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The Last Mile: Key to Primary Care Delivery

By: TIP Global Health | May 11, 2021

Primary health care is widely perceived as the pathway to universal health coverage and achievement of the United Nations’ Sustainable Development Goals for health. As nations in the Global North and the Global South alike transition to primary health systems, success will depend upon the ability of local healthcare delivery systems to encourage early and ongoing access to preventive care and the adoption of healthy behaviors. 

While primary health care holds much promise to deliver universal health care and achieve the Sustainable Development Goals, this promise is threatened by the current demands on frontline health workers whom primary care systems depend upon around the globe. The onus for successful primary care delivery falls onto the shoulders of frontline health workers who deliver care and health care recipients who are expected to follow through on care recommendations. Frontline health workers carry the heavy burden of responsibility for providing higher quality of care to more people who must access care more often, while encouraging return visits, inspiring healthy behavior change, and ultimately improving health outcomes at the individual and community level. They often do so in settings with limited resources and where the socioeconomic barriers faced by their patients seem insurmountable. 

Working under these conditions can place frontline health workers at high risk of burnout, an increasingly common syndrome in which health workers exhibit signs of emotional exhaustion, depersonalization, and lack of a sense of accomplishment. Research has demonstrated that increased levels of health worker burnout is associated with poorer quality of care provision. With current burnout rates among health workers in some African countries between 40-80% and a global shortfall of 18 million frontline health workers, health systems must be designed to ease rather than compound workforce burnout.

TIP Global Health was founded on the belief that quality health care starts from the bottom up, in early alignment with government priorities, and with frontline health workers and the patients they serve at its core. For the past 12 years, we have succeeded in developing highly-effective and self-sustaining community-driven solutions that transform health care delivery and health systems.

TIP Global Health is a leading authority in developing lasting solutions on the frontlines of health. TIP’s transformative approach to collaborating with frontline health workers, alignment of its work with government priorities, and rigorous data-gathering, enables the scale-up of highly-effective solutions to extend access to life-saving quality care.

We empower frontline health workers to take the lead in creating lasting solutions, and we work to strengthen health worker capacity, resilience, and hopefulness. TIP never forgets the undue burdens and stressors placed on under-resourced and too few frontline health workers. The well-being of frontline health workers and the relationship between health care provider and patient is key to every step of our problem-solving process.

Early on, we align with government partners and priorities for ease of scale-up. TIP works in true partnership with government officials from the start to align with their priorities, protocols, and existing structures, by sharing information with all who need it, and by developing solutions on the frontlines that are self-sustaining and easily replicable. To ensure effective implementation strategies and scale-up policies, TIP designs a mechanism for communities and frontline health workers to provide feedback to government officials. TIP serves as a go-to resource for government officials and implementing organizations on how to get things done and in the right way.

TIP’s local on-the-ground expertise and community-driven solutions are key to lasting improvements and quality of care.  All of TIP in-country staff come from the communities we serve. We know that local leadership is crucial to the design, implementation, and effectiveness of our programs for the betterment of people’s lives. TIP’s experienced team apply and adapt the best thinking and most transformative approaches to solving persistent health challenges. TIP builds strong relationships with community stakeholders by listening, learning, and co-designing for successful solutions. 

Finally, TIP’s rigorous data-gathering and impact reporting combined with a strong commitment to the participation of frontline health workers and the community is unique to TIP and leads to highly-effective and enduring health outcomes. We apply exacting business processes, procedures, and metrics to all we do to ensure effective, cost-efficient, and measurable results. TIP shares its findings widely, to help build the knowledge of other organizations to help meet the global goal of health care for all. No one organization can do it alone.  

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