REACH: Taking Quality Healthcare to Communities in Kano State

Worker-owned home-care cooperatives are emerging as an alternative to the for-profit agencies that dominate America's direct-care sector. In these cooperatives, professional caregivers earn an average of $2 more per hour than the industry standard, share in business decision-making, and stay on the job at nearly double the rate of workers at traditional agencies. Patients also stay with co-op agencies twice as long, suggesting higher satisfaction and quality of care.

Clinica Amistad is a free, volunteer-driven primary care clinic addressing the healthcare access gap for uninsured and underinsured residents, particularly among the Hispanic/Latine community. Operating on $600,000 or less per year, the clinic offers a wide range of services, including chronic disease management, behavioral health counseling, and a Spanish-language pre-diabetes education program. In 2024, the clinic served 956 patients across nearly 2,500 visits, with patient volume growing 10% since 2017.

Helpster Charity operates a tech-enabled emergency financing model that connects families facing urgent medical bills with donors through a website and app. The nonprofit uses volunteers stationed at partner health facilities to identify patients who can’t afford critical care for conditions like malaria, sickle cell anemia, and kidney problems. The organization has helped provide treatment for over 2,000 families across Nigeria, Kenya and Bangladesh.

A mobile diabetes clinic in Calgary brings comprehensive healthcare directly to people experiencing homelessness or low income at community health centers. The team provides services including foot care, retinal scans, blood and urine screening with immediate results, dietary counseling, and connections to housing and mental health programs. The "one-stop-shop" model eliminates the need for patients to travel to multiple appointments, ensuring they get the care they need.

Several doctors are working together to integrate oral health into medical checkups for children, pregnant women and others who can’t afford or access a dentist. With the help of a five-year, $6 million federal grant, a team of doctors and dental hygienists has trained 250 primary care providers in how to provide oral health care in several states, allowing patients to access dental care during regular checkups.

Program for All-Inclusive Care for the Elderly (PACE) provides care to elders including adult day care, home health care and supplies like bed rails, eyeglasses and access to medications, while simultaneously providing respite to family caregivers. Studies show PACE program participants have lower rates of hospital use and shorter lengths of stay compared to those participating in other programs or opting for general nursing home care. The PACE centers in Metro Detroit serve 1,600 adults across its seven centers. Statewide, there are 14 active PACE programs across 24 centers.

Several government programs and funding measures are emerging to improve home care options for families in need, such as increasing wages and benefit opportunities for providers. There are also nonprofits like All Things Home Care that provide transportation to area home care workers and represents its workers with a union to afford them better treatment to ensure those in need can still receive necessary care at home.

Although offering at-home care has been a practice for some time, the coronavirus pandemic has helped prompt more health insurance companies to allow health care workers to implement the practice at a larger scale. Treating patients in their homes doesn't just reduce the caseload for doctors in hospitals but also has been shown to have positive effects on the patient's overall health and well-being. Since the change in health insurance police, "interest in the programs has skyrocketed."

The Anambra State Health Insurance Agency (ASHIA) extends health coverage to Nigeria's hard-to-reach groups by embedding insurance premiums into weekly transport worker fees and partnering with cooperatives and trade unions for group enrollment. It also offers an “Adoption Model" that allows donors to sponsor vulnerable residents' coverage. With 235,000 active enrollees, ASHIA has dramatically reduced out-of-pocket healthcare spending from 92.1% to just 10% for those enrolled and has also significantly increased the number of people who seek coverage.

Community paramedicine programs have been in existence for years but are just recently gaining popularity as a means of letting paramedics act less like crisis managers and more like health counselors. Initially designed to "decrease emergency department utilization, save health care dollars and improve patient outcomes," the program flags frequent 911 callers and prompts a conversation between the paramedic and patient about joining the mobile healthcare program.