Please describe the goal of your initiative; outline what you are trying to achieve
The purpose is of KOHCP is to give rural Nepalis agency over their own oral healthcare. Unlike many health initiatives, which aim to treat many people in a short time, KOHCP’s goal is to foster a gradual change in heath culture that ends with an organic and sustainable health environment.
Therefore, KOHCP measures success by how many people can and do make effective prevention and treatment choices on a daily basis--regardless of income, location or social status.
This choice depends on many factors: access, affordability, education, attitude. KOHCP endeavors to put in place all the factors that cause patients to seek their own treatment—and to reduce the number of patients that get created in the first place. That's our definition of sustainable change; it makes us unnecesssary.
What has been the impact of your solution to date?
We are running two programs in two neighboring villages. Over 5-6 years, we’ve observed a drop in the incidence of dental problems among children; the gritty spice mixture for brushing is hard to find in local shops; “fluoride” is a household word; hundreds of adults and thousands of children have been treated with dental care locally or through city partners. With two medical technicians and five teachers, we have given access to education and affordable dental treatment to an area of about eighteen thousand people.
We are currently completing surveys that will quantify our observational impact on beliefs, household habits, and socialization of oral health care concepts. So far we have assessed these factors by measuring program participation, referral follow-up, payment of nominal treatment fees, participant referral to new participants, fluoride use, and walk-in rates (drop-ins at our dental clinic who came without referrals because they already knew it was there).
What is your projected impact over the next five years?
Having recently hired a full-time Program Director in Nepal, we will launch 2-4 new replications in 2012 and each year thereafter. Each replication should be absorbed by local schools and health institutions within 2-3 years. Population density of Nepal’s villages varies tremendously, and it’s hard to predict the impact that working in more remote areas will have on our speed. But we can assume that each replication will affect an area of 4000 – 10,000 people. Of the 20 million rural Nepalis without sustained dental services, we estimate that KOHCP will access 40 to 80 thousand in the next five years. Critically, this number represents a permanent change in oral health infrastructure for that population, not a transient intervention. With time, there is no limit to the potential impact.
What barriers might hinder the success of your project? How do you plan to overcome them?
Every village is different. No matter how much we learn, or how close our staff stays to the ground, the societal factors that hinder self-care will be new to each and every replication. Being keen to these nuances is essential. Similarly, environmental factors such as access to water and roads will grow more difficult as we expand to needier areas. The goal is always to use the lightest touch, to ignite existing resources, and add essential missing nutrients so that the entire system comes to life. Often these solutions are clarified in discussions in the grass with local teachers or leaders. The only singular solution is therefore to hold these conversations, be adaptable, and maintain a clear hold on the purpose of our activities so as to effectively navigate the project.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Conduct impact surveys on existing projects, lay groundwork for turnover, launch one new replication.
Now think bigger! Identify your 12-month impact milestone
In a year, launch 2-3 additional programs and hand over the oldest program (Kaskikot Village) to local management.