Progress Report Q1 2013
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P R OGRESS RE P O RT
JA NUA RY - M A R C H 2 01 3
Hope Through Health
Progress Report Q1 2013, Page 1
Dear Friends,
I am excited to share Hope Through Health’s first quarterly progress report. Our hope is that
this report will keep you informed about the impact that your support is having on the
patients we serve in Togo, West Africa. In the following pages we share with you an honest
portrayal of the successes and challenges we face in attempting to improve quality and
expand access to health care for the most underserved in northern Togo.
The first quarter of 2013 was an exciting period of growth for Hope Through Health and our
partner organization, AED-Lidaw.
• Our central Kara Clinic was recognized by the Ministry of Health for maintaining the
highest adherence and lowest rates of loss to follow up in the Kara Region. • Staff implemented a new Monitoring, Evaluation and Quality dashboard designed
with the help of Partners In Health and participated in computer literacy training
conducted by MIT students from our partner organization, GlobeMed.
• In the US, our first annual report was released (http://hthglobal.org/files/
HTH_2012_Annual_Report.pdf), we launched a new partnership with One Day’s
Wages and our Annual NYC Benefit, held in January, was a huge success.
As with all of our efforts, this report is a work in progress and we welcome your feedback.
Please reach out to me or any member of our team with your questions and suggestions. We
would love to hear from you and continue this dialogue about the transformative impact
your support has on improving the health of individuals and communities in Togo.
With gratitude,
Jennifer Schechter, Executive Director
e| [email protected]
c| 631.721.5917
Hope Through Health
Progress Report Q1 2013, Page 2
About HTH
MISSION
Hope Through Health works to expand access to health care for all individuals through
community driven initiatives in partnership with the public sector in Togo, West Africa.
VISION
Hope Through Health envisions a world in which high quality health care is available to all
individuals regardless of their ability to pay thereby promoting equity and human dignity.
VALUES
HOPE | HTH believes that better health outcomes are possible even when there is some evidence to the
contrary.
HEALTH | HTH believes that health is more than the absence of disease or infection but includes the
promotion of social, economic, educational and spiritual wellbeing.
EQUITY | HTH believes in working to address the root causes of social and economic injustice to ensure
that all individuals have an equal right to live healthy and productive lives.
SOLIDARITY | HTH believes in working alongside and in collaboration with the people we serve to
ensure responsiveness to their specific needs.
COMMITMENT | HTH believes in making long-term investments to address global health inequities and
bring about greater justice.
OPERATING PRINCIPLES
PARTNERSHIP | Establishing long-term relationships with local governments and communities
in which all parties have an equal voice.
HEALTH SYSTEMS STRENGTHENING | Strengthening the capacity of the public sector to effectively
scale up quality health care services.
COMMUNITY CAPACITY BUILDING | Supporting local groups engaged in improving the health of their
own communities through medical, psychological and/or educational activities.
ACCESS TO HEALTH CARE | Eliminating barriers in order to improve access to quality health care for
all.
GENDER BASED PROGRAMMING | Prioritizing services for women and children as the most effective
means to strengthening entire communities.
EVIDENCE BASED PRACTICE | Implementing medical and public health interventions through
decision-making based on the best available evidence and information.
MOVEMENT BUILDING | Fostering engagement and building connections across the globe in order to
combine efforts into a larger movement for social justice.
Hope Through Health
Progress Report Q1 2013, Page 3
Selected Indicators
Thanks to the generous support of Dr. Lisa Hirschhorn and her team at Partners in Health,
especially Dan Chiu, Hope Through Health has piloted a new Monitoring, Evaluation and
Quality (MEQ) dashboard which enables our team to easily analyze data and make program
improvements in real time. A selection of indicators from the dashboard are presented here.
