COST IMPACT PROFILE*

~$45,000 to implement the approach for a village (average village size is 1,500 people). Example impacts:

  1. Near elimination of child malnutrition
  2. Improved child survival: for every 1,000 live births, ~50 fewer infant deaths compared to rural India overall
  3. Multiplied impact through training health workers
*See Case Study tabs for more and full case study analysis for sources of data

Community-Based Health and Development Programs

In low-resource communities around the world, millions of children continue to suffer and die from preventable and treatable illnesses. Comprehensive community-based health programs successfully address the social stratification, traditional beliefs, and economic barriers limiting the ability of communities to address their health needs and access proven tools such as vaccines. These programs not only achieve excellent health outcomes but are also cost-effective, transformative, and sustainable. They:

  1. Take a long term view and build local capacity to solve problems
  2. Emphasize behavior change and preventive care with links to hospital care when needed
  3. Integrate programs addressing the root causes of poverty through education, livelihood, and water and sanitation

These strategies work because many of the major causes of poor health are things that can be addressed at the community level (e.g., dirty water, malnutrition, social caste, and limited education). They are particularly cost-effective because unnecessary sickness and more costly medical care are avoided with prevention and early detection.

Case Study: The Comprehensive Rural Health Project

The Comprehensive Rural Health Project (CRHP) based in Jamkhed, India pioneered this community-based approach and has led its expansion throughout the world through their training institute. CRHP’s approach tackles the social, cultural, economic and health workforce barriers perpetuating poverty and sickness. CRHP engages all stakeholders in the community to find local solutions that address root causes of ill health and under-development. In doing so, CRHP fosters behavior change leading to sustainable health outcomes.

How It Works

CRHP inspires change through three main reinforcing components (see graphic). Village Health Workers and community groups mobilize local and outside resources to promote social and behavior change. These programs harness existing human resource capacity and overcome traditional caste and gender barriers.

Community level programs are integrated with mobile health teams, a CRHP-run hospital, and development initiatives such as sanitation, job training, banking, and agriculture. The CRHP Training Center introduces health workers from around the world to this approach.

Representative Impacts
  1. Near elimination of child malnutrition (e.g.,1% in CRHP villages, compared to 46% in rural India)
  2. Improved child survival: for every 1,000 live births, ~50 fewer infant deaths in CRHP villages compared to rural India overall despite being an impoverished region. The infant mortality rate in CRHP villages is 8 per 1,000 live births compared to 55 per 1,000 for rural India.
  3. Improved maternal outcomes: In CRHP villages, more than 99% of pregnant women receive prenatal care and have safe deliveries. The resulting maternal mortality ratio (annual deaths due to pregnancy causes per 100,000 live births) is 50% less than India overall.
  4. Multiplied impact through training health workers and influencing policy globally
  5. Sustained improvement in key development indicators including food security, women’s economic and social status, and clean water and sanitation

Scaling of Impact
  1. From the initial 30 villages in the early 1970s, the project has expanded to serve a population of over 500,000
  2. Over 25,000 health workers from around the world trained
  3. The approach of CRHP has reached hundreds of millions of people through its incorporation into India’s National Rural Health Mission and other public health programs around the world
Cost/Impact Profile

~$45,000 to implement the approach for a village (average village size is 1,500 people). (See “Representative Impacts” section).

CRHP is active in project villages for an average period of five years, during which it builds community capacity and empowers villagers to take on leadership of all health and development initiatives.

Taking Action

Community-based health programs like CRHP not only provide a great bang for buck but they also create impact that is sustainable, scalable, and transformative. Read more...

  1. For donors looking for specific organizations that use a comprehensive, community-based approach, here are a few examples: Learn more…
  2. For donors looking to assess a rural health program or for donors who are already engaged with an organization and are interested in supporting adoption of this approach, here are general characteristics that are shared by the most effective implementers. Learn more…
  3. For entrepreneurial donors looking to develop new approaches, here are key principles that underlie this successful strategy: Learn more…

*See full case study analysis for references and sources of data