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Underserved Rural Patients

By Dale Knutson | 28 Dec, 2016

Delivering health care to rural communities around the world proves challenging even under the best of circumstances. I work in a very poor country with inadequately trained physicians who focus on symptom relief. Are there private sector models that help those who lack health information to access good care? Also are there models giving incentives physicians to serve the poor. i.e..who pays for the services in a resource limited environment?



Sharon Brownie Replied at 2:04 AM, 28 Dec 2016

Evelyne MUKAKABANO Replied at 2:25 AM, 28 Dec 2016

Happy New year 2017 dear panalists
Thank you for this sensitive topic
I'm working in rural village for more than 10yrs
My Country initiated a community health workers scheme.
Elected opinions leaders are trained in basic health care like testing
Malaria ,delivering ARTS and counseling etc.. Then the MOH provides
training ,packages and follow up in villages
This strategy is really successful

Thomas Bauer Moderator Replied at 8:57 AM, 28 Dec 2016


Thank you for your post... Can you share some details on this program? How do you select and train the opinion leaders?

Thank you


Saad Hashmi Replied at 7:08 AM, 30 Dec 2016

I designed a healthcare model for rural areas.I uploaded document with title of "Healthcare Reforms in Pakistan"

Please let me know in case you can't find it.

Mark Siemon Replied at 7:53 PM, 30 Dec 2016

Community Health Workers are excellent additions to health and social service organizations in low and middle income countries WHO Global Health Workforce Alliance ( has some excellent online resources. There is also a USAID report on "Developing and Strengthening Community Health Worker Programs at Scale" (

Attached resources:

Jacqueline MUKAKAMANZI Replied at 2:31 AM, 31 Dec 2016

Hey dear all,
This a very good my country community health works (CHW) are very
helpful in the management and treatment of some diseases.
They are having skills in the diagnostic of malaria using RDT therefore
delivering drugs like coartem.In this day,people from low income familiesa
and those with malaria are treated for free. This is helping in malaria
related mortality reduction.
Those CHW also delivers family planning services and look after pregnant
mothers until they give birth.
Happy new year 2017.

Monique Germain Replied at 11:55 PM, 31 Dec 2016

Thank you for sharing your information with us. I would like to know how you measure the effectiveness of the delivery of care of the community health workers. Can you share this with us?

Saad Hashmi Replied at 9:11 AM, 2 Jan 2017

Please find link here to view healthcare delivery model for rural areas.

Attached resource:

Mark Siemon Replied at 12:15 PM, 2 Jan 2017

To All,

Measurement of the effectiveness in the delivery of care by community health workers is complex due to their different roles and responsibilities. A number of reviews have been published documenting evidence of CHW effectiveness including:

Lewin, S., Munabi-Babigumira, S., Glenton, C., Daniels, K., Bosch-Capblanch, X., . . . Scheel, I. B. (2010). Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases (No. CD004015). Cochrane Database of Systematic Reviews, 3.

Viswanathan, M., Kraschnewski, J. L., Nishikawa, B., Morgan, L. C., Honeycutt, A. A., Thieda, P., . . . Jonas, D. E. (2010). Outcomes and costs of community health worker interventions. Medical Care, 48(9), 792-808.

World Health Organization [WHO] (2007). Community health workers: What do we know about them? Geneva, Switzerland: World Health Organization. Retrieved from

Also, Section 4, Chapters 13 & 14 of the USAID report "Developing and strengthening CHW programs as scale" has information on evaluation and measurement of CHW programs.

Best Wishes for a peaceful New Year

Mark Siemon

Monique Germain Replied at 2:21 PM, 2 Jan 2017

Thank you for the Health Care Delivery link you posted. The model seems to be very comprehensive. The Flow Chart of Proposed Health Care Process in a Province is easy to follow and to apply.

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This community is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.