Clínica Verde – Building a New Model of Care for Families in Need

Clínica Verde – Building a New Model of Care for Families in Need

NicaraguaUnited States
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
$100,000 - $250,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Clínica Verde provides high-quality healthcare to poor women and children in Nicaragua in an environmentally sustainable, well-designed community environment.

About Project

Problem: What problem is this project trying to address?

Nicaragua has the highest rate of adolescent fertility and the second-highest maternal mortality rate in Latin America. One in five children suffers from chronic malnourishment; this figure nearly doubles in rural areas. In the department of Boaco, where Clínica Verde is located, there are roughly 40,000 women of fertile age, 6,000 pregnant women, and 30,000 children under 5. Serving this area are just 5 gynecologists and 4 pediatricians. Nutrition education is absent. In Boaco, unemployment rates are as high as 70%, so social security tax covers only a few. Most attend poorly funded government clinics sponsored by the Ministry of Health (MINSA). Nicaragua’s annual expenditure for health per capita is $254. (WHO 2010.) Neighboring Costa Rica is $1,165 per capita and the U.S. is $7,410.

Solution: What is the proposed solution? Please be specific!

Clínica Verde is a new model for health care, focused on maternal and infant care, including family planning, prenatal care, and education for health, nutrition and wellbeing. Clínica Verde is founded on the principle that good health starts from the ground up, beginning with sustainable building practices that take a holistic approach to the environment, community and quality of life. This plan applies to the design and operation of Clínica Verde’s prototype clinic, which includes not just exam rooms but a garden, community room, café and a play area for children. Through clinical care and education, the clinic will reduce hospitalizations for infant dehydration, the number of babies of low birth weight, and rates of adolescent fertility. Benefits to the community include improved health through excellent clinical care and nutrition education, increased information and communication, and community support. Clinica Verde will replicate its model in Nicaragua and the developing world.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Prenatal care for our population includes regularly scheduled visits with a physician, including a complete history and examinations, tests for syphilis/HIV/other STDs, urine tests for protein, gestational diabetes testing, fetal heart rate measurements, ultrasounds, nutritional assessment and a delivery/birth plan. Contraception, lactation, and newborn care will be discussed. Postnatal care includes immunizations, general examinations, and specific examinations to look for malnutrition and infection. In addition to medical care, Clínica Verde will stress preventative health care education for the entire family, including basic nutrition, general hygiene, and food preparation and handling. This hands-on education will take place at Clínica Verde’s on-site garden and demonstration kitchen. Families will explore healthier ways to store food, prepare meals, and add nutritive value. Families will also learn the importance of hygiene and food preparation and handling to prevent common respiratory and gastrointestinal illnesses and to limit intra-household and neighborhood transmission. Expanding care beyond the boundaries of the clinic will be a major focus. Patient attendants will be trained to assist physicians at the clinic and to be educators and observers in the community. These patient attendants will rotate to serve in the clinic or in rural areas. Their role in outlying posts will be to provide clinical care (routine general care, first aid, triage, and health education) and to be observers of home life, assessing the impact of the clinic on actual behavior.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Boaco's hospital, Jose Neibowski, has 111 beds and faces serious funding shortages. Outpatient clinics include Profamilia, Chontales, El Socorro, and MINSA clinics. Profamilia is a small private clinic, supported by USAID, which serves the middle- and upper-class. Chontales also serves the insured. El Socorro is a public clinic providing general care and some special services to patients with social security. MINSA clinics provide free care to the poor, using new physicians who turn over often. Much of the budget is for salaries, limiting resources for treatment and equipment for women and children. Clínica Verde will cooperate with these facilities. By providing specialized services and education, Clínica Verde compliments existing clinics. Our clinic welcomes NGOs and medical missions.

Founding Story

Clínica Verde was founded in 2007 after Susan Dix Lyons and her husband, Dr. Tim Lyons, visited Nicaragua and experienced the dismal conditions of healthcare for the poor. They arranged shipments of equipment/supplies to a hospital in Boaco, but realized that this aid would not change the long-term health of patients. Health is a complex equation including access to services, health/nutrition education, community support, family planning, and economic stability in the home – most of which are headed by single women. With a background in architectural history, Susan felt strongly that a clean, attractive, responsibly designed space is the first step to well-being. Susan knew she couldn’t accomplish this vision without local support, so she partnered with Margarita Gurdian, Nicaragua’s former Minister of Health, and Cristiana Chamorro, the founder of a nonprofit in Managua and the daughter of former President Violeta Chamorro. Their participation was the green light Susan needed.
About You
Clinica Verde
About You
First Name


Last Name

Dix Lyons

About Your Organization
Organization Name

Clinica Verde

Organization Country

, CA, Napa County

Country where this project is creating social impact

, BO

How long has your organization been operating?

1‐5 years

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How long have you been in operation?

