Nyaya Health

Nyaya Health

Founder(s)	Jason Andrews, Sanjay Basu and Duncan Maru
Type	Healthcare Non Governmental Organization
Tax ID No.	20-3055055
Founded	2005
Location	135 College Street, Suite 323 New Haven, CT 06510 USA
Key people	Bibhav Acharya (Executive Vice President) Jason Andrews (Chief Medical Officer) Mark Arnoldy (Executive Director) Gregory Karelas (Country Director) Duncan Maru (President) Dan Schwarz (Chief Operating Officer) Ryan Schwarz (VP of US Operations)
Area served	Achham, Nepal
Mission	1. To provide free community based healthcare in rural Nepal that strengthens the public sector. 2. To develop and disseminate effective strategies of health delivery in resource-poor settings throughout the world.
Website	www.nyayahealth.org

Nyaya Health is a non-governmental organization (NGO) providing free health care in Achham, a district in the Far Western region of Nepal. Nyaya (Nepali for "Justice") operates the Bayalpata Hospital, one of only two hospitals in Achham (population 250,000), as a partner of the Nepali government's Ministry of Health and Population. It also supports and oversees some of the Nepali Ministry of Health’s community health workers in the region around Bayalpata Hospital.

Outside of its work in Achham, Nyaya works with other organizations in the global health field to share lessons-learned and help develop best practices for the field.

Nyaya is a partner project ^[1] of Partners in Health ^[2]and a member organization of Still Harbor’s Praxis Network.^[3]

History

• Nyaya Health was founded in 2005 ^[4] Its first project was a community-based antiretroviral therapy program in Kathmandu, the capital of Nepal.^[5][6][7][8]

• Nyaya Health spent the next year doing epidemiological studies, negotiating with the Nepali local and central governments, establishing supply chains and raising funds. A former grain shed in Sanfe Bagar, Achham District, was selected as the site for Nyaya’s first clinic, The Sanfe Bagar Medical Clinic.^[9]

• In 2007, Nyaya was selected as one of three organizations around the world to be beneficiaries of an international design contest sponsored by Open Architecture Network and AMD.^[10][11] The design challenge was for a telemedicine center, and was won by Max Fordham LLP of London, UK.^[12] However, the telemedicine center was never built due to lack of funding.

• The Sanfe Bagar Medical Clinic was opened on April 6, 2008. Initial programs focused on maternal health, child malnutrition, and HIV and tuberculosis treatment.^[7]

• Soon after the opening of the Sanfe Bagar Medical Clinic, the community requested that Nyaya Health take over the administration of the nearby Bayalpata Hospital. The hospital had been built in 1976, but had never been staffed and had fallen into disrepair. Nyaya joined in a formal contractual partnership with the with the Nepal Ministry of Health and Population to jointly renovate and scale up services at the facility over a period of 5 years. The hospital opened June 21, 2009.^[13][14][15]

• In August of 2009, the first ultrasound machine in Achham was installed at Bayalpata Hospital.^[16][17]

• In September 2009, Nyaya instituted a new Mortality Review Program.^[18] Each death occurring at the Bayalpata hospital is reviewed by both the Nepali and international teams for systems-level changes to prevent future deaths.^[19] The de-identified reports are then published for review by the Web community.^[20]

• In 2010, the hospital revamped and expanded its Community Health Worker program by integrating it with the Nepali government's Female Health Care Volunteer program. To do this, an agreement was negotiated whereby Nyaya Health would pay the women volunteers for performing certain tasks, thus raising the status of the women and establishing accountability for the first time.^[21]

Organizational Structure

Nyaya Health is organized as two closely connected NGOs, the Nepal-based NGO that implements health programs in partnership with the Nepali Ministry of Health and Population, and the International NGO that provides technical assistance and fundraising for the Nepal NGO.^[22] Many of the INGO volunteers are young Nepalis who have gone abroad for higher education and are now using their skills to improve conditions in their homeland.^[23]

Open Access and Transparency

Since its inception, Nyaya Health has focused on using Web technologies to create as open and transparent an operation as possible. The primary mechanism for this has been to maintain a public wiki,^[24] where clinical protocols, management strategies, programmatic work plans, deidentified aggregate patient data and detailed budget reports are routinely posted.^[25][26][27]

Do to the international distribution of Nyaya Health team members, most organizational communication is conducted using approximately 30 listserves (currently implemented as Google Groups). The full directory of these listserves is made public.^[28] The majority of these listserves are fully open to being read by the general public. The policy for determining when to restrict a group from public browsing is also published.^[29]

Advocacy

In addition to providing free health care in Achham, Nyaya Health's international volunteers, both individually and collective, act as advocates for various topics affecting the well-being of the poor in rural Nepal. Some examples include the cultural and economic forces that result in resource denial,^[30][31][32] the status of women,^[33] active screening for visceral leishmaniasis,^[34] and the need for political decentralization in order to bring about socio-economic transformation in underprivileged areas.^[35]

