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Digitally Bridging Doctors and Patients

Tele-health platform that connects at-home female doctors with underserved patients, providing access to quality health care in Pakistan.

Photo of Dr. Sara Saeed Khurrum
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What specific problem(s) are you trying to address?

Pakistan is at high risk of annual flooding,spontaneous earthquakes and faces a chronic threat of political/religious instability. Millions of adolescent girls in Pakistan are in need of humanitarian assistance –displaced by conflict or uprooted by disaster. A crisis heightens their vulnerability to gender-based violence, unwanted pregnancy, HIV infection, maternal death and disability, early and forced marriage, rape, trafficking, and sexual exploitation and abuse. We believe that provision of safe spaces, mobile medical teams and youth engagement are effective ways to reach displaced, uprooted, crisis-affected girls at a critical time in their young lives.

What are some of your unanswered questions about the problem(s) you are working to address?

1- The number of hubs and spokes required to reach displaced adolescents girls and women in disaster struck zones of KPK and Sindh regions of Pakistan
2- How our proposed idea can be more technologically feasible to improve uptake among our end users/beneficiaries.
3- How we can effectively utilize real time technology to provide SRH advocacy and services, gather realistic data and enable young women to serve as change agents

Explain Your Idea

To improve access of sexual and reproductive health services to young girls and women, We aim to deploy a hub and Spoke model which allows beneficiaries to use smartphone, tablet or a laptop to perform a video conference with a provider, discuss their medical history, and then decide on a collaborative management plan. The E- Hub will be a centralised local health unit equipped with real time technology that will serve as a referral point for Community health workers who will travel door to door to reach young adolescents and women to provide them health services and education. We will also capitalize our on already established network of CMWs and LHWs in Sindh and KPK and provide them capacity building and training to utilize our proposed digital solution to deliver SRH services.

The innovation aims to build young people’s individual capacity to make safe choices; to make Sexual and Reproductive Health services better adapted to young people’s individual needs; and to strengthen the linkages between information and service provision.

Name the three most important ways that your idea will address your identified problem(s).

1. We will deploy an interactive digital platform that will bridge the gap between displaced young adolescents/women and SRH specialists. This will serve as a one stop solution for our end users and enable them toSaves time and money to travel to far flung SRH centers
2. We will capatilize on developing a network of existing human health resource and infrastructure at community level by providing them capacity building and technical training to effectively utilise our digital solution to deliver SRH services and advocacy
3. We will develop capacity of young adolescents/women by empowering them with tools to improve their uptake of SRH services, advocacy and information through engagement with our proposed digital solution.

How is your idea unique?

We will deploy a holistic real time solution that will enable end users to utilise digital medical information, virtual consultations, digital lab reports, e-pharmcy and referrals. This will enable our end users with access to a comprehensive workflow, i.e. patient registration, retrieval and management, history taking, record keeping, lab tests results uploading and viewing, diagnosis and care plans entry, advocacy tools, SRH specialists, educational modules and e-prescribing medicine. The unique feature of the portal is that it offers a real-time screen sharing option that enables health care professionals to educate girls and women regarding their sexual and reproductive health conditions and its consequences. All the inducted women and girls in the system will receive automated generated SMS for sexual and reproductive health promotion messages.

What are some outstanding concerns or questions that you have regarding your idea?

1) Finding community partners and stakeholders to ensure acceptability of our Hub/Spoke model in disaster struck zones
2) Finding Appropriate human resource in the communities to implement the model efficiently( male coordinators/female mobilizers and female front line workers
3) ensuring training and capacity of the hired human resources in disaster struck zones
4) Ensuring government buy in to carry out our implementation.
5) By passing cultural conservative norms

Who are your end users?

Our target beneficiaries are young adolescents (10-16) and young people (16-24) in remote areas as they are better informed, more adaptable to change and thus better able to make healthier choices regarding their sexuality. Our indirect beneficiaries are community health workers and out of workforce female doctors and specialists to train them to deliver sexual and reproductive health services while considering community sensitiveness.

Where will your idea be implemented?

  • Pakistan

What is the primary type of emergency setting where your innovation would operate?

  • Natural disaster
  • Prolonged displacement
  • Community at risk of disaster

Tell us more about the emergency setting that you intend to implement in

Our primary implementation Setting Includes Sindh and KPK, two major provinces in Pakistan.Sindh is prone to flash floods from the Indus River and Kpk Falls on the most vulnerable earthquake zones of the country. More than 10 millions have been lost. Some risks for the interventions:
Connectivity and technical failureRisk for services
Community Uptake for tele-health services due to cultural constraints
Affordability of Community Beneficiaries to access health services.
Political pressures

What is your organization's name?

Sehat Kahani

Tell us more about you.

