Organization
Nyaya Health
Mission
Nyaya Health is a for-purpose organization that exists to realize the right to health by delivering transparent, data-driven health care for Nepal's rural poor.
Organizational Expertise
Health, Monitoring and Evaluation, Research
Other Organizational Expertise
Nyaya Health employs 155 Nepali employees delivering hospital and community-based health care via a public-private partnership with the Government of Nepal in the country's Far-Western region. NH has treated over 131,000 patients in Nepal since care delivery began in 2008 and currently operates Bayalpata Hospital in addition to a Community Health Program that covers over 22,000 individuals.
Technologies & Fuels
Not Applicable
Clean Cooking Activities
Nyaya Health currently does not have any initiatives underway involving clean cookstoves, though we are in the planning stages of a study taking a look at clean cook stove adoption rates in Achham, Nepal. Below is a brief overview of our approach.
Background
Despite the tremendous need and demonstrated efficacy in laboratory studies, improved cook stoves® have often failed to be effective in field studies. This is largely owing to poor maintenance and® uptake over the long run. In rural, isolated communities in extreme poverty, there is unlikely to be a® single behavioral or technological “fix†to this problem. Like other essential social safety net® services, access to clean household air should be considered a basic human right and, as such,® incorporated into the public sector health system. Interventions aimed at increasing the real-world® effectiveness of ICS should thus focus on enhancing the effectiveness and financing of public sector® systems that support ICS.
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Approach
The study will take place in rural Achham, Nepal, through the non-governmental organization®
Nyaya Health in partnership with the District Health Office of Achham. The approach we take®
involves: 1) partnering with an ICS organization with considerable experience in Nepal; 2) training® existing public sector community health workers in the utilization and maintenance of stoves; 3)® integrating the ICS work of these community health workers within the existing public sector® primary healthcare system; 4) creating a clear management system for oversight and maintenance of® the community health workers and the stoves.
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Evaluation®
We hypothesize that incorporating ICS within the public sector health system framework will enhance the durability of ICS adoption. A second hypothesis is that implementing chimneys to improve ventilation, a more passively acceptable intervention, will also result in improved health outcomes. To assess this, we will conduct a cluster randomized controlled trial in Achham, Nepal, and will implement a two-by-two design examining 1) ICS adoption rates and 2) the health effects of ICS and improved smoke ventilation, ICS alone, and improved ventilation alone. The study will take place over the course of a 3-month pilot period.
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Repeated household surveys will be used to collect adoption outcomes data. The primary adoption outcome will be the proportion of time in which a household with an ICS exhibits proper use of it.® Secondary outcomes include ICS-related metrics such as time spent on fuel collection, money spent on fuel, numbers of meals cooked, time and money spent on maintenance activities, and attitudes about and satisfaction with stoves among community health workers and users.
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Primary health-related outcomes to be compared between ICS and improved ventilation, ICS alone, improved ventilation alone, and control households include exhaled carbon monoxide as a measure of smoke exposure, under-five acute respiratory tract infections, and chronic obstructive pulmonary disease control among patients suffering from this condition.
Partnership
With Bayalpata Hospital as the hub of our operations and a vast network of community health workers covering a catchment area of over 22,000 people, Nyaya Health has an excellent reputation in Nepal as a healthcare delivery organization that provides transparent, data-driven care to the people of Far Western Nepal.
Nyaya Health takes an implementation science approach to program expansion and scale. We define implementation science as an analysis of quantitative and qualitative data from impact assessments of programs to create generalizable knowledge for use in local, national, and global policy-making. Our organization's strategic priorities drive service delivery. We then analyze the services within a scientific framework appropriate to the global policy need and the local operations realities. This is an approach our team has extensive experience in, and plan to offer to the field of cook stove research.
Regions Operating In
South Asia
Country Based In
United States
Address
17 West 17th St., 7th Floor
New York, NY 10011
Website
Primary Point of Contact
Name: Mr. Jamie Lim
Title: Executive Assistant
Email: jamie@nyayahealth.org
Phone: (857) 272-3031
Secondary Point of Contact
Name: Mr. Mark Arnoldy
Title: Executive Director
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