Central
Clinic
1
Satellite Clinics
Kara
Bafilo
Ketao
Kante
Kabou
Total
1110
229
124
79
39
1581
% Children
8%
14%
6%
15%
8%
10%
% Women
71%
63%
69%
65%
82%
70%
Number of Active Patients
2
Number of Patients on Antiretroviral Therapy
614
119
44
28
26
831
3
% ART Refill Appointments
Respected
95%
61%
55%
48%
45%
61%
4
% ART Patients who had a CD4
Count in Last 6 Months
6%
0%
0%
0%
0%
1%
5
% Infants Who Test Positive for HIV
0%
0%
0%
0%
0%
0%
6
Number of Patients Benefiting from
a Community Visit
435
160
61
62
24
742
7
Number of Beneficiaries at the
Community Pharmacy
561
118
73
50
13
815
8
Number of Patients Participating in
a Support Group
134
13
3
26
0
176
9
Number of Patients Receiving
Psychosocial Counseling
142
70
45
21
0
278
120
0
0
0
0
120
10
Number of People Tested for HIV
Highlights:
- Extremely high adherence rate at central Kara site (Row 3)
- Zero infants born to mothers living with HIV tested positive for HIV at 18 months (Row 5)
Challenges:
- Relatively low reported adherence rates at satellite sites (Row 3)
- Extremely low percentage of patients having CD4 count due to lack of availability of CD4
testing reagents (Row 4)
Hope Through Health
Progress Report Q1 2013, Page 4
Case Study
The purpose of this case study is to share stories
of our work which illustrate the successes and
challenges characterizing our efforts to improve
global health equity.
Introduction
The indicators highlighted on the previous
page reflect differences between Hope
Through Health’s central Kara Clinic and
our four satellite clinics. The Kara Clinic is
a full-service health center providing
comprehensive care to individuals living
with HIV. HTH staff oversee every aspect
of service delivery at this clinic from
hiring, training and supervision through
data collection and analysis. At the four
satellite clinics, HTH works in partnership
with the local district hospital. Hospital
staff provide clinical services and HTH staff
provide the wraparound services required
to support patients in care, including home
visits, access to the community pharmacy,
food assistance, counseling and support
groups.
The central Kara clinic was born out of the
necessity to provide HIV treatment services
when none existed and demonstrates the
impact of providing high quality care. In
order to expand access to care for all
Togolese, HTH believes that integration
with public health centers, as modeled in
our satellite centers, is the most effective
way to scale our model. The following case
study highlights both the need and
challenges inherent in this approach.
Background
*All names have been changed to protect
patient confidentiality
Working in partnership with the National
AIDS Program, HTH staff from our Ketao
satellite center organized a day of HIV
education and testing in a remote corner of
their district. While this effort expanded
access to necessary education and tesing
services, the follow up required to ensure
Hope Through Health
HTH Counselor Sylvie providing home-based HIV
counseling and testing
access to care proved challenging both for
community members and HTH staff.
The First Failure
An HTH staff member recalled the sad day,
“Awa approached me holding the
emaciated body of her dying child. I asked
the baby’s age and she told me he was five
months old, but from his size I would have
guessed he was two months. We watched
his little chest rise and fall with each breath,
but any attempts to rouse him elicited no
more than a fluttering of his eyelids. We
took immediate action in getting
permission from Awa’s family to take him to
the hospital right away, but the baby’s life
ebbed away between the time that
permission was granted and when we
reached the truck to leave.”
For far too many of our patients, losing a
child is often the first indication that there
may be concerns about their own health.
For Awa, the death of her child represented
the end of a long and ardous struggle to
access the health care her family so
desparetely needed. Awa had taken her
child to the health center in her village. Her
house was just a ten-minute walk from the
local health care provider, so she could
access its services with ease whenever she
needed them. Unfortunately, this local clinic
did not provide the level of care required to
save Awa’s child’s life.
Progress Report Q1 2013, Page 5
Nana lives about a quarter of a mile away
from Awa’s family in the same small village
on the border with Benin. Both Awa and
Nana tested positive for HIV during the
rural HIV education and testing day
organized by HTH. Sadly their stories
illustrate two very different outcomes.
When Awa tested positive for HIV, she had
a CD4 count of just 57, a critically low value
suggestive of advanced AIDS. Despite her
own poor health, Awa fought hard to save
the life of her child. After her child’s death,
Awa’s family was reluctant to continue to
invest in the health care system that had
failed them. Awa’s family was poor even by
the standards of the remote village in which
they live. Awa never received antiretroviral
therapy or any other treatment for HIV. Awa
passed away within a year. The system
failed her.
A Second Chance
When Nana’s brother-in-law heard that a
day of HIV education and testing was being
organized in his village he gathered all his
family to come. These services rarely come
to places as remote as his village, and the
expense to go into town to access such
services is considerable. This was an
opportunity that he didn’t want any of his
loved ones to miss. On the day of testing,
Nana learned that she was HIV positive.
