The $1 Visionary

In Kern County, where pregnancy-related mortality rates are more than double the California average and Black mothers face life-threatening complications at nearly three times the rate of white women, community doulas are working to bridge the gap between patients and the medical system. Since California expanded Medi-Cal coverage to include doula services in January 2023, more than 1,400 doulas have enrolled statewide, with active training pipelines building the workforce locally.

In 2017, residents of Kabuga Aisami in Kano built their own maternal and child health hospital to address maternal mortality rates and improve access to care. Led by the Kabuga Aisami Community Initiative (KACI), community members pooled resources to construct the facility, which includes two labor rooms, three wards with 40 beds, four laboratories, a pharmacy, 25 toilets, and three self-contained flats for doctors to enable 24-hour care. Patient volume has since increased by over 250%, and the hospital has expanded to serve 10 surrounding communities, as well.

The Mamacare Foundation has trained over 860 traditional birth attendants (TBAs) in hygiene, safe delivery practices, danger-sign recognition, and timely referral systems over the past decade to improve maternal care in the region. The program pairs each TBA with a supervising midwife, creating a collaborative bridge between traditional and modern maternal care. The training has increased referrals from TBAs to clinics by 40%, and district hospitals report fewer emergency cases arriving in critical condition since the Foundation has formed.

After sudden U.S. government funding cuts jeopardized South Africa's HIV programs, Limpopo's Hlokomela Clinic quickly reorganized around existing resources, training community health workers to identify and encourage farm workers to visit still-operational clinic sites for HIV testing. By leveraging volunteers, they partially offset the impact of losing their dedicated HIV testing outreach team and program funding.

Aflorar Herb Collective provides herbs to community members in the wake of Hurricane Helene and intense recovery efforts to address high levels of stress, anxiety, insomnia and other mental health struggles. The group uses locally grown herbs and traditional practices to make teas, salves, soaks and other remedies to calm the parasympathetic nervous system and provide a moment of much-needed self-care and rest to those impacted by the storm.

Local activists are joining together to protest the potential closure of Southwest Memorial Hospital’s birthing center, advocating and organizing to ensure the hospital stays open and locals can access the care they need in rural areas.

Toronto’s Vaccine Engagement Teams Grant has awarded $5.5 million to community organizations in 140 neighborhoods to hire and train local ambassadors for vaccine outreach. Because the ambassadors share a lived experience with the communities, they can effectively identify the barriers people face. The on-the-ground effort includes sharing information, advocating for community needs, and helping people access services. The outreach focuses on people often overlooked by government services, such as unhoused people and people who do not speak English or have precarious immigration status.

Rural communities throughout the United States are experimenting with a Boston-based senior-assistance program that implements a shared-services approach to senior care. Although barriers to creating connectivity in isolated rural regions can be more challenging than in more urbanized cities, rural areas in Colorado and Montana are finding ways to make it work.

A community-focused health care program in Harlem, New York helps connect local residents with people from their own community – known as "health coaches" – who can help address their health concerns. Doctors from local hospitals have reported that this type of program "unburdens" them, and that the "hands-on, person-to-person connection" is crucial for determining underlying reasons for health problems.

The United States now has a variety of federally-supported nutrition programs, but the health care system remains disconnected from the social determinants of health. Many doctors simply lack the resources to provide the comprehensive care proven to have greater impact on health than strictly medical treatment. A group called Health Leads is training young volunteers to treat the social factors, like poor nutrition and housing needs.