Our team includes:
1)Dr. Sara Saeed Khurram-CEO/Co founder: leading all operations)Dr.Iffat Zafar Agha-CDO /Co founder: Business Development 3)Makkiya Jawed-Director Operations: leads the preventive health portfolio 4)Adil Fazal-Assistant preventive health care:implements preventive care campaigns 5)Mahek Pethani- Lead Research and Analysis 6)Sajid Brohi- Lead clinical operations: clinical management 7)Naveed Ashraf Karachi) Ashraf Higazi (Sindh), Raheel Khan(KPK) Assistant Clinical Mangers: regional clinical operations Sarfaraz Ahmed- Accounting/ Finance 8) Asif Khan-Logistics9) Nida Shehzad-Marketing Lead
Clinical team:42(1 frontline worker, 1 female mobilizer and 1 male mini coordinators per clinic)
32 doctors-network of 500 doctors.

Organizational Characteristics

  • Women-led organization

What is the current scale of your proposed innovation?

  • Community - 1+ communities within 1 country

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

Our Company is registered and based in Pakistan

What is your organizational status?

  • Registered for-profit company, including social enterprises.

What is the maturity of your innovation?

  • Roll-out/Ready to Scale: Completed a pilot and am ready / in process of expanding.

Website

http://www.sehatkahani.com

How has your idea changed based on feedback?

Based on the valuable feedback we have received from the OPEN IDEO community we deployed a prototype to test user feasibility and gauge impact of our activities. In this prototype we engaged 150 young adolescents and encouraged them to participate in devising their own user journey when they need to seek SRH services. We also wanted to explore perceptions of our end users when they seek SRH services from home based specialists using virtual consultation. We learnt that young adolescents were more comfortable consultation with female specialists rather than male even if it was virtual. This allowed them to speak more freely about their health issues and thus allowed for more accurate diagnoses and treatments. However, we also realized that due to lack of education the idea of telemedicine was difficult to understand. This lead us to focus on designing effective mobilization of e-SRH services for improved uptake and better health outcomes.

Who will implement this idea?

Our implementation team comprises of 10 full time core team members, 50 on ground community health workers/midwives, 500+ volunteers, 32 female doctors / specialists [currently deployed and engaged] and a network of 100 female doctors and specialists based all across Pakistan. We reach out to our customers through our community activation strategy using a female mobilizer in each community. To reach out to our end users and maximize impact, we will utilize our telecom such as Telenor and Jazz, community Partners such and Sangi, Kaawish and BISP, non government partners such as Legal Aid office, Rotary, Govermental partners such as Maternal and Neonatal child Health and Pakistan Medical Association and our Development partners such as UNDP and UNICEF.

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

We utilize a human-centered approach that emphasis on a continuum of interventions in the community to convey mainstreamed scalable and sustainable SRH services based on user feedback. Our innovative integrated approach focuses on working with community players, creating mechanisms and procedures to encourage dialogue and a sense of mutual accountability. To facilitate such linkages, we are learning from our failures, we are continuously working to develop technical and clinical capacity that will enable us to understand community needs based in disaster struck zones, empower our end users to improve SRH service uptake and deliver appropriate, high-quality services which they have been devoid from.

What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?

Barriers to access can be diverse, e.g. a river crossing washed out in a flood, an unfamiliar language or culture, a perceived lack of acceptance or linguistic barriers. Limits on girls’ mobility that traditionally come with adolescence are intensified, and an adult may be required to accompany them to any safe space. For all adolescent girls, but especially aged 10 to 14, gaps in services and family networks reduce their ability to access age-appropriate and developmentally-appropriate information and services for their health and well-being, including for their sexual and reproductive development. At system level no strategic plan or guideline at National level has been implemented that address the need of SRH services for young adolescents in marginalized regions

Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?

Impact: By 2022 we aim to increase our reach and deliver digital SRH services to 8.1 million young girls and adolescents by creating 50 e-Hubs and 100 spokes all across Pakistan

Question: How do we create a socio-culturally adaptable, self sustainable and replicable model that enables us to reach and monitor the impact of our deployed SRH services to 8.1 million beneficiaries by 2022.

What is it that most attracted you to Amplify instead of a more traditional funding model?

By utilizing Amplify model, we will be able to understand the scope and the potential of our proposed impact as well as it will also provide us experimental space and right tools to deal with sustainability challenges. Peer to peer feedback will also enable us to continuously redefine our idea and maximize the desired results.

Do you intend to implement your Amplify idea in refugee camps / temporary settlements?

  • We aim to implement our Amplify idea in support of displaced populations, but not in a refugee camp / temporary settlement.

How long have you and your colleagues been working on this idea together?

  • More than 2 years

How many of your organizations’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?

  • Between 10-20 paid, full-time staff

Is your organization registered in the country you intend to implement your idea in?

  • We are registered in all countries where we plan to implement.

My organization's operational budget for 2016 was:

  • Between $50,000 and $100,000 USD

What do you need the most support with for your innovation?

  • Business Development / Partnerships Support

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Photo of Chelsea Takamine
Team

Congratulations Dr. Sara Saeed Khurrum and team - welcome to the Amplify portfolio! Check out this winners blog post featuring your idea: https://challenges.openideo.com/blog/amplify-reproductive-health-challenge-winners-announced

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