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Maya Welch
Impact Lead, Healing Fields Foundation
Innovation in Partnership
Healing Fields Foundation is an NGO with a vision to build an ecosystem that ensures access to affordable and quality healthcare for all, especially women from resource-poor communities. Healing Fields Foundation provides training and support for women as health change agents in their communities. Healing Fields works in rural areas of poorer states to impact change in the areas with the greatest need. Our approach is comprehensive -- working to prevent health problems through education; facilitate access to health services, entitlements from the government and health products; and treat minor health concerns with care. Our work is firmly rooted in evidence-based methods and innovation in partnership with the women we serve.
To that end, Healing Fields empowers women as Community Health Entrepreneurs (CHEs). To date, more 6,000 CHEs in as many villages have been trained across 10 states, reaching 7.5 million individuals. Their work sits in three pillars– catalysing behavior change, creating access to health services and entitlements, and community leadership- as these factors affect determinants of health and the burden of disease directly. They lead health education around preventative health, nutrition, sanitation, and health seeking behaviors. They become elevated as leaders, influencers, and telehealth facilitators in their villages towards women’s empowerment and healthy communities. In fact, 94% of community members covered by a CHE regularly practice improved health behaviors.
Innovation at the core
Innovation and data-driven impact prioritize creating technology and discovering new frontiers of data. Tackling the challenges of our digitized future lies not only in mining data but ensuring that data is usable by those addressing challenges in their communities. Transforming our world requires creating problem solvers at the first mile who can themselves identify root problems — through evidence and compassion — and build solutions. The answer is not only innovation– but the empowerment of innovators and problem solvers at the first mile.
This innovative paradigm in the community-embedded model benefits both the citizen beneficiary and the last-mile delivery of the services. It empowers women from marginalised communities as health change agents who reach basic health services to the difficult-to-reach community on a regular basis. Assessments, medicines and counsel that help the citizen beneficiary navigate access to health are the broad areas of engagement.
We engage the community to shape the programming. The result: innovation happens organically.
The CHE brings innovation to the village level by solving problems through evidence and creativity. That commitment to the continuing need for evidence led us at Healing Fields Foundation to pioneer digital tools to generate data and evidence accessible to rural and digitally not-so-literate communities to solve their problems at the micro level.
We do evidence-based work. Data points are narrowed down to aid in understanding the village’s health landscape. Once the services are activated, their reach, delivery and pervasiveness is measured.
In the context of public health being assigned a low priority, HFF developed one of the first and early micro health insurance programs for rural communities in India. In the past, some of the features were adapted by the Government Health Insurance models. The lessons learnt from these micro health insurance initiatives led to the genesis of the Community Health Entrepreneur program to build health leaders in rural villages. As the community model evolved, the demand for a sustainable ecosystem led us to add entrepreneurship training, products, and services to build the current Community Health Entrepreneur movement and work towards completeness into the program. Seeding local women as health agents of change unlocks the intertwined impact opportunities of empowerment, health & entrepreneurship. With our program, we have observed our CHEs constantly learn to build a local ecosystem that leads to resilient communities with improved well-being.
For the Community, by the Community
Once women establish themselves as health leaders, our field journey tells us that it breaks deep-seated barriers – patriarchy, caste and religion - as she is the one who can provide healthcare in an emergency and get them remote consultation with the doctor when they cannot reach a qualified health provider. This is a strong collateral gain for the woman in a marginalised sphere.
COVID taught the CHEs that when traditional support structures are unavailable or overstretched, they can lead and respond themselves – including negotiating with the leaders and frontline health workers in their communities to create access to entitlements and much-needed healthcare. This active involvement has led them to be perceived as respected leaders and change-makers in their villages.
The ‘for the community, by the community’ approach leads to benefits and outcomes that are transparent to both the citizen beneficiary and the CHE.
As catalysts for change, Community Health Entrepreneurs bridge the gaps in their local health ecosystems by generating demand and facilitating supply as patterns shift. They meet demand for up-to-date and contextually appropriate health information with the knowledge gained through training. They meet improved health-seeking behaviour with services like entitlement facilitation and telehealth. And they meet the increased demand for health products with entrepreneurship.
Data in the hands of CHEs towards problem solving
The tools for data are often basic— from simple paper registers to free and low-cost digital survey tools. Creating and owning this kind of community level data allows them to identify trends and problem areas. This data is innovative because granular information on these rural villages is made available to CHEs to analyze and find solutions when it would otherwise be either unavailable, inaccurate, or inaccessible to the communities themselves.
At the start of their work, CHEs undertake a community registry where they survey families in their communities for socio-demographic details, entitlement access, and health behaviours and ocndition. This allows CHEs to understand the exact needs of households in the community and target specific interventions. In 2022, one of the greatest gaps between awareness, eligibility and access of public systems was the Ayushman Bharat program. Only 65% of families reported no enrollment in our working areas of UP, Bihar and Jharkhand. Upon finding enrollment gaps, CHEs facilitate registration to government entitlements and services. CHE reports show that 64.7% of the entitlements facilitated in 2023 have been enrolled in Ayushman Bharat, demonstrating the power of target, evidence-driven interventions.
One CHE, Ritu Devi says, ‘When I started surveying, I found out people ignore health problems or resources. I want to bridge this gap and increase health services in my village so that small health issues do not become fatal.’ Her work matches her ambitions. Since undergoing training in 2022, she has helped two women receive widow pensions, a nine-year-old girl receive a disability pension, ten people receive Adhaar cards, two families receive ration cards, and 30 people access teleconsultations.
CHEs are comfortable creating change across this wider understanding of health. One CHE, Pramila Kumari, keeps logs of all the girl children in her village and their school status in order to prevent dropouts, and early marriage, and ensure awareness of menstrual hygiene and Nutrition. Another CHE, Kalawati Devi, identified that a specific pocket of her village was suffering from chronic diarrhea and found a contaminated shared water source.
These cases illustrate the power of innovation at the village level to create lasting impact.
By evolving programs and tools in partnership with the women agents of change, Healing Fields enables women to build resilient health ecosystems in rural India.
