Section 1: Issue Identification
1. What health inequity does your initiative aim to address? Which specific regions, populations, health disparities, etc.? Please be as specific as possible.
reach52 takes our name from the fact that 52% of the world lacks access to essential health services. This issue is impacted by a global health worker shortage, projected to reach18 million workers by 2030. As such, reach52 is specifically addressing access barriers to high quality primary health care (PHC) for rural populations. We work across multiple disease areas, focusing on mobilization of private sector capital to promote capacity building of health systems through digitization and upskilling of Community Health Worker Agents.
reach52 beneficiaries are lower-income residents of disconnected rural communities in LMICs in Asia and Africa. We currently have active campaigns in Cambodia, India, Indonesia, Kenya, Myanmar, Philippines and South Africa. These households have high out-of-pocket expenditures for health; travel long distances to access routine primary care; are underserved by current systems; have concerns about the legitimacy of medicines accessed from local pharmacies; have lower health literacy; and face catastrophic expenses in the case of a serious illness or accident. More than 60% of our registered beneficiaries are female, but our services are designed to engage across genders and age groups.
2. Why did your organization choose to prioritize this specific inequity/initiative for action?
We opted to focus on PHC because it has the ability to reap tremendous dividends, yet is chronically under-resourced. It forms the basis of universal health coverage, particularly in lower-resource contexts, creating more equitable outcomes for service users. According to the Lancet Global Health Commission, “PHC is the best platform for providing basic health interventions (including effective management of non-communicable diseases) and essential public health functions.”
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00005-5/fulltext
Section 2: Initiative Overview
1. Please provide an overview of your initiative / approach and which department owns it.
reach52 is a health-tech social enterprise redesigning healthcare to reach the 52% of the world who lack access. We partner with a wide range of stakeholders to improve primary health care outcomes for underserved populations in rural areas of LMICs. reach52 works with the private sector to mobilize resources to address health financing gaps, as part of our sustainable, core business. Under our data-driven, human-powered approach, we empower our networks of Agents and retail partners to engage rural populations with evidence-based health and wellness campaigns, supported by our leading edge, offline-capable digital mHealth platform ‘Access’.
Used by our Agents, ‘Access’ supports the facilitation of health campaigns in areas of low internet connectivity. Agents can collect individual-level data, syncing back to the cloud when a connection is available, providing critical insights and tools to support the design, implementation and monitoring of community-level campaigns.
Through the platform, targeted interventions are delivered to cohorts of residents filtered from our baseline data. Our Agent-resident engagements focus on health education; community screenings; and referrals to care. Through our growing network of retail partners, reach52 also provides access to a range of health-supporting products aligning to campaigns.
reach52 generates revenue by providing services to global firms in the pharma, consumer health, and FMCG sectors, aligning with both impact and commercial targets. We help to action CSR/ESG strategies; provide data and insights; promote patient engagement; enhance brand awareness; and support product distribution.
Campaigns are designed and implemented in collaboration with government funded health systems. We engage in capacity building efforts, through our digital technology and upskilling of CHWs. We also enjoy close relationships with NGOs and CSOs in our partner communities. These organizations are typically contracted by reach52 to serve as implementing and strategic partners. Due to their long-standing presence and trust in communities, they act as a vital bridge to residents. They bring decades of experience and knowledge, informing the design of our campaigns to amplify impact.
2. Which of the four domains of health equity action (organization, offerings, community, ecosystem) does the initiative target?
The case could be made that reach52 impacts all 4 domains of health equity action. Certainly we promote a healthy workforce; and our products and services are specifically designed to promote equitable health outcomes. However, we align specifically well with “community” and “ecosystem”.
Community: reach52 supports local health priorities through the adoption of bottom-up, participatory strategies. The design of campaigns is informed by our extensive individual-level baseline data collection. We supplement this with detailed qualitative data from key informants and stakeholders, through focus-group discussion and semi-structured interviews. As a result, campaigns are dynamically developed to targeted specific local conditions.
Ecosystem: This domain is perhaps most relevant to reach52’s work, as we see ourselves as a coordinating platform for the mobilization of private sector capital; public sector resources; and community insights/knowledge. We work with large pharma, consumer health, and FMCG firms; publicly-funded health systems; intergovernmental agencies; and community-based organizations to achieve impact across the spectrum of primary care, supported by our digital tools.