Although she spoke to a counselor, like with
Awa, no one followed up with Nana to
ensure she had access to the necessary
treatment services.
The lack of follow up on the part of HTH
following this rural testing program
represents a tragic failure to serve those
patients most in need. The fact that these
two women were not immediately enrolled
in care, quickly followed up on at home by a
community health worker and provided
with the highest possible quality of care
and treatment represents a tragic failure in
the delivery of our approach. The system
that HTH is striving to build failed in this
instance and the consequence was the loss
of two lives, a mother and her child.
Fortunately Nana’s health was strong
Hope Through Health
enough to give HTH a second chance. It
took a valiant and creative effort on the
part of one HTH staff person, but Nana was
located and finally enrolled in care more
than a year after initially testing positive for
HIV. Thanks to the addition of an excellent
new counselor to the HTH team, Nana was
able to be counseled, retested and enrolled
in care without leaving her village. Since
that time, Nana has found that she has a
healthy CD4 count, and established a
relationship with a doctor who can monitor
her HIV as well as treat her for epilepsy.
Now HTH must ensure that Nana is assigned
a community health worker who will
provide home-based support and ensure
Nana is retained in care for the long-term.
“Hope Through Health believes that
integration with public health centers is
the most effective way to scale our
approach.”
Decentralized Care
HTH’s philosophy of bringing necessary
services as close as possible to patients
guides our rural satellite strategy. While it
is not always easy, relative to managing our
own clinic in Kara, it is the most effective,
scalable, long-term strategy to improve
health outcomes for all Togolese.
Acknowledging the tremendous barriers
that patients must overcome to access care,
we partner with district level hospitals and
village health clinics to reinforce the
services available closest to our patients.
We support a network of community health
workers who collaborate directly with
public health facilities to ensure that
patients can access and be retained in care
at the local level.
Awa and Nana’s stories illustrate the
necessity of that approach. It is quite
possible that bringing a counselor to Nana’s
village made the difference between the
loss of Awa and her child, and the health of
Nana! We will make every attempt possible
to learn from the failure of Awa’s story and
to honor her memory by improving the care
we provide to others.
Progress Report Q1 2013, Page 6
Development Metrics
Q1 Raised
Q1 Target
% Raised
Annual Budget
$71,699
$75,000
96%
$282,350
January - March 2013
January - March 2012
Donation
Amount
Total
Monies
Raised
Number of
Donors
Donation
Amount
Total
Monies
Raised
Number of
Donors
<100
$4,552
82
<100
$4,106
80
100-499
$17,635
101
100-499
$6,260
33
500-999
$6,390
9
500-999
$2,750
4
1000-2499
$6,922
5
1000-2499
$4,200
3
2500-4999
$6,200
2
2500-4999
$5,000
2
10,000+
$30,000
2
10,000+
$20,000
1
TOTAL
$71,699
201
TOTAL
$42,316
123
Revenue by Campaign
(January - March 2013)
Grants
Hope Through Health
Progress Report Q1 2013, Page 7
Thank You to Our
Supporters!
January - March 2013
Stand With Us Members
(Recurring Monthly Donors)
Anonymous
Kelsy Baker and Jeremy Dodd
Paul and Sarah Balian
William E. and Delphine Barron
Jacqueline Bleazey
Norbert and Catherine Chenard
Al and Joanne Cimorelli
Taylor and Cindy Corby
Elia Cubillas-Saldana
Peter Davenport
Emma Davenport
Abe and Alene de la Houssaye
Aimee de la Houssaye
Sam Eisner
Laura Fiery
Dawn Fiori
Kevin and Deborah Fiori
Kevin and Jennifer Fiori
Thomas Fiori
Devin Flaherty
Daniel F. and Christiane D. Geisler
Rachael Gerber
Amy Glick
Eric Goldman
Nina Goldszejn
Greg Hathaway
Shannon Heuklom
Karl Hofmann
Katherine Holding
Mark Ingram
Fred Joiner Jr.
