It seems that Mississippi is learning to copy the healthcare system that was established in Iran some 30 years ago. This with the help of Iranians no less.
nytimes.com
What Can Mississippi Learn From Iran?...
“When the Iranian system was developed in the 1980s, there were no doctors in rural Iran,” Miller says. “And this is similar to the problem in the delta today.”
The Iranian reforms were relatively inexpensive to implement there. It was the early ’80s, just after the Ayatollah Khomeini’s return and the Iranian revolution, which had promised the country’s rural villagers the kind of social justice that had been lacking under the shah. At the time, more than half the population lived outside major cities, in or around more than 60,000 villages. The Iranians built “health houses” to minister to 1,500 people who lived within at most an hour’s walking distance. Each house is a 1,000-square-foot hut equipped with examination rooms and sleeping quarters and staffed by community health workers — one man and one or more women who have been given basic training in preventive health care. They advise on nutrition and family planning, take blood pressure, keep track of who needs prenatal care, provide immunization and monitor environmental conditions like water quality. Crucially, in order to gain trust, the health workers come from the villages they serve.
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Shahbazi suggested that he and Miller approach Shirley. He arranged for the two men to visit Shiraz, Iran, and meet some of the people responsible for creating and administering the country’s health houses. The two groups decided to establish an official academic partnership between Shiraz University and Jackson State, and Shirley returned to Mississippi a convert. Later that year, several Iranian doctors and administrators and their wives made their own trip to Mississippi. They were surprised by what they saw: “This is America?” they asked. In 2010, the Iranians returned for a month, calculating how many health houses Mississippi would need, as they had done in Iran. Shahbazi began work on a program at Jackson State for the training of community health workers. Using resources from the Medical Mall Foundation, Shirley started HealthConnect to show how interventionist, door-to-door community health workers might save hospitals money and began the process of putting health houses in Jackson schools. Eventually they hope to build the Mississippi Community Health House Network, a pilot version of their project, in the Mississippi Delta.
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The Iranian model goes a step further by making the community health workers responsible for their villagers’ well-being from birth. It’s an approach very much at odds with the American ethos of self-reliance. But in Iran, the seeming intrusiveness is required, according to Dr. Kamel Shadpour, one of the architects of the Iranian system. “If you go to one of these community health workers and ask him or her how many people they cover, they won’t tell you around 2,000,” Shadpour says. “They will tell you exactly 1,829 people. If you take out the family file with the No. 62, he or she will know which family that is, and she will tell you that the father is this old, and they have five children, their ages, their vaccinations, how they were doing family planning, everything.” |
