Nyaya Health: Transparent, data-driven health care for the rural poor.
This project also has a Changeshop where you can read more about its latest progress.
Go to Changeshop: Nyaya Health: Building a strong, open and efficient public sector health system in rural Nepal..
Nyaya Health is leveraging innovative tools of transparency and open data to create and disseminate a new standard
for health care delivery in rural Nepal.
About You
About You
First Name
Mark
Last Name
Arnoldy
Twitter URL
Facebook URL
About Your Organization
Organization Name
Nyaya Health
Organization Website
Organization Country
United States, MA
Country where this project is creating social impact
Nepal, XX
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
1‐5 years
Has the organization received awards or honors? Please tell us about them
- Distinguished as a "Standout Organization" (top 1% of 750 organization's examined) by the rigorous nonprofit evaluator GiveWell for ability to treat Nepal's poorest and do so with "unusual transparency."
- Winner of the 2008 Yale Entrepreneurial Society’s Business Plan Competition
References - Please provide two references with a two-sentence biography, email address, and phone number for each
Dr. Paul Farmer - Medical anthropologist and physician Paul Farmer is the Kolokotrones University Professor, Harvard University; Chair of the Department of Global Health and Social Medicine at Harvard Medical School; and a founding director of Partners In Health (PIH).
Please email Mark Arnoldy at mark(at)nyayahealth.org for contact information.
Rebecca Weintraub, M.D., is the Executive Director of the Global Health Delivery Project, an Associate Physician in the Division of Social Medicine and Health Inequalities, a member of the Hospitalist Service at Brigham and Women's Hospital, and an Instructor in Medicine at Harvard Medical School. She currently serves as a technical advisor to Ashoka, promoting the work of Health Entrepreneurs.
Please email Mark Arnoldy at mark(at)nyayahealth.org for contact information.
The information you provide here will be used to fill in any parts of your profile that have been left blank, such as interests, organization information, and website. No contact information will be made public. Please uncheck here if you do not want this to happen..
Innovation
Select the stage that best applies to your solution
Growth (your pilot is up and running, and starting to expand)
How long have you been in operation?
Operating for 1‐5 years
The Need: What problem are you trying to solve?
We believe that delivering transparent, data-‐driven public sector health services for the rural poor is a moral imperative. But government services in poor countries like Nepal are underfunded and opaque. Over 2.2 million people live in Nepal’s Far-Western Region, where the average annual per capita government health expenditure is about $8. Non-governmental organizations that could choose to inject capital and provide transparency fail to do so. The 2008 Global Accountability Report revealed that nearly all major NGOs perform extremely poorly on transparency, with most ranking lower than private, for-profit corporations.
The Solution: What is your solution? Be specific!
Nyaya Health partners with Nepal’s government at all tiers of health infrastructure – hospitals, clinics, and community health workers – to deliver comprehensive care to Nepal’s poorest by using innovative tools of transparency and open data to ensure accountability for all outcomes and operations. NH employs an all-Nepali staff to deliver health care at a comprehensive 25-bed hospital serving over 260,000 people and through a Community Health Program that provides income and training to 73 community health workers who provide health education, followup, treatment adherence, and referrals for over 17,300 people. To disseminate innovations globally, we conduct implementation research and publish all data, protocols, budgets, and manuals on our organizational wiki. To operate transparently, we also make all materials, including outcomes data, line-by-line budgets, internal documents, and email correspondence freely available.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
In rural Nepal, there is a genuine fear of corruption within the public sector, and financial resources often do not reach their intended destinations, compromising medical systems and care. NH, however, has been able to set a new standard for financial transparency and accountability through a formal partnership with the Ministry of Health and Population. Since NH began operations in Nepal, an accounting system was built using open source software to ensure that every single line-by-line expenditure made in Far-Western Nepal is made globally accessible via a public organizational wiki. This history of public line-by-line expenditures in addition to other financial metrics and analyses can be found at: http://wiki.nyayahealth.org/w/page/4682609/Budget, and the commitment has since been matched by NH’s new U.S. office that opened in August, 2011. This is just one example of how NH has layered technology on top of underperforming public sector services to strengthen them and set a new standard for care delivery and quality. The model has also been followed for the publication of open data, evaluating and improving pharmaceutical procurement and supply tendors, and fully publicizing the budget process. Additionally, these technologies of transparency are complemented by qualitative documentation of organizational and clinical failures and lessons learned via http://www.blog.nyayahealth.org
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
1. Local private medical practitioners – While a few have respect in the community because of a long work history, these lower-level trained providers falsely promote themselves as doctors and are guilty of over-prescription and over-charging patients. NH offers higher quality care from certified Nepali allopathic physicians without user fees and utilizes internationally certified pharmaceuticals. NH also utilizes community advisory committees to direct decisions about expansion and care.
2. Family Health International - A multinational organization conducting HIV education, research, and counseling to HIV-infected individuals in Far-Western Nepal. However, they do not provide direct care and focus solely on HIV rather than more comprehensive health systems.
This Entry is about (Issues)
Social Impact
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
Here is the content of the email written by Co-Founder Dr. Jason Andrews in 2006 after visiting Far-Western Nepal.