Operating for less than a year

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Access, Quality.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

Clínica Verde’s clinic provides high-quality healthcare to poor women and children in an environmentally sustainable, responsibly designed facility. Clínica Verde proposes a novel social environment where patients can improve their health interactively – by receiving the highest quality health care and participating in nutrition and health education. Clínica Verde will provide a medical home for 4,000 children for 12,000 visits per year and prenatal care for 1,500 high-risk pregnancies for 6,000 visits per year. The clinic aims to reduce by 20% the number of hospitalizations for infant dehydration, infant mortality and the number of babies of low birth weight. The clinic will also focus on adolescent fertility, given that 25% of all pregnancies in Nicaragua are to adolescent mothers.

What has been the impact of your solution to date?

Clínica Verde opened its doors to Boaco and the surrounding countryside on January 4, 2012. In its first month of operation, Clínica Verde had 837 patient visits, including 231 children under the age of 9. Treatment ranged from dehydration and flu to prenatal care for pregnant women. As Clínica Verde continues its outreach to outlying areas and as the community begins to develop trust in the promise of the clinic, we are seeing demand grow exponentially.

In these early weeks of the clinic's operation, the primary quantifiable benefit of the clinic has been economic. Consistent with its mission of environmental sustainability, construction of the facility, which was completed in mid-2011, used locally sourced materials and supplies, as well as local labor. This approach infused significant economic stimulus into the community of Boaco and nearby towns. Additionally, the clinic is providing 10 well-paying jobs in a very poor area, with that number projected to grow over time.

What is your projected impact over the next five years?

Nicaragua’s Ministry of Health has defined maternal, infant and perinatal mortality as a priority, consistent with the UN Millennium Development goals. Clínica Verde will support this, with the aim of significantly reducing mortality, improving pre- and postnatal standards of care, and empowering women to care for families through better nutrition and improved hygiene in the home. Through a sustained campaign of education and partnerships with schools, nonprofits, and local businesses, we will target the high rate of adolescent fertility by providing health care and education, as well as opportunities for young women. One of our five-year goals is to train teen girls as community health care workers, providing an opportunity to effect change and promoting a sense of self-esteem.

What barriers might hinder the success of your project? How do you plan to overcome them?

Clínica Verde is focused on the unique needs of women and children. However, the clinic will serve anyone with a need we are equipped to address, meaning demand for services will be high. Patients with insurance will be asked to remain with their providers in order to direct resources to the poorest. Once our services for the poor are running smoothly, we will open an exam room to serve paying patients during designated hours. This model provides a revenue stream to help subsidize care for the poor. Fundraising in the current global economic environment is also a challenge. We are realistic about the need to continue actively seeking donors while simultaneously building a business model that generates independent income. We are devoted to creating a model that ensures long-term success.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

Clinica Verde will treat 300 women and 700 children/month with a package of high-quality, high-impact interventions.

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Comply with Ministry of Health regulations, implement basic package of services, implement protocols & standards

Task 2

Manage Medical Outcomes: Develop and monitor a system of data collection to track health goals

Task 3

Community outreach: Family, children and pregnant women census; implement referral system; train community volunteers

Now think bigger! Identify your 12-month impact milestone

Provide care to 500 women & 1,000 children/mo.; expand community outreach; and achieve 80% of quality standards in all services.

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Comparative benchmarking of first year data: Application of quality standards measurements semi-annually on each service

Task 2

Outreach: Continued training of teen and other community health volunteers/leaders to conduct community outreach

Task 3

Technology: Implement electronic medical records to facilitate real-time patient monitoring, impact analysis, and recordkeeping

Tell us about your partnerships

Our partners include foundations, corporate/individual donors, and in-kind gifts. Among our many supporters are: COFRA Foundation, Vista Hermosa Foundation, John C. Griswold Foundation, Grace Episcopal Church, Violeta Chamorro Foundation, American Nicaraguan Foundation, Clif Bar Family Foundation, Cornucopia Family Foundation, Christadelphian Meal a Day Fund of the Americas, and the Grace Family Foundation. In-kind service has been provided by Valley Architects of St. Helena, CA, and Archilogix of Santa Rosa, CA. We have had a project page on Global Giving and Google Grants since 2008.

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?


What type of operating environment and internal organizational factors make your innovation successful?

Clínica Verde provides a clean, sustainable, caring environment for vulnerable populations, allowing women and children to receive high-quality care in a welcoming and safe environment. The sustainable building principles provide natural light, clean water, and operational efficiency to ensure that our patients have a high-quality experience. Each patient will be triaged by an LPN and each patient will see a physician who will determine the best course of treatment. Clínica Verde will implement one of Nicaragua’s first electronic medical records systems, providing accurate patient histories, real-time reporting, and 24-hour access for physicians to patient data. Our comprehensive system of education and monitoring will enable measurable progress against significant healthcare inequities.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list

A number of organizations have approached us for our sophisticated architectural plans and concept. We are currently working on a purchasing agreement for use of these plans. We are also exploring with an intellectual property attorney the possibility of one day franchising Clinica Verde.