Better. Together.

The World Health Organization estimates there is a shortage of about 4.3 million health care workers globally. As an example, Africa has only about 10% of the world’s population and is affected by about 24% of the global disease burden but has only 3% of the global health workforce. Sub-Saharan Africa is deficient the 1.5 million workers that would be necessary to provide adequate health care. In addition, countries with better developed primary health care systems have been found to have better health. We have a significant challenge before us: to build a healthier world.

Fortunately, we know what works. Abundant evidence-based policy solutions exist for strengthening decentralized low- and middle-income country (LMIC) primary health care services, yet adoption is slow. Local context strongly influences the adoption of interventions in low-resource settings. Currently, the capacity of LMIC local health systems is often not adequate to support basic primary health care services, much less to innovate, conduct critical quality improvement, or disseminate research. To address this lack of capacity, health leaders often form partnerships with external agencies, governments, or universities. Global health partnerships can benefit health services development, improve retention and attrition rates, and impact service sustainability through health services implementation research. Because understanding the local context is central to implementing and improving primary health care services at the local level, implementation researchers that have significant field experience are more likely to foster successful collaborations and conduct meaningful research that leads to sustainable projects. Immersion in the local environment improves perspective, dialogue, negotiation, and collaborative problem-solving. However, the challenges for research personnel to establish a continuous presence in decentralized, local settings adversely impacts their ability to monitor process and develop a comprehensive understanding of context and systems . 

A partnership between a LMIC community, the Peace Corps, and US-LMIC academic institutions using a community-based participatory research (CBPR) approach emphasizes the local context of health policy implementation and could increase access to primary health care services at the local level in low resource settings while identifying community health policies that have implications beyond the local level. Peace Care offers partnership management that links

  1. LMIC community members and health care providers 
  2. Peace Corps and Rotary Chapters
  3. U.S. and LMIC academic centers

The Peace Corps facilitates the partnership by liaising between the community and the academic partners and offering community expertise, cultural guidance, onsite project coordination, and community advocacy. The universities offer professional technical and public health training resources and evaluation support. Partnership project planning meetings occur longitudinally through distance communication and document sharing. Community Advisory Board (CAB) meetings, focus groups, data collection, policy discussions, and technical trainings occur primarily during biannual university site visits. The participatory partnership and CAB meetings guide the health service adaptation, implementation, quality improvement, and the evaluation. 

The outcome of a partnership is a sustainable health service, trained health care providers, service guidelines directed at a locally-prioritized health issue, and health service implementation research using mixed methods to evaluate the process and impact of the health service. The expansion of a community-Peace Corps-academic approach would foster the development of global health partnerships that

  1. consistently use participatory approaches to address the need of sustainable community health systems in low resource communities and
  2. focus on primary health care services implementation research.

Community-Peace Corps-Academic Partnership Approach

The role of Peace Care is to foster access to quality primary health care services at the local level in low- and middle-income countries through partnership and project management. Peace Care aims to provide the following services for these partnerships:

  1. partnership management (orientation, coordination, grant writing, advocacy and dissemination),
  2. Project management (logistics, strategic planning, translation coordination),
  3. Health systems strengthening consultation (information and referral systems, workforce development, community information and education, resources management, health service financing, leadership and governance, policy development), and
  4. Research network (community-based participatory research, health services implementation research, comparative effectiveness research)