The Dignifying Solution to America's Care Crisis

The Ohio District 5 Area Agency on Aging hires state-tested nursing assistants (STNA) to act as community care specialists and provide in-home care to seniors. This care provides respite for unpaid family caregivers and allows seniors to continue living independently in their homes. In 2023 alone, the program served 130 residents, providing 2,371 hours of in-home care.

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.

The Abiye Project registered over 20,000 pregnant women using a community-based model to ensure they receive proper healthcare. The program connected women with trained health rangers who served as liaisons with traditional birth attendants (TBAs). When TBAs’ resistance stalled the program, the government introduced financial incentives, paying them for each patient referral, leading to more hospital births and a reduced child and maternal mortality rate.

Modeled after a similar program in Costa Rica, Neighborhood Nursing has teams of nurses and community health workers who host weekly visits throughout the community to provide free medical care — particularly preventative care — to those who need it. Neighborhood Nursing has helped build trust between residents and healthcare workers and aims to serve more than 4,000 people within the next year.

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.

In order to tackle opioid addiction, the state of Virginia found a way to make drug treatment accessible to people with medicaid by boosting “reimbursement rates to addiction treatment providers.” Historically, drug treatment hasn’t been covered by health insurance. Virginia is changing that. Already, “the percent of Medicaid members with an opioid use disorder who received treatment went up by 29 percent from April to December 2017 compared to the same period the previous year.”

The Safer Hands Health Initiative (SHI) aims to reduce maternal mortality across the country by educating and empowering birth attendants, healthcare centers and pregnant women to use safe delivery practices. SHI partners with medical boards and area hospitals to provide free training for birth attendants and also provides sterile birthing kits to expectant mothers. So far, SHI has trained over 200 birth attendants and has distributed more than 10,000 birthing kits.

The Veterans Health Administration's Caregiver Support Program offers resources to family caregivers looking after veterans, including a monthly stipend, medical services, counseling and mental health care, respite care and coverage for travel expenses. The Program launched in 2011 and by 2014 about 15,600 caregivers had been approved for support — greatly exceeding the Program’s original estimate of 4,000 people.

The United Kingdom's single-payer health insurance system, known as the National Health Service, has helped citizens obtain the essential care they need without having to worry about the cost of the care. While the model has shown proven success in reducing overall health costs and increasing positive health outcomes, some citizens say that care can be delayed due to demand, which leads them to pursue supplemental insurance.

Black American mothers are about 3.5 times more likely to die from complications related to childbirth than white American mothers. A program called Pregnancy Medical Home in North Carolina has contributed to successfully eliminating this disparity by targeting low-income mothers and focusing on risk factors that contribute to poor maternal outcomes. The program is funded by Medicaid and mothers who are identified as being high risk are paired with a care manager who helps them to achieve the health plans set forth by their doctors.