Olgahelena Joos
Ismail Kassam
Amir Khastoo
Chelsea Kocis
Donald and Louise Krumm
Mark Krumm
Marybeth Krumm
Paige Lapen
Justin and Marjorie Locke
Colleen Lynch
Joan Marshall-Missiye
Taylor Maturo
Alyson McArdle
Ryan McCannell
Hope Through Health
Josephine McCarthy
Charles and Monica Merrill
Joanie Smith Miller
James Mills
Danielle Jaeggi Murphy
Gavin and Megan Oxman
Michael and Christine Pata
Camilla Pearson
Natalie Powers
John and April H. Quinlan
Bryan and Alison Rash
Jeremy Ritz-Totten
Sabina Rogers
Joanne Roll
William Rubenstein
Duncan and Eloise Schechter
James D. Schechter
Leslie Schechter
John Simonetti
Alisha Smith-Arthur
Lindyn Soviero
Melanie Spence
Thomas and Karen Spence
Kenneth Steward
Michael Swor
Paul and Kim Thomson
Matthew Vaccaro
Randy and Karen Veeh
Casey and Jessica Whitsett
Lanre Williams
Founders Circle
> $10,000
Anonymous
William and Barbara Cowan
Leaders Circle
$2,500 - 5,000
Sarah Sallee
William Racolin and Alison
Williams
Advocates Circle
$1,000 - 2,499
Ivan Hageman and Carol Brown
Partners Circle
$500 - 999
Anonymous
Michael and Rose Allocca
Bill and Melinda Gates Foundation
Matching Gifts Program
Wayne and Ann Kennell
Vincent and Jomarie Pica
Helen Stein
Mark and Jean Tansey
Supporters Circle
$100 - 499
Parham Alizadeh
Evan Azus
Elizabeth Bergold
Annie-Norah Beveridge
Elizabeth Bird
Kelly Biscuso
Tom and Linda Blucker
Brian and Sandy Bochner
John Buckley
Mickey Chapman
Jay Chen
Anne Crisafulli
Richard Cunningham
Susie de la Houssaye
Heather Dietrick
Jonathan Dorfman
Brittney Escovedo
Daniel Fehlig
Richard and Terry Landry Fisher
Amanda Fitzsimons
David Gold
Zachary Goldsztejn
Brian Hanlon
Meghan Horstmann
Alex Jacobs
Isabella Johansen
Ella Jolly
Christina Kocis
Marisa Lascher
Rachel Lewis
LG& Design Associates, LLC
Michael LoBue
Leah MacDonald
Denise Maroney
Dennis Math and Judith Ferbel
Lisha McCormick
Christine McKenna
Joanna Merrill
Kip Moncrief
Lee Nussbaum
Matthew Oxman
Stephen and Patricia Oxman
Justin Palmer
Natalie Pica
Lianne Pimentel
Edward and Leslie Powers
Ruth Rice
Samantha Rosen
Hilary Rovins
Progress Report Q1 2013, Page 8
Kimberly Russell
Rachel Sam
Jackie Sansone
Elizabeth Savetsky
Douglas B. Schechter
Jordan Sheff
Tali Shmulovich
Joshua and Juliana Simon
Donna Slywka
Michael and Grace Sole
Douglas Soviero
Masha Spaic
Brian Spence
Barbara Steward
Brenda Steward
Christine Walsh
Cara Waltrip
Ellen Wheeler
Audrey White
Pia Williams
Deanna Witt
Mira Nakashima Yarnall
Victor Zonana
Friends Circle
< $100
Ken Ben-Ari
Erinn Blicher
Katie Callahan
Kendra Elstad
Jennifer A. Poulin Grden
Chelsea Harris
Jack Harris
Amy Horne
Daven Johansen
Kathryn Kempton Amaral
Chelsea Kilian
Taylor Krauss
Jon Lascher
Ava Lentini
Monica Lewis
Philip Luloff
Alena Lygate
Liza Mackintosh
Laura Mahony
Tapan Maniar
Kate McMullan
Catherine Merschel
Carolyn Mohsenzadeh
Heidi Nakashima
Vicki Nakashima
Lauren Neidhardt
Jenny Payne
Tina Rojee
Hope Through Health
Michael Rudnick
Jenni Samuels
Xinshu She
Laurie Sheff
Gillian Singerman
Socialvest Ventures LLC
Chelsey Speir-Morrone
Alexa Steponaitis
Tida Tep
Elizabeth Tung
Ryan Turner
Greta Velezdevilla
Lauren Walsh
Jackie Ward-Rebuck
Ashley Waterman
Elizabeth Weller
*Every attempt has been made to
ensure accuracy in the donor list.
However, in compiling such a list,
omissions and misspellings
sometimes occur. Please advise us
of any errors by emailing Kelly Lue
at [email protected]. Thank you.
Progress Report Q1 2013, Page 9