design approach was also shared with office staff and interns. Queries like: ‘How can we make this solution self sustainable for a long time’ and ‘What can we do to convince those parents' were made and iterations were done on the research.

What are the key steps for implementation in the next 1-3 years? (You can attach a timeline or GANTT chart in place of a written plan, if desired.) (1000 characters)

Gantt chart attached with steps for implementation within the next year

Describe the individual or team that will implement this idea (if a partnership, please explain breakdown of roles and responsibilities for each entity). (Feel free to share an organizational chart or visual description of your team). (500 characters)

Sehat Kahani is led by two young female doctors and has a core team of 12 members, 45 peripheral staff and a network of over 1000 female doctors. The implementation of this idea would involve the core team members who will help arranging training platform to the ambassadors along with the community health workers and mobilizers who will actively play a role in encouraging and enrolling the female youth into the program. Experts will be taken on board for capacity development and health education

What aspects of the idea would potential BridgeBuilder funds primarily support? (500 characters)

Sehat Kahani has access to communities through e-hubs and comprises of a good community health worker and mobilizer system to engage the community. Hence, Bridgebuilder funds would primarily support; 1) in-depth user design research in all communities where e-hubs are located 2) piloting the capacity building training and skills development courses by experts within 3 communities 3) prototyping networking events to build bridges between TASK ambassadors and corporate in all 3 communities

In preparation for our Expert Feedback Phase: What are three unanswered questions or challenges that you could use support on in your project? These questions will be answered directly by experts matched specifically to your idea and needs.

The three key questions or challenges that require support include; 1) Which tools would work best in providing training to these female youth and to monitor and evaluate the outcomes 2) What methods are best suited to create a link between the corporate sector and the community so as to create a sustainable model and a platform to generate funds for future programs 3) What feedback mechanism can be used to tackle issues and obtain information which can help reach out to a large number of audience.

Final Updates (*Please do not complete until we reach the Improve Phase*): How has the idea evolved or responded to your user research during the Beneficiary Feedback Phase and any further insights provided if you participated in the Expert Feedback Phase? (1000 characters)

The idea of TASK has evolved through the beneficiary and expert feedback phase to become more human centered with tools incorporated to allow a two way interactive process of learning between the training providers and recipients. Prototyping the idea allowed us to understand the role of this program in bridging peace, planet and prosperity through a clear cut impact of the solution within the communities as indicated by the acceptance level and positive feedback of the trainees and their families. Further incorporation of various feedback tools will allow us to measure the impact of the idea (on both the training process and the health awareness outcome) and ensure the quality maintenance of the program so as to identify and help solve any challenges coming along the way. Through this interactive feedback mechanism, young female participants will be able to boost their confidence and develop their creative personalities contributing to the prosperity of the community.

During this Improve Phase, please use the space below to add any additional information to your proposal.

Testimonials from the female youth enrolled low fidelity prototype have been incorporated in order to understand the scope of the idea is in alignment with the needs of the community and that the idea is well perceived among the female youth in the community. These testimonials are in Urdu as this is the national language of Pakistan however descriptions have been provided in English to understand what the user is saying. The User map experience has also been reiterated to include the relevant expert feedback

Note that you may also edit any of your previous answers within the proposal. Here is a great place to note any big final changes or iterations you have made to your proposal below:

The proposal idea follows the same process however major final changes has been made in three steps 1) Pre training advocacy of program– The idea of TASK will be marketed amongst the community through the support of people in the community who are considered authoritative and are the key decision makers within the community such as community elders, religious leaders and local governmental officials. Sehat Kahani community mobilizers will also be conducting a campaigning session where community members will be able to understand the rationale behind the proposal and how it can be beneficial for them 2) Monitoring and Evaluation Tools - Timely improvement of the training process would be done by both the trainer and trainee through the following methods: - Weekly feedback sessions - Qualitative surveys by the trainees - Observation based evaluations by Sehat Kahani management team and external stakeholders, - End of training knowledge and skill assessment - Regular monitoring and evaluation reports. 3) Post training advocacy - External stakeholders such as corporate firms and organizations will be able to see the program impact through pictures, videos and success stories shared on social media platforms. An open-house session will also allow the stakeholders to visit the trained youth female and analyze their potentiality in order to facilitate their placement in the communities.