References

1. ^ ""Partner Projects"". Partners In Health. http://www.pih.org/pages/partner-projects/. 
2. ^ ""Nyaya Health / Nepal"". Partners In Health. http://www.pih.org/pages/nepal/. 
3. ^ ""Praxis Network"". Still Harbor. http://www.stillharbor.org/praxis-network/. 
4. ^ Sale, Claire (24 January 2011). ""FACT Featured Project Interview: Ryan Schwarz From Nyaya Health"". NetSquared. http://www.netsquared.org/blog/claire-sale/fact-featured-project-interview-ryan-sch. 
5. ^ ""Nyaya Health Timeline"". Nyaya Health Wiki. http://wiki.nyayahealth.org/w/page/4682784/Timeline. 
6. ^ "Conversation with Duncan Maru". GiveWell. 17 March 2011. http://www.givewell.org/files/DWDA%202009/Nyaya/Conversation%20with%20Duncan%20Maru%202011%2003%2017.doc. 
7. ^ ^{a b} Subrahmanyam, Divya (1 February 2008), "Bringing hope to Nepal", Yale Daily News, http://www.yaledailynews.com/news/2008/feb/01/bringing-hope-to-nepal/ 
8. ^ Bernardo, Mary Lou (26 May 2008), "Nyaya Health: Improving Healthcare in Western Nepal", Angels in Medicine, http://www.medangel.org/nyaya/nyaya014.shtml 
9. ^ ""Nyaya Health 2007 Annual Report"". Nyaya Health. http://www.nyayahealth.org/Library/2007_Annual_Report.pdf. 
10. ^ Oppenheim, Leonora (12 October 2007), AMD Open Architecture Asia Challenge: Nyaya Health, Nepal, TreeHugger, http://www.treehugger.com/files/2007/10/amd-nyaya-health.php 
11. ^ Sinclair, Cameron (15 January 2008), Visiting Nyaya Health in Sanfebagar, Nepal, Cameron Sinclair, http://www.cameronsinclair.com/index.php?q=node/7 
12. ^ "AMD Open Architecture Challenge | Asia". Open Architecture Network. http://openarchitecturenetwork.org/competitions/challenge/2007/asia. 
13. ^ Schwarz, Dan (4 March 2010), "Developing a health system: The case of Nyaya Health in rural Nepal", Health and Human Rights, http://www.hhrjournal.org/index.php/hhr/article/view/327/526 
14. ^ Tewari, Kanupriya (2 August 2010), "PIH-supported project in Nepal celebrates hospital’s first anniversary", Partners in Health, http://www.pih.org/blog/entry/celebrating-bayalpatas-first-birthday/ 
15. ^ Bhattarai, Anil (January 2010), "Health is not the only DISEASE", Hardnews, http://www.hardnewsmedia.com/2010/01/3395 
16. ^ Maru, Duncan; Schwarz, Ryan; Andrews, Jason; Basu, Sanjay; Sharma, Aditya; Moore, Christopher (14 October 2010), "Turning a blind eye: the mobilization of radiology services in resource-poor regions", Globalization and Health 6, doi:10.1186/1744-8603-6-18, http://www.globalizationandhealth.com/content/6/1/18 
17. ^ Mathema, Paavan (19 November 2010), "Resurrection Achham", Nepali Times (528), http://www.nepalitimes.com/issue/2010/11/19/Nation/17650 
18. ^ Kanupriya, Tewari (02 August 2010), PIH-supported project in Nepal celebrates hospital’s first anniversary, Partners in Health, http://www.pih.org/blog/entry/celebrating-bayalpatas-first-birthday/ 
19. ^ Maru, Duncan (29 October 2009), Nyaya Health’s Mortality Review Program, Nyaya Health, http://blog.nyayahealth.org/2009/10/29/mortalityreview/ 
20. ^ "Mortality Data", Nyaya Health Wiki, http://wiki.nyayahealth.org/MortalityData 
21. ^ Duncan, Maru (10 April 2011), Following up: Update on Nyaya Health’s Community Health Worker Program, Nyaya Health, http://blog.nyayahealth.org/2011/04/10/chwfollowup/ 
22. ^ ""Nyaya Health Organizational Structure"", Nyaya Health Wiki, http://wiki.nyayahealth.org/w/page/4682708/Management_INGO 
23. ^ Thapa, Saurav J. (18 March 2011), "Diaspora - How young Nepalis abroad are serving their country", MyRepublica, http://173.201.29.101/portal/index.php/thweek/www.cpnuml.org/[e-mail]?action=news_details&news_id=29340 
24. ^ Nyaya Health Wiki, http://wiki.nyayahealth.org/ 
25. ^ Maru, Duncan Smith-Rohrberg; Sharma, Aditya; Andrews, Jason; Basu, Sanjay; Thapa, Jhapat; Oza, Shefali; Bashyal, Chhitij; Acharya, Bibhav et al. (1 December 2009), "Global Health Delivery 2.0: Using Open-Access Technologies for Transparency and Operations Research", PLoS