WILD4LIFE HEALTH

The Wild4Life model is a comprehensive, integrated set of five core facility- and community-based interventions that address health system weaknesses and inequalities in rural communities—the hardest-to-reach and most vulnerable populations. It identifies and coordinates low-cost interventions with high returns on investment to achieve durable health outcomes.

1. Train health care providers

   Frontline health workers are the backbone of the rural health system in African countries. We ensure they are equipped to deliver high-quality care with the ability to treat all conditions in their communities.

2. Make health care facilities functional

   Functional clinics are the foundation for delivering effective healthcare in rural areas. We identify the parts of the system that are missing or broken and fix them, ranging from pharmaceuticals to lab diagnostics. Training and mentoring healthcare workers and village health workers help to build the skills and confidence to accurately diagnose and treat patients, resulting in improved quality care. Accurate diagnosis and treatment translate into fewer repeat visits for the same symptoms, lessening the burden on the health system.

3. Promote increased utilization of health care services

   Once people begin to trust the system works, demand for services increases, cases are identified faster, and people get the treatment they need. We bring people into the system through advocacy health education and integrated outreach programs.

The Wild4Life model is a comprehensive, integrated set of five core facility- and community-based interventions that address health system weaknesses and inequities in rural communities—the hardest-to-reach and most vulnerable populations. The program uniquely combines some widely practiced and some novel interventions that are customized to flexibly resolve whatever imbalances or barriers contribute to under-performance in specific facilities/communities.  At a high level, the innovation of the model is its systems approach to re-structuring core processes in the rural health system, and then facilitating those process changes with minimal external inputs. Highlights of the five interventions follow:

1. Comprehensive Clinical Mentoring: Wild4Life-trains and organizes multi-disciplinary teams of six MOH-employed specialists comprehensively mentor clinic staffs on all primary care conditions (HIV, TB, IMNCI, MCH, S/RH, L&D)—not one-off vertical areas targeted by other approaches in Zimbabwe. Process also covers M&E data quality, pharmacy and clinic management during twice-quarterly visits over 24 months. Mentoring is tailored to each clinic’s specific challenges, using “soft” interactive coaching skills to build trusting relationships with clinic staffs. Includes systematic training of staffs on national Continuous Quality Improvement program, establishing CQI targets for resolving gaps/weaknesses, with mentor follow-up/support to routinize CQI procedures and assure sustainable progress beyond end of program. Customized numerical “grading” of results for follow-up.
2. Integrated Primary Care Outreaches: Same mentor team, while already in field for clinic visits, joins local nurses in remote villages to provide outreach services for all primary needs (far broader than common “silo” approaches in Zimbabwe). This “double duty” by mentors saves significant costs. Inclusion of acute care like dental services attracts high volumes of patients who then also utilize other services (e.g., HIV testing, family planning), thus patients benefit sooner from preventive/curative care.
3. Village Health Worker Support:  This community volunteer MOHCC cadre in Zimbabwe is sporadically trained and never assessed/mentored. Wild4Life focuses on assessing their skills/knowledge in the field, then program staff/facility nurses mentor them on their deficiencies. To support long-term sustainable improvement, Wild4Life forms a novel sub-cadre of VHW peer mentors who continuously educate local colleagues.
4. Community ART Refill Groups: Wild4Life aggressively rolls out/manages this established mechanism which supports stable HIV/ART patients at community level. Provides health benefits from psycho-social and drug-adherence support, and greatly reduces congestion in clinics so under-staffed nurses have extra time to focus on care quality, conduct outreaches, improve data quality, etc.
5. Health Center Committee Engagement: Wild4Life trains these lay community leaders on how to maintain facilities, mobilize community demand for services, and advocate for quality care from nursing staff. Novel best-practices exchange program among clinics results in significant infrastructure improvements, “health days” and other events that raise health-seeking behavior, and strategic use of clinic funds.