Explain your project idea (2,000 characters)

Sehat Kahani (Story of Health) is a unique tele-health social enterprise that connects female doctors to underserved patients providing access to quality health care. This is done via the establishment of telemedicine enabled E-hubs in low income communities which use virtual technology to connect underserved beneficiaries to qualified female health providers who are deprived of the ability to pursue their careers due to social restrictions. This program has effectively managed to impart quality health care to 15 deprived communities at a subsidized value as well as improve the female employment rate in the medical workforce. However, through a needs assessment and feedback survey of every community where an e-Hub is located, Sehat Kahani understood that for any sustainable long term health impact to take place, it is crucial to involve the community in the process of change. Factors such as high inflation rate (4.19%) and inaccessibility to healthcare (HAQ Index 36.7) has led to a halt in any health care development which can be specified by minimal improvement in previous national health indicators, Additionally, the 2018 National Human Development Report for Pakistan states that the youth make up to almost 1/3 of the country’s population, yet 55% of these youth are either underpaid or are unemployed. Hence, TASK – The Ambassadors of Sehat Kahani is an initiative that revolves around development of the skills of the youth (particularly the females) living within these communities leading to the formation of a group of ambassadors that will advocate Sehat Kahani’s vision and its health related campaigns via a continuous education and training process. This idea provides the female youth with access to practical skill and capacity building trainings that can be used as a buffer against social and economic challenges such as poverty, unemployment and poor health giving rise to a population who is able to cope up with existing and upcoming problems effective

Who are the beneficiaries? (1,000 characters)

Existing beneficiaries of Sehat Kahani which include; • Low income communities in Pakistan with access to E-hub clinics • Female physicians who need a platform to provide health services while maintaining their social roles. • Female community health workers, nurses and mobilizers who are a channel of communication between the doctor and patient This project will further benefit: • Female youth of ages 15-29 within low income communities. This will enable them to work as Sehat Kahani ambassadors to deliver preventive campaigns and improve the living standards of their communities. Pros of this strategy include the easy adaptation of health campaigns due to the trust factor in the ambassadors as they are ‘one of them’. This will also provide a channel for expression of voice and prevent them from getting involved in illicit activities such as substance abuse. • Forthcoming generations as families will be health literate • Economy of country as this will serve as platform for jobs

How is your idea unique? (1,000 characters)

The concept of Sehat Kahani is unique as its health workforce comprises of female doctors who are unable to achieve their career potentials and has been given the flexibility of providing consultations while maintaining their family roles. Sehat Kahani also has a unique benefit of incorporating the use of digital technology to connect these female doctors with the patients. The use of technology in healthcare makes our approach successful as it provides services in the most efficient way, saving time and travel related costs as well as integrating technology into the communities who lack the knowledge of it. Moreover, engaging women to lead the female youth ambassadors would set a role model for the societies who consider females a less significant contribution to development and deprive them from higher education. Teaching the youth virtual technology will not only empower them but raise their self-esteem, develop their skills and contribute towards economic and social development.

Idea Proposal Stage (choose one)

  • Prototype: I have done some small tests or experiments with prospective users to continue developing the idea.

Tell us more about your organization/company (1 sentence and website URL)

Sehat Kahani – The story of health, is a social impact initiative whose objective is to democratize healthcare by creating an all-female health provider network to facilitate access of efficient and effective healthcare solutions to under-served beneficiaries in Pakistan through the use of virtual technology.

Expertise in sector

  • 3-5 years

Organization Filing Status

  • Yes, we are a registered social enterprise.

In 3-4 sentences, tell us the inspiration or story that encouraged you to start this project.

18 year old Rani belonged to a community where an e-hub clinic was set. Having a passion for public speaking, Rani worked as a Sehat Kahani mobilizer who loved to convince women to visit the e-clinics for antenatal checkups. Unable to afford higher education, she pursued a job in tailoring to meet the family needs. Rani is one of the several cases which motivated us to create a platform for female youth to develop their skills and work to help improve the quality of life of their communities.

