Can Health Houses Help the U.S.?
Yes if we can preserve the cognitive factors that make them work.
Mississippi is in trouble when it comes to health and healthcare. According to the National Institute of Health (NIH) they have the highest rates of obesity, hypertension and teenage pregnancy in the country. Their infant mortality rate is 50% higher than average and 20% of the population has no health insurance.
They have spent millions but report in a recent NIH news story:
“We’ve been attacking this problem over and over again with just heartbreaking results,” said Shirley, chairman of the Jackson Medical Mall Foundation, a one-stop health care facility for Mississippi’s underserved.
Now they are trying to import a health service delivery model, called the Health House from the middle east. The Health House developed during the 1980-88 Iran-Iraq war is simple but apparently very effective.
According to the article, Iranian Health Houses Open the Door to Primary Care, the Health House is staffed by a female and male healthcare workers with clearly defined duites.
“Among their duties, female community health workers are responsible for vaccinations, registrations and administering medicines. A male community health worker is charged with activities mainly outside the health house, such as making follow-up visits to patients and identifying them in surrounding villages. The minimum age for male and female health workers is 20 and 16 respectively. They are required to have had 11 years of regular education, plus two years of theoretical and practical training before being awarded a certificate to be allowed to practice. “Even after their graduation, the behvarzan are subject to regular monitoring and distance-learning,” Motlaq says. ”
Other key features include being nearby and free. They are staffed with folks that are “from the people and have their approval” and who take the time to developed and document “extensive knowledge” about each of their patients including the enviornment they live in.
It is these cognitive factors – approval from the patient and detailed knowledge of their environment, conveniently delivered for free- that drives changes in health behaviors.
We have seen this same formula at work in successful health change models in the US. For example, the Asheville Diabetes Management model pays community pharmacists to coach patients is health habits and medication compliance. The patients gets diabetes meds for free and finds it easy and convenient to use the service because they are going to the pharmacy anyhow.
According to the LA Times, Mississipi is seeking $30M in funding for a 3-year pilot. Hopefully, they will be able to reproduce these cognitive factors as they import the Health House model to the U.S.
June 26th, 2010 at 10:13 am
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