By considering health care an inalienable right and a collective responsibility, the 5-2035 plan conceives of a new class of health professionals called CHNPs (community health nurse practitioners). These CHNPs will work closely with the citizens they serve and will revolutionize health in Mauritius as a model for the rest of the world by being frugally innovative, driven by the SEED-SCALE (Self-Evaluation for Effective Decision-making + System for Communities to Adapt Learning and Expand) model for sustainable community empowerment [1]. The 5-2035 plan envisions an integrated and sustainable community-centered health care and human development with the 5-2035 CHNP at its heart.
Introducing the 5-2035 CHNP Innovation
Introducing the SEED-SCALE* model for sustainable community empowerment for 5-2035
*Self-Evaluation for Effective Decision-making + System for Communities to Adapt Learning and Expand
The key to the SEED-SCALE model [1] is that to build better lives, we do not necessarily need technical breakthroughs, but we need to change behavior at the community level. In what we view as an exquisite syncretism of the Koranic concept of Umma | Shura | Maslaha (community | mutual consultation | public interest), American philosophy of pragmatism and Indian practice of jugaad (frugal innovation) in practice, SEED-SCALE re-imagines the relationship between stakeholders, content experts, officials and the community itself (Fig. above). In the traditional model (Fig. above, A), there is a one-way top-down flow from content experts who advise government officials, who then implement programs in communities. By this mechanism, grassroots effort often fail because larger, more complex systems are required for people in communities to learn how to take advantage of opportunities, and this traditional model is usually in a tight timeline with changing content experts and officials with no follow-through and sustainability.
Effective change, write the Taylors [1], grows from the community level, but the bottom-up growth does not happen on its own. Grass provides an analogy. To grow the roots, grass needs top-down nourishment from sun and rain (government help) and outside-in nourishment from fertilizers and micro-nutrients (content experts). Likewise, the SEED-SCALE approach (Fig. above, B) builds from what should be self-evident: on their own, communities are unlikely to make significant (behavioral) changes. Mobilizing community growth is a complex process, requiring a three-way partnership of top-down support from government, outside-in innovation from experts and bottom-up hard work from local people, seamlessly interacting with each other.
The 5-2035 vision with the CHNP / CHDr team at the center, motivates new and existing institutions to unleash the power of SEED-SCALE to strengthen communities to work towards the goal of 5-2035. The SEED-SCALE system views community development akin to successful parenting: the child must believe in their capacity and build on strengths. Communities that are skeptical about their potential may endure, accommodate, or pretend, but they will not develop. Privileged starting points and resources do not matter as much as resourcefulness and positive conviction about the future. A vision, that is shared in the community, a conviction that the common future will be better, is the foundation for development. Please see the 5-2035 Executive Summary to have an overview of our plan or request the full 76-page 5-2035 White Paper for further details. The GFCH Mission Statement and Charter can be found here. If you have any specific questions, please do not hesitate contact us. Our response time may be slow as all of us at the GFCH are volunteers for the 5-2035 mission and have full time commitments.
References:
- Taylor-Ide, D. and C.E. Taylor, Just and Lasting Change. 2002, Baltimore, MD: The Johns Hopkins University Press.
- O’Brien JB. How Nurse Practitioners Obtained Provider Status: Lessons for Pharmacists 2003 Am J Health Syst Pharm 60(22): 2301-2307
- Donaldson, M.S., et al., eds. Primary care: America’s health in a new era. 1996, National Academy Press.