Antimicrobial resistance: Patient led contact tracing helping Ugandan medics to fight drug resistant TB

Project ECHO - driven by a single doctor with a cause - pulled together a team of specialists to develop a model that combines technology with collaborative care and careful patient tracking to help cure for diseases spread to patients around the world through community healthcare agents, as opposed to only specialty centers. This kind of "disruptive innovation" is effectively working to demonopolize health care knowledge and access, and lends to a health system capable of meeting today’s soaring demands for care.

Patients in U.S. hospitals suffer high rates of infection due to poor practices such as lack of proper hand-washing and lack of sanitization when inserting central line catheters. The Michigan Health and Hospital Association set out to reduce the rate of infection in their Intensive Care Units by developing a 5-step protocol for nurses and doctors to follow when inserting central lines. What they found was astonishing-- following these simple steps reduced the rate of infection to zero within three months of implementation.

Teams of Community Direct Distributors (CDD) are leading drug distribution campaigns to prevent and eliminate neglected tropical diseases in hard-to-reach, rural areas. These CDDs are members of the community they serve and are trained to educate the locals on disease prevention and administer the drugs themselves. With the CDDs’ help, several states have already eliminated some diseases and greatly reduced the spread of others.

Following an outbreak of yellow fever, officials in the West Nile region of Uganda rolled out a mass vaccination campaign through community health centers and regional hospitals. Thanks to awareness efforts and diligent testing, the outbreak was addressed with no new infections, and vaccines for yellow fever are now being added to Uganda's routine vaccination schedule.

Liberia's community health worker program taps residents of rural areas to receive training in disease surveillance and basic health care, creating a network of on-the-ground professionals to report potential outbreaks before they begin to spread. The program has contributed to more rapid treatment of malaria cases, with 71 percent of cases treated within 24 hours in 2021, and has significantly increased the number of rural residents with access to care.

Across Cross River, the government is partnering with traditional leaders, both chiefs and Muslim clerics, to build communication, trust, and acceptance of its polio vaccine program in local communities. The strategy has contributed to the fact that 900,000 children have received both sets of the vaccine and the state remains polio free.

Different chapters of the Nigerian Medical Students’ Association came together to form the National Malaria Elimination and Sensitisation Project or NMESP in 2021 wherein 433 of their members volunteered to carry out outreach work. They collaborated with local churches, youth groups, and the local health centers to reach the community. In 46 days, they had spread malaria awareness in about 38 communities and tested 523 people with Rapid Diagnostic Test kits. They also prescribed medications, and distributed free repellents and insecticide-treated mosquito nets.

Williamson Health and Wellness Center is a federally qualified health center in rural West Virginia, that provides medical, dental, and mental health care as well as chronic-disease management and wellness coaching on a sliding scale. The health center addresses social determinants of health with programs like fresh produce delivery, a community garden, and workforce development. The community health worker program has seen success by hiring local people to visit patients at home and work with them to monitor their blood sugar, take their medications properly, and learn healthy lifestyle choices.

Drive-through coronavirus testing sites aren't just safer for all involved, they're also more efficient. Although the limited exposure to hospital personnel and other patients is critical for slowing the spread, drive-throughs, and walk-up tents also allow for more people to be tested at a faster rate by eliminating barriers such as patient intake.

The Norwegian government has banned residents from retreating to their rural, vacation homes as they self-isolate during the COVID19 pandemic. Those that do will face a nearly $2,000 fine, or 15 days in jail. This ban is in place because rural health infrastructure cannot handle the influx of residents if they were to arrive and start testing positive for the novel coronavirus.