“…I literally had 10 women a night knocking on my door asking for medical help. All but 1 of their husbands worked in India, and 50% of them were widows at 25-40 years old. Among those that knew their HIV status, all were positive. There are no health services available beyond the most basic primary care (and that is often geographically and financially inaccessible). The nearest facility providing HIV care is a 12 hour bus-ride away. It's not just HIV that's a problem, of course. 95% of births take place in a home without a health worker present and >60% of children in those two districts are malnourished. One night I was sitting, having dinner in a room full of the women I had been providing my meager medical advice to and it struck me that they would almost all be dead within 5 years. Since that moment, I’ve felt wholly compelled but completely adrift..."
Please describe the goal of your initiative; outline what you are trying to achieve
In the next 5 years, we will be working in partnership with the government at all 3 tiers of the public sector health infrastructure – hospitals, clinics, and community health – in the 3 poorest districts in the Far-Western development region of Nepal and will have advanced the use of tools of transparency to make systems of accounting, procurement, management, and medical treatment and follow-up highly accountable. We expect to lobby for and receive a 10 fold investment increase from the Ministry of Health and Population (from $35,000 to $350,000) in order to support transparent and data-driven care systems.
What has been the impact of your solution to date?
Nyaya Health has built a health clinic, managed it for one year, and transitioned it to the government after the organization was invited to renovate and operate comprehensive services at Bayalpata Hospital. In the last 3.5 years, over 80,000 patients have been treated during 1 year at the clinic and 2.5 years at Bayalpata Hospital. A Community Health Program has been built on the back of the government’s volunteer health worker program, reaching over 17,300. All together, over 110 Nepalis have been employed to deliver health care in the country’s most neglected and poor region.
What is your projected impact over the next five years?
We will provide comprehensive care to over 300,000 of Nepal’s poorest patients in the next 5 years, and our Community Health Program services will cover a population of 100,000. We will have built a model of working in partnership with Nepal’s primary care facilities – health posts – that will extend a package of primary care, delivery and referral services to a total combined catchment area of 100,000.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
We will have performed the first c-section delivery in Bayalpata Hospital’s history in a new operating theater.
Identify three major tasks you will have to complete to reach your six-month milestone
Task 1
Hire the districts first MD-GP level trained physician (Generalist with surgical training) as a Clinical Director.
Task 2
Complete infrastructural renovations on Bayalpata Hospital’s only remaining clinical building.
Task 3
Complete training for our local surgical team in partnership with Nepal’s top community hospital.
Now think bigger! Identify your 12-month impact milestone
We will be cutting the ribbon of our next major clinical facility in partnership with the government in a neighboring district.
Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1
Bolster Nepali senior-level management (Specifically, hire an experienced Deputy Country Director).
Task 2
Increase government investment through our public-private partnership from $35,000 annually to $115,500 annually.
Task 3
Increase revenue in 2012 compared to 2011 by a factor of 1.8.
Sustainability
Tell us about your partnerships
Partners in Health (PIH): As an official PIH Partner Project, NH belongs to a reputed network of organizations in the field of global health delivery that are sharing technical expertise, best practices, and resources.
Ministry of Health and Population, Government of Nepal (MOHP): Since 2009, NH has been a formal partner with the MOHP and operates via a Public-Private Partnership in order to strengthen the public health sector. The MOHP has guaranteed NH $175,000 USD for investment in health infrastructure over a 5-year period.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
Yes. While Nyaya Health has only thus far operated in Achham District (home to 260,000) in Far-Western Nepal in order to sufficiently test our model, we are currently looking to expand within the broader Far-Western development region (home to 2.2 million). Because every act of expansion takes place through existing government health infrastructure, each innovation presents a valid opportunity to advocate and scale elsewhere in Nepal. Our open source model also allows for these innovations be shared via an organizational wiki to collaborators around the world.
What type of operating environment and internal organizational factors make your innovation successful?
Success is rooted in the organization’s core values which can be viewed here: http://wiki.nyayahealth.org/w/file/49193085/Nyaya%20Health%27s%20Core%20...
The extremely isolated and resource-deprived conditions we work in demand innovative solutions if meaningful transparency, accountability, and uses of data are to be realized. It is the very resource deprivation that drives a culture of innovation, leap-frog technology solutions, and managerial efficiency.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
The needs listed above vary. In 2012, Nyaya Health will be looking to bring additional staff support to the U.S. office and Nepal team and is therefore continually interested in receiving inquiries from interested talented and committed individuals.
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 | 16 weeks agoMark Arnoldy said: Hi Jessi - Thank you so much for your interest in our work. To answer your question briefly, we do not intend to be health care ... about this Competition Entry. - read more > |
| 16 weeks agoNumfor Alenwi said: greater hights about this Competition Entry. - read more > |
| 16 weeks agoJessi Wolz said: Hi Mark, I congratulate you on the awesome work Nyaya is doing in Nepal. I really like the emphasis on partnering with the government ... about this Competition Entry. - read more > |
| 17 weeks agoMark Arnoldy said: Hi all - I wanted to share our recent Yale Medicine Magazine cover story that highlights our genesis story and operating model that ... about this Competition Entry. - read more > |
| 18 weeks agoMark Arnoldy updated this Competition Entry. |
| 18 weeks agoMark Arnoldy updated this Competition Entry. |
| 18 weeks agoMark Arnoldy updated this Competition Entry. |
| 18 weeks agoMark Arnoldy submitted this idea. |
