PatientPower: Transforming Healthcare Systems in Places of Extrem

PatientPower: Transforming Healthcare Systems in Places of Extrem

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Last Update: September 25, 2013

PatientPower is an innovative model elevating standards of care in places of extreme poverty by bridging gaps between patients and the healthcare systems that serve them. By committing to 1) executive-level community control, and 2) integration of primary-care clinics with holistic services, PatientPower provides empowerment and infrastructure for communities to take charge of their own health.

The Problem

PatientPower’s pilot site is Nairobi’s Kibera slum, the largest slum in Africa. Although 1.5 million people live in Kibera, the government does not formally acknowledge its existence and does not provide infrastructure: no roads, hospitals, schools, sanitation services or access to clean water. These deplorable living conditions and resource scarcity lead to the rapid transmission of disease. Kibera’s child mortality rate is 4 times higher than in the rest of Kenya, and life expectancy is 20 years lower. Women face additional health risks: over 66% of girls trade sex for food to survive, and women are 5 times more likely to contract HIV than their male counterparts. The gaps in medical care are astonishing, summarized by residents as: prohibitively high costs, low-quality care, lack of trust in diagnosis and treatment due to limited time spent with providers, overuse of the same diagnoses, over-prescription of drugs, no room for questions or participation, long lines and inefficient systems, and lack of respect and dignity afforded to patients by caregivers.

The Solution

In extremely low-resource areas, the educational, class and racial divides between medical professionals and their patients run deep—such that despite millions of dollars of foreign-aid, health outcomes remain dismal, and patients experience constant frustration and loss of dignity. To subvert the patient-provider divide endemic to the developing-world, the PatientPower model ensures that grassroots community leaders retain executive-level positions within their local healthcare organizations. By putting patients who have experienced health-care delivery first-hand in the pilot seat, PatientPower uniquely empowers individuals living in extreme poverty to take control of their own health—creating the space and the resources for change to come from within. Second, PatientPower integrates bio-medical primary-care clinics with holistic community services. Direct medical services are not enough to combat the full range of disease factors caused by severe deficits in sanitation, diet, clean water, and education. That’s why in the Patient Power model, the clinic does not stand in isolation, but is tangibly linked to multi-faceted income-generating social services that serve to both alleviate sickness-inducing symptoms of poverty and ensure long-term organizational sustainability. In 2009, Shining Hope for Communities (SHC) initiated implementation of the PatientPower model in its pilot site: Nairobi’s Kibera slum. I am the co-founder and Executive Director of SHC, and lived the first 23 years of my life as a resident and community leader of Kibera. I believe that PatientPower will not only transform my community, but by partnering with other grassroots leaders from other places of extreme poverty—this model can extend to communities like Kibera around the world.


SHC, an active community based organization in Kenya since 2004, has a proven track record of unparalleled grassroots credibility and social impact in Kibera. All of SHC’s programs aim to combat inter-generational cycles of gender inequality and extreme poverty. Already we have provided community-run infrastructure such as a free school for girls, sanitary toilets, filtered water, vertical gardens, and literacy/computer training. Our impact has mitigated local deficits in education, sanitation, health, food security, and technological job skills. In the past year, our sustainable community services have reached 11,720 unique individuals. Malnourishment dropped by 98% among Kibera School for Girls students since opening, and rates of gender violence among female participants of our community programs were reduced by 75% in just the first year of operations. However, despite these important successes, without access to primary and maternal health services, residents of Kibera remain trapped in a cycle of poverty that makes poor health inescapable. As a result, for the past year we have actively engaged the community in broad dialogues to design a healthcare model that would meet their needs. PatientPower’s 14-room pilot clinic was born out of these community focus groups and leadership meetings, and will provide high-quality primary healthcare for Kibera residents. Once the clinic is open, and the Patient Power model is complete, our impact in our pilot site will exponentially expand. This model has the potential to have tremendous impact to make healthcare more effective for 1 billion individuals living under $1/day across the globe.

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