Travel anywhere in the world and it is likely that you will come across an Indian medical professional at the local hospital. Though at face value this trend seems like an indication of progress, it has had far reaching negative consequences on the Indian healthcare system. The lure of developed countries has lead to a severe shortage of medical professionals in India. It is estimated that there is just 1 doctor for every 10,000 patients and a shortage of 2 million nurses. These staggering statistics— coupled with the rapid increase of chronic conditions— illustrate the enormity of India’s healthcare burden.

Noora Health (NH), a non-profit based in Bangalore founded in 2014, is working to relieve some of this burden. The organization came about as an outcome of a class project by Katy Ashe, Edith Elliott, Dr. Shahed Alam, and Jessie Liu, a group of Stanford students. During a visit to India for their project, they spent time at Narayana Health in Bangalore. As their maiden exposure to Indian healthcare, they were struck by how disengaged family members were in the healthcare delivery process. They also noticed how overwhelmed Indian physicians were by the sheer numbers of patients they had to see. The group realized there was a connection between the two problems they observed: if patients and their families were educated about the disease and treatments, it would help in their recovery and this, in turn, would relieve some of the burden on the physicians. The solution seemed obvious-– patients and their families had to be educated.

This realization lead to the creation of Noora Health with a simple mission: “to train patients and their families with high-impact health skills to improve outcomes and save lives”. The team pitched their idea to Y-Combinator – a startup seed fund in San Francisco – and received an initial funding of $20K. They returned to India in 2014 to develop their team and implement their ideas. NH now consists of a content development team made of graphic designers and videographers, and a training & implementation team consisting of physicians, a master trainer, senior nurse providers, healthcare management and public health professionals. The content development team creates patient and family education materials on a range of medical conditions. The information is then disseminated to partner hospitals through the implementation team. The partner hospitals in turn use the material to train their patients and their respective family members. A critical component of NH’s approach is their ‘train the trainer program’. The NH trainers educate each hospital’s patient education team on the best methods for teaching adult learners, and on the proper use of the print and video training materials provided. The NH curriculum is currently developed for patients who have experienced significant life events like heart surgery or a cancer diagnosis. They also cater to general medical, surgical, neonatal and maternal cases. Families are taught the basics about how to take care of their loved ones practically and about behaviors and habits like hygiene and hand washing.

In a short span of time, NH has created a lasting positive impact. “Narayana Hospital caters to a diverse group of patients. So sometimes we would have a farmer’s wife getting trained alongside an MBA professional, and that in itself was a wonderful experience,” shared Dr. Alam. “Moreover, it was really magical to see how much information the families want to take up and how the information translated into changed behaviors in the hospital and even in the home,” he added. The program has already resulted in a 71% reduction in patient complications, as well as significant decrease in hospital readmissions. In their neonatal patient population, they have observed a 42% decrease in readmissions for neonates and a significant increase in practice of key healthy behaviors. Narayana Health now runs the program across all their hospitals in India and monitors it as a Key Performance Indicator or KPI. Noora Health has also partnered with the Government of Punjab, Karnataka and Madhya Pradesh to implement the program in all their district hospitals.

The success of NH lies not only in its simple grassroots approach, but also in the scientific methods used to evaluate their program. The NH team diligently monitors the following parameters:

The number of sessions conducted at each hospital as well as the number of attendees in each session.
The quality of the instructors and program (via regular audits and feedback surveys)
The practice of healthy behaviors, medical complications and readmissions*

*The survey tool used to collect patient data has been developed in partnership with the Harvard School of Public Health.

What’s in store in the future for Noora Health? After a successful proof of concept in India, their team is thinking big. “Our goal has always to be a system-wide intervention across the whole spectrum of healthcare. We are looking for more partners as we grow, but our vision is global. Next year we are expanding outside of India. We want patient and family education to be the standard of care throughout the world,” shares Dr. Alam.

How Noora Health’s Family Engagement Program is Saving Lives

Noora Health trains patients and their families with high-impact health skills to improve outcomes and save lives, writes Sama Bég

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