Overview

Despite tremendous advances in medicine, many communities still lack access to essential health care. This disproportionally affects the world's most rural and remote places, home to about a billion people. Such areas also often lack electricity and the crucial infrastructure of telecommunications and road networks, which keeps the people who live there out of reach of the health-care system. How do we overcome the last-mile problem and bring quality health care to places that conventional approaches don't reach? The physicians and experts Prabhjot Singh and Raj Panjabi outline a transformative approach to delivering services in remote areas and show how it can revolutionize access to care. The targets of these efforts include the United States, where rural and remote communities across the country struggle to stay healthy. Building on years of experience working in last-mile settings, Singh and Panjabi explain how rural communities are taking the lead in designing a new generation of technology-enabled and people-powered health-care systems. Complementing the conventional hospital-centric system, remote areas can implement a microgrid : providing care in clinics and homes, with locals as staff, using portable off-grid materials, backed by an integrated system that helps all these pieces work together. The microgrid model can transform rural health, and it also offers a way to address growing health inequality in urban areas. Giving vivid firsthand examples from places as diverse as Liberia and Alaska, Rwanda and New Mexico, Mali and Brazil, The Last Mile is a powerful portrait of the innovations that will challenge-and change-how primary health care is designed and delivered everywhere.

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9780231185981

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Very limited scholarship exists that consider twenty-first-century ideas to solve this problem of equity gaps in health. This book does that with depth of insight, novel analyses, and compelling stories. -- Duncan Maru, CEO and cofounder of Possible

Author Information

Prabhjot Singh is director of the Arnhold Institute for Global Health and chair of the Department of Health System Design and Global Health at the Mount Sinai Health System, as well as special advisor for strategy and design at the Peterson Center on Healthcare. He is the author of Dying and Living in the Neighborhood: A Street-Level View of America's Healthcare Promise (2016). Raj Panjabi is cofounder and CEO of Last Mile Health and assistant professor of medicine at Harvard Medical School and the Division of Global Health Equity at Brigham & Women's Hospital. He is the winner of the 2017 TED Prize and was named by Time as one of the 100 Most Influential People in the World and by Fortune as one of the world's 50 Greatest Leaders.

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