Health Care and the Art of Motorcycle Maintenance

Nurse Initiated Management of Antiretroviral Treatment (Nimart) provides special training to nurses, allowing them to prescribe antiretroviral medicines to manage HIV treatment, increasing access among those who need the care. Previously, only doctors were allowed to prescribe the drugs, but since Nimrat launched all 17 area clinics now offer treatment and an average of 732 patients started treatment each month in the first year the program started.

Pakistan's poorest citizens, who previously panhandled for their basic needs, were launched onto an entrepreneurial path by the Heritage Foundation Pakistan. Eight impoverished communities have been trained in the craft of glazed tile work and terracotta art to lift the participants out of poverty. The program also created a market of interdependence, so the villages can purchase goods from one another, freeing them from relying on cities for their livelihood.

In many rural communities, access to specialty care represents the biggest health challenge. Since 2003, a groundbreaking initiative called Project Echo at the University of New Mexico has confronted that gap — with promising results in small towns across New Mexico and, now, around the world.

In South Africa, the extreme gap between rich and poor is the root cause of cyclical poverty, and those living in slums face particularly high barriers to education, healthcare, and quality of life. The Ubuntu Education Fund is using a comprehensive approach that includes sustainable investment in community leadership and infrastructure, a cradle-to-career household stability service, and a dexterous, community oriented approach to helping break the cycle of poverty.

Boda boda motorcycle taxi riders have become frontline HIV health advocates through the LISTEN (Local Innovation Scaled Through Enterprise Network) Community of Practice. Trained in HIV self-testing, prevention methods and counseling, the riders hold monthly awareness days, operate two community testing stations, and distribute preventive items to the public. Since the initiative began in 2019, the association has reached approximately 10,000 people, referred 2,000 for antiretroviral treatment and tested around 400 people per month.

Several state and local programs are emerging to fill the shoes of retiring doctors in the area, like the Advanced Nursing Education Workforce (ANEW) program. ANEW covers the cost of higher education for local nurses to become APRNs to then work as primary care nurse practitioners tto help address the lack of doctors and increase access to healthcare. So far, about 40 APRNs have graduated from the ANEWA program, 68% of which are from rural communities.

Our Lady’s Health Center — which is managed by Sisters of the Holy Cross — works to address the stigma and provide care to those with HIV/AIDS, specifically antiretroviral therapy services. The Center has established three community posts within local markets where those in need of care can easily access it in a discreet way.

Leadership groups formed by sex workers are helping to reduce HIV rates by traveling door to door and hosting meetings to educate people on HIV/AIDS awareness and how those with the disease can care for themselves, encouraging regular visits to clinics and antiretroviral therapy use. The program began in 2013 and now has 12,000 sex workers from around the country who are trained to provide aid and advocate for those with HIV.

In parts of Uganda, ride-sharing has been transformed into a medical delivery service to ensure that those who are unable to travel to their doctor for antiretroviral refills have access to the medications they need to stay healthy. Although the program is limited in terms of the areas it can serve due to cost, doctors in the region hope to continue and expand the program after seeing such success since implementation.

Rural counties in California face a shortage of psychiatrists and therapists. Some counties are responding to this issue by investing in mental health workers. In Amador County, the Amador College Connect program allows students who want to pursue a certificate or associates in human services to enroll in online courses. 44 students have been sponsored through the program since 2014.