Basic Health Services

It might be hard to imagine how something as fundamental as a toilet is not on the top of someone’s priority list. Or to understand why a patient stops taking his tuberculosis medication even though it’s free. But the reasons are simple: People living in extreme poverty face numerous challenges and conflicting priorities at every turn.

Children across India suffer needlessly from malnutrition. Evidence-based school health programs, administered well, are key to changing that situation. In the coming months, we look forward to progress on three clear fronts.

Careful planning now will help ensure state-by-state adoption of well-designed deworming programs. And if that happens, we may achieve a future in which intestinal worms and malnutrition are a rarity, not a baseline expectation, especially among the poor.

Deworming programs have been shown to be highly effective. With a long term commitment to the program, Rajasthan is likely to reap dual benefits from the program: Improved childhood health and elevated educational levels.

In the effort to promote universal access to sanitation, we can’t get distracted by the relative glamour of a technical design competition to reinvent the toilet. We also need an arsenal of non-technical strategies.

Our job in the coming years is to bring the right government stakeholders and the right program-implementation partners to the table to help ensure that the existing solutions are effectively implemented using money that’s already there.

A recent article in the Stanford Social Innovation Review critiqued private foundations for the tendency to fund diseases that are “highly visible and ownable.” The critique hit home for us – not because it reflects the way we work, but rather because it reflects some of the thinking that’s led us to our current approach to health issues in India.

The health benefits of deworming are proven and the implementation methodology for mass, school-based, urban health interventions has now been successfully modelled. Now it's time to expand on what we've learned.

On February 21, the government of Delhi kicked off a massive, school-based deworming effort to treat an estimated 3.5 million children. Our hope is that this effort serves as the catalyst for a more comprehensive school-based health program in Delhi, and that it becomes a model for other Indian cities seeking to embark on public health programs with the potential to help millions of children get healthier and stay in school.

When Ana Trejo moved to Austin 13 years ago, she joined the expanding Latino population in Travis County, which has grown by 50% over the last 10 years and is expected to double again in the next 10 years. She hardly knew anyone and barely understood English