What are the health needs and challenges?

In many developing countries, most people live in rural or semi-urban villages. Health education, health-seeking behavior and health expenditure are low in these communities, where women and children are especially affected by health problems.

Health problems are also amplified by poor sanitation, hygiene, nutrition, and a lack of clean water. In many communities, tuberculosis, diarrhea, pneumonia, malaria, mother and child malnutrition, gastrointestinal problems, noncommunicable diseases, such as hypertension and diabetes, and an alarming rate of infant mortality are common. In India, for example, more than 65% of the population has limited or no access to healthcare, primarily due to underdeveloped healthcare infrastructure.

Partnership activities and how they address needs and challenges

In 2007, Novartis launched “Arogya Parivar” in India, the first of several Novartis Healthy Family programs. Novartis Healthy Family is an integrated business model that builds local, sustainable capabilities for healthcare in developing countries.

Arogya Parivar (“Healthy Family” in Hindi) works with local resources and empowers villagers to help themselves. Novartis recruits and trains locals in remote villages to become “health educators,” who help inform communities about health, disease prevention and the benefits of seeking timely treatment. Local teams also work with doctors to organize health camps in remote villages – mobile clinics that provide access to screening, diagnosis, and therapies. “Health supervisors” serve as the initiative’s local sales force, interacting with local pharmacies and doctors.

The program, which became self-sustaining in less than three years, offered more than 40, low-cost medications for communicable and noncommunicable diseases that are prevalent in rural India. Its approximately 400 traveling health educators and sales supervisors have become a welcome sight. The program is currently being refreshed to refine the therapeutic area focus in line with decentralization of specialty disease care.

Given Arogya Parivar’s success in India, Novartis has rolled out similar programs in Vietnam and Kenya. The initiative has been adapted to local market conditions and disease prevalence in each country. In Vietnam, the Healthy Family model is based on a public-private partnership. Healthcare professionals in public health roles collaborate with Novartis and travel to rural areas to conduct health awareness sessions in commune health centers screening for hypertension and diabetes in adults over 40 years old.

The product portfolio is adapted to the diseases most prevalent in the rural areas of each country. To be included in the portfolio, products need to be simple to use and relevant to local patients. The current portfolio of medicines includes antibiotics, non-steroidal anti-inflammatory agents, diabetes, hypertension and dyslipidemia medicines as well as anti-infectives that can be used in gynecological treatments.

Novartis plans to evolve the portfolio to include more innovative medicines as governments decentralize tertiary care. Further, the company plans to prioritize key disease areas where it has established comprehensive programs. For example, in India, the focus will be on areas where the Healthy Family team supports ecosystems of care in diseases such as leprosy, sickle cell disease, malaria and avoidable blindness.

The model is based on six “A’s”:

Awareness

Health education meetings on hygiene, nutrition and common and specific prevalent conditions increase disease awareness and inform communities about prevention and the importance of good health.

Affordability

Medicines in the Healthy Family portfolios meet affordability criteria in rural settings. Further, providing health services and medicines close to home minimizes travel costs, which can be more expensive than treatment.

Adherence

Several factors account for low adherence rates to treatment in developing countries, including the out-of-pocket cost of drugs or low levels of health literacy. Heath education meetings and health camps help by providing information about the importance of following treatment through.

Adaptability

Products are tailored to the local disease burden, and health educators adapt the program to local needs, including dialect and culture. Training of health educators and supervisors – as well as communication – are also suited to local conditions.

Availability

Healthy Family programs ensure availability of medicines and healthcare in rural settings. Strong links with healthcare practitioners, pharmacists and distributors help make medicines available in the most remote areas. Through health camps, doctors travel to rural areas to provide screening, diagnosis, treatment and preventive care.

Alliances

Implementing large-scale health solutions requires alliances with multiple partners, including governments, NGOs, distributors, companies, academic institutions, digital/telehealth implementation groups, etc. Healthy Family programs work with several groups to deliver integrated healthcare solutions, from health awareness through to treatment affordability