Section 3: Impact & Accountability
What impact has the initiative achieved? Please be as specific as possible, focusing on outcomes rather than outputs. How was impact measured: strategy, metrics used, tools employed, relevant standards, etc? How and where are you reporting impact (internally, externally)?
As an impact-focused business, we directly align our targets towards the achievement of the SDGs. We are principally focused on SDG3 (good health and wellbeing), while also contributing to SDGs 5 (gender equality and women’s empowerment) and 8 (decent work and economic growth). We now have 1.5 million beneficiaries, implementing new and sustainable programs with leading global firms.
reach52 has trained 14,000 Agents to scale delivery of health products and services in non-communicable diseases, infectious diseases, maternal & child health in rural remote areas via our reach52 access app. An external evaluation demonstrated that reach52's model generates US$2.10 of social value in our target communities for every US$1 invested.
To support SDG 3, we operate campaigns across a range of disease areas, with the goal of supporting equitable access to high quality primary care and universal health coverage for disconnected rural populations. We have active campaigns focusing on malnutrition, maternal and child health, COVID-19, vaccine delivery, WASH, and eye care. Some campaign-specific outcomes we’ve achieved:
· 65% reduction in stage 2 hypertension from baseline for participants in NCD management program
· 78% of vaccine-hesitant residents accessed immunization services following engagement with a reach52 Agent.
Our work on SDG 5 is supported by our campaigns on maternal and child health. During these 1-on-1 door-to-door engagements, trained Agents deliver health education messaging, collect vital data, and enhance linkages to local health facilities. Following engagement with a reach52 Agent, 70% of beneficiaries disconnected from care accessed ANC services.
Over 90% of reach52’s Agents are female, creating an intersection with SDG 5 and 8. The majority of our Agents are existing Community Health Workers (CHWs). As these workers preform their government-assigned duties on a voluntary basis, or for modest monthly stipends, reach52 provides an important income generating opportunity for completing social-impact oriented tasks. These tasks include registering new beneficiaries; completing community screenings; or providing referrals to care. In addition, reach52 provides training on transferable skills, such as tech literacy; social marketing; and community engagement strategies. These opportunities are typically welcomed, given the lack of economic opportunities for many rural women in LMICs.
Section 4: Partnerships
What organizations (e.g., civil society, public sector organizations, businesses, governments) did you partner with to complete this initiative? How did these partners contribute throughout the initiative’s lifecycle? What role in this partnership does your organization play (e.g., funder, convener, etc.)? How is the initiative actively involving impacted communities throughout the initiative lifecycle (e.g., in the identification and alignment of priorities, (co-)creation and delivery of interventions, in measurement and review, etc.)?
Among our private sector clients, we are currently leading projects in partnership with Bayer Consumer Health; Johnson & Johnson; Essilor; and Unilever. Through these business relationships, reach52 is helping these global firms translate their investments into social impact for disconnected populations, typically coupled with commercial returns for their shareholders. This win-win model underpins reach52’s approach to sustainable social business.
We also work with more traditional funders, having delivered projects in partnership with organizations including UNDP; UNICEF; UNCDF; Save the Children; Pfizer Foundation; and Grand Challenges Canada. In addition, we work with a range of national NGOs who support our work as implementation partners. reach52 also works closely with MoH/DoH in various countries, to build capacity and support strategic priorities.
We are a member and former Steering Committee chair of the Universal Health Coverage 2030 (UHC2030) Private Sector Constituency, a World Bank-led platform for the actioning of UHC commitments. We are members of the Digital Connected Care Coalition; Transform Health; Million Lives Collective; and allies of the Community Health Impact Coalition.
Section 5: Learning & Next Steps
What is the future vision for the initiative / approach? Will it scale to other regions, translate to other drivers of health? What is the strategy for long term sustainability?
reach52 will continue to scale our solution to additional markets, and within existing ones. We see tremendous opportunity for growth and greater impact in South Asia, Southeast Asia, and Sub-Saharan Africa, aligning with our focus on primary care. We have plans to introduce various financing mechanisms to ensure that we’re balancing the twin goals of achieving sustainable inclusive business and health equity.