1. Nyaya Health: Achieving Justice in Health in Achham Mark Arnoldy | Incoming Executive Director GIZ 4.25.2011

2. Outline of Presentation The Nyaya Health Story What We Do | Who We Are Nyaya’s Unique Model of Delivering Health Care A Call to Action

3. “The ease with which young people die in Achham and the ease with which it is accepted continues to horrify me.” -RumaRajbhandari, MD, MPH, March 22, 2011.

4. Nyaya Health: Who We Are What We Do: Nyaya Health is building a replicable system of hospital- and community-based healthcare in rural Nepal via an open-access, public-private partnership.

6. Partners In Health (PIH) Partner Project

7. Nyaya Team:

8. 31 full-time employed Nepali staff + ~50 CHWs

9. 1 full-time US-based Executive Director

11. Achham: People ~270,000 people 99.6% Hindu 60% agricultural >80% of men migrate to India, and 35% of families rely on remittances from India 33% literate: 54% men, 14% of women <$1USD is daily per capita income

12. Achham: Infrastructure 2006: >90% of houses have did not have electricity 0 doctors for 270,000 people 45% had access to clean water – 2.5x worse than national average Hydroelectric plant functioning <50% capacity Extremely limited landline telephone capacity, one cell phone tower Paved road ended in SanfeBagar Airport destroyed during war Hospital 5 hours, surgery 6 hours, ICU 14 hours

14. 24-hour emergency services

15. 24-hour birthing center

16. 15-bed Inpatient ward

17. Laboratory with point of care tests

18. Testing and treatment for HIV, tuberculosis, and malnutrition

19. In-house pharmacy

20. Ambulance service

21. X-ray

22. Ultrasound

23. Safe abortion

24. Community Health Workers (CHWs)

25. Telemedicine8

26. What problems plague the NGO system in Nepal?

28. Managed by a volunteer Board of Directors, 31 full-time employed Nepali staff and many volunteers around the world

29. Over 99% of all funds used directly in Nepal

30. Transparency

31. Prioritizing the most marginalized Staff: 70% achhami 60% female 35% dalit Patients: 65% female 10

33. Management policies

34. Financial data

35. Clinical protocols

36. De-identified clinical data

37. All pages viewable to the public

38. A forum to share lessons-learned from Achham with organizations in similar settings around the world

40. Government partnership contract for 5 years signed June, 2009 – June, 2014

42. Funding 14

43. Next Steps: Continue Renovations 15

44. Next Steps Next Steps: Scale-up of Surgical Services 16

45. Next Steps Next Steps: Building Solar Power Capacity 17

46. Next Steps Next Steps: Expanding Community Health 18

47. A Call to Action: Leveraging a $75,000 Matching Grant Nyaya Health has just received a $75,000 USD matching grant from the Nick Simons Foundation. How can YOU help leverage that for the benefit of Achhamis? Connectionfor a funding partnership? A personal contribution? Facilitating more presentations or meetings? Time, advice, mentorship?

48. Questions, Reflections, Comments? THANK YOU! www.nyayahealth.org