Small Island, Big Experiment

Hospitals in New York improve healthcare quality and reduce medical costs by staying in frequent contact with patients requiring frequent or long-term care. Montefiore's Accountable Care Organization pulls in care providers from across the medical and social spectrum to improve patient health while curbing expenses.

The rate of Cesarean sections is on the rise in the United States, despite the higher risks of hysterectomy, hemorrhage, and infection, as well as the elevated expense. San Francisco General’s maternity ward, however, stands as an outlier by following evidence-based medicine that suggests decreasing C-sections and has also shifted from a pay-per-service incentive for the doctors to a salary or shift position.

Organizations are mobilizing volunteers in hospitals to connect low-income families with human services which address social factors like poor housing, nutrition, etc. so patients are able to work and thus afford healthier lives.

In Uruguay, illegality and stigma surrounding abortions resulted in problems with maternal mortality rates. Utilizing a unique solution, a medical protocol was created to provide initial information and followup care to women seeking abortions.

A collaboration between architectural designers and medical providers created a cholera treatment clinic in Port-au-Prince where the design of the building itself supports treatment. The building is well ventilated and filled with natural light, provides an open space for providers to see many patients and be able to respond in case of crisis, and has the ability to collect and treat water.

The poliovirus has plagued Nigeria for years, but the country is approaching near-eradication thanks to community public health workers' efforts to increase education, immunization and reporting. Throughout the country workers known as Disease Surveillance and Notification Officers are trained to recognize the symptoms of polio so the cases can be reported and addressed immediately. Coupled with the efforts of community informants, this approach has already resulted in parts of Nigeria becoming polio-free.

Enrolling local agents allows global partners to connect underserved and remote communities to healthcare. A partnership between Rwanda’s Health Ministry and the Boston-based nonprofit, Partners in Health, trains community-based health workers to communicate and connect people on the ground to health services across the country. Rwanda has also implemented reforms and services such as government-subsided healthcare, which has helped improve the life expectancy of its citizens.

The United States and Italy have been playing catch up in the mitigation of the coronavirus pandemic and were resistant to implementing social distancing, while other countries took more aggressive approaches. Now both countries are looking to China and South Korea to learn how sweeping actions and industrialized scaling of measures such as fever clinics, temperature check points, portable CAT scanning, and social isolation, have helped to contain the pandemic.

The HIV/AIDS clinical trial network’s 30 sites have spent years building trust among historical marginalized communities so that more clinical trial participants come from communities of color. Educational outreach, awareness-raising efforts, and one-on-one conversations are among the strategies used to make the scientific process more transparent. The engagement model is upfront about abuses from the past and uses straightforward explanations with no medical jargon. Infectious disease experts are using the trust-building model to increase the racial diversity of participants in COVID-19 vaccine trials.

Teams of Community Direct Distributors (CDD) are leading drug distribution campaigns to prevent and eliminate neglected tropical diseases in hard-to-reach, rural areas. These CDDs are members of the community they serve and are trained to educate the locals on disease prevention and administer the drugs themselves. With the CDDs’ help, several states have already eliminated some diseases and greatly reduced the spread of others.