Please explain how your selected topic areas are influenced, in the local context of your project (1,000 characters).

All three topic areas are influenced by various factors. Prosperity is influenced by the low education attainment status, low employment opportunities, less vocational facilities for the deprived population and the constant political insecurity and corruption within the country which proves to be an obstacle in the development of the country. Planet is impacted by the high levels of infectious and preventable diseases in the population along with the common occurrence of natural disasters such as drought and famine contributing to the increased mortality rate particularly of mothers and infants and a high public health concern. Man-made pollution also exists in all form at a great level. Peace is influenced by the religious and political tensions in the country as well as the presence of terrorism and social isolation particularly of females, minorities and trans-genders.

Who will work alongside your organization in the project idea? (1,000 characters)

• Capacity building trainers - who will be identified from the market and engaged to provide with the necessary training skills • Female health care providers – to provide with relative up to date health information so that the female youth can be health literate. • Community leaders and heads of various local institutes such as schools – to help facilitate in creating an enabling environment so that the program is carried out successfully. • Corporates and private sector – to help in providing networking and supporting the youth in their health campaigns • Sehat Kahani Ambassadors – once trained they will be given the opportunity to be employed in preventive healthcare domain where they will conduct activities of awareness, screening and referral to the clinics where needed. The cause of Sehat Kahani itself is community-centered thus involvement of local community health workers, nurses and mobilizers are an essential component in healthcare delivery through our e- hub clinics.

Please share some of the top strengths identified in the community which your project will serve (500 characters)

Pakistan’s 1:1 gender ratio emphasizes the need for females to be trained in order to improve the health of the communities. Setting e-hubs and employing mobilizers from within the community has endorsed a bond of trust so as to convince families to encourage their girls to apply. The number of unemployed youth is more than half of the population and combining this with poor health conditions shows potential willingness of the youth to employ in strategies to improve socio-economic conditions.

Geographic Focus

Disaster prone and low income communities in Interior Sindh, Interior Punjab and KPK, Pakistan

How many months are required for the project idea? (500 characters)

The project requires 12-18 months to see effective changes. This involves strategic planning and youth engagement activities along with collaboration with training bodies and healthcare providers. Following this, ambassadors will be allocated to different causes that need to be addressed and campaigns will be lodged after attaining partnership and funding. Evaluative surveys will be conducted and number of cases will be noted to see the impact of the project and improve strategies and methods.

Did you submit this idea to our 2017 BridgeBuilder Challenge? (Y/N)

  • Yes

If Yes, how has project idea changed, grown, or evolved since last year? (2,000 characters)

Sehat Kahani participated in the 2017 Bridgebuilder challenge however this time it has come up with a different idea since last year. Our previous focus involved the employment and engagement of female health care providers to give consultations at e-clinics through virtual technology while at the same time allowing them to maintain their social roles in their families. This method provided communities, deprived of primary health care facilities, access to quality health care as well as preventive health campaigns which focused on providing an authentic source of health information and strategies to improve their standard of living to the community. This method also used community health workers and mobilizers from within the society as a medium of communication and delivery of health care facilities. The current idea has grown from last year to advance the objective further as from various feedback and surveys; it has been evident that for long term sustenance, going deeper into the community is required. Therefore, the idea has progressed into involving that percentage of the population who has the potential to become future leaders of the community and possibly of the country as well i.e. the youth. Our focus also is on female youth members for several reasons. One is to encourage girls, who are unable to achieve higher education, into acquiring the necessary knowledge and skills to establish a career. This would also prevent them from early marriages and childbirth. Engaging girls can also help improve the community since they are potential family makers who can understand the health requirements of the family and make sound decisions based on the knowledge and skills acquired. Knowledge may also be transferred down the upcoming generations giving rise to a health literate population in the future. Ultimately this would reduce the burden of maternal mortality and infant mortality and improve the overall health status and sanitation within the community.


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