THE VISION

“Poor communities cannot pay for healthcare. How many times have I heard this? We’re breaking the myth. By the end of 2007, the pilot project in Pedro Vicente Maldonado, which serves 50,000 people, will be able to maintain itself with little or no outside help. How? – by providing high quality, permanent services utilizing innovative financing mechanisms to cover operating costs, and always leaving the door open for the truly indigent.”
dddddddddddddddddddddddddddddddddddddddddddddDavid Gaus, MD.

The AHD Model

Primary Healthcare (PHC) as a strategy has accomplished much in the developing world since the 1977 Alma Ata Proclamation. Ecuador is a good example of that when one reviews the traditional health indicators. With all of the political, economic, administrative, and cultural challenges that still exist, Ecuador, like many countries around the world, has successfully implemented many aspects of PHC.

There continues to be women who suffer greatly and continue to die from pregnancy complications. Children continue to die at an alarming rate from infectious disease. New diseases such as diabetes, cardiovascular disease, arthritis, and mental health disorders are now making inroads in developing countries still trying to combat the old traditional diseases known to the lands.

These more complex health conditions require more complex solutions that transcend PHC. Recognizing the need to continually reinforce PHC, it is apparent that “secondary care” services (basic hospital care) in rural areas of developing countries need to address these complexities. Unfortunately, few rural hospitals in developing countries possess the tools to accomplish this. Limitations in clinical and administrative knowledge, coupled with financial constraints and unclear policies make for an unfavorable environment unable to confront these challenges.

This limitation is where AHD has asserted itself. Hospital PVM proves that great secondary care can indeed be locally financed and provided to poor populations to address health problems that go beyond PHC.

The Ecuadorian Ministry of Health’s recognition of the importance of this pilot project and their invitation to AHD to introduce the AHD model in government rural hospitals will have a dramatic impact on healthcare practices and more importantly on the health of communities in such great need.
SPACE

• Genuine community partnership is critical in developing and maintaining quality, long-term healthcare services.
• The secondary care services provided by a rural hospital are a vital complement to primary care. Localized secondary care improves health outcomes and saves lives of the target population that primarily includes women and children.
• Financial resources are already available in most rural communities. Although widespread poverty exists in these areas, there are pockets of resources that can be mobilized to offset, in part, the cost of healthcare services. Frequently these financial resources are spent inefficiently in times of crisis.
• The successful rural healthcare system depends on the development of relationships between public and private sector partners in the community. This includes local government, business leaders, labor unions, school boards and healthcare provider
• Strong leadership and governance are fundamental to fostering and maintaining public and private partnerships.