Health Outside the Clinic: Community Health Workers and the Future of Healthcare

During the United Nations General Assembly in late September, Heads of State, government officials, civil society, and the philanthropic and commercial private sector will convene in New York with a focus on Universal Health Coverage (UHC). UHC is a key part of Sustainable Development Goal 3 and a shared commitment by United Nations member states to ensure everyone has access to health services without undue financial hardship. The vision is lofty and worthy, but the barriers are plentiful.

A key risk we will collectively face in the march toward UHC is the widening disparities in access to quality care and the risk of catastrophic, out-of-pocket expenditure, which is disproportionately carried by underserved populations across high, middle, and low income countries alike. This is an important moment for all of us — especially those in the philanthropic community committed to the underserved, with nimble capital and a focus on systems transformation. This moment calls for us to invest in ways that ensure our collective progress benefits socially and economically disadvantaged populations.

At the Medtronic Foundation, we believe building the capacity of community health workers, as part of primary care teams, is critical. This ensures that underserved populations are effectively linked to healthcare and are able to effectively manage chronic conditions like heart disease and diabetes. This also drives improved health outcomes and prevents catastrophic complications. Community health workers can customize care to the individual while supporting patients in navigating healthcare and better managing drivers of health like access to healthy food and transportation.

Last year, I had the opportunity to meet Maria Sanchez Torres in rural Minnesota. Maria told me she had many expectations as she prepared to be a new mother, but a diabetes diagnosis wasn’t one of them. She had to balance diabetes care with caring for a newborn, and it became increasingly hard to keep up. Like many people living with a chronic condition, Maria struggled to manage daily medications, blood sugar monitoring, regular doctor’s visits, and growing costs of medications, all while balancing a job and family life. Slowly, as she focused less on herself, diabetes began to steal her eye sight. She couldn’t do it alone.

With support from the Medtronic Foundation, Maria’s local clinic connected her to a community health worker named Raquel Rendon. Raquel regularly visits Maria in her home, and has helped her manage her care. “We don’t come with judgement or tell them what to do, we’re there to help them accomplish their goals,” Raquel said. “That really gives people meaning. It helps them gain confidence again and feel empowered to be able to care for themselves.”

Raquel connected Maria to local resources like diabetes classes, and helped her better communicate with her doctor about the challenges she faced. Today, she is successfully managing her diabetes and actively participating in diabetes classes and exercise sessions at her clinic.

The Medtronic Foundation has supported programs like Maria’s for more than five years. Our partners have trained more than 3500 community health workers across multiple countries. The vast majority of the health workers are women; and the majority have retained employment in the health sector, and are well positioned to grow in the health sector.

Once more community health workers were active in their local areas, we started to see significant improvements in patient outcomes. For example, in two towns in Brazil, we saw more than half of patients effectively managing hypertension and nearly two-thirds effectively managing diabetes after our interventions were in place. In Minnesota, the number of patients effectively managing hypertension jumped 24 percent and those meeting their diabetes targets jumped 22 percent. Importantly, we did this by working closely with local non-profits and government agencies; remaining embedded and sustained in local systems of care.

As we debate the immense challenges in realizing the vision of UHC, we believe the future depends on human capital, people like Raquel Rendon, empowering people like Maria to own her health and well-being. On a global scale, achieving UHC is an immense challenge. But community by community, the Medtronic Foundation is helping move the needle by connecting more frontline health workers with those most in need and ensuring they have the tools for long-term care management without financial risk.

Jess Daly is director of Global Health for the Medtronic Foundation, where she focuses on building strategic alliances with governments, corporations, associations, and foundations to improve public health outcomes.  

The Medtronic Foundation was a 2019 recipient of the HUD Secretary's Award for Public-Philanthropic Partnerships.