Independent trials have demonstrated that there are certain clinical interventions that are effective. Yet such interventions can – and do – still fail if we do not take account of so-called ‘local effect modifiers’. In other words, factors in the wider ecosystem – ranging from stigma, cultural norms, poverty, transport infrastructure, financing and incentives – can limit or even nullify the impact of ‘best practice’ interventions. We listen to our partners and collaborate to create new models of care which recognise these factors. One such model takes micro-finance as an entry point to treatment and retention of patients with chronic diseases. Another is testing the ability of those living in poverty to pay for long-term medication through a ‘whole system’ approach. Multi-sector partnership lies at the heart of these models of care.
Read on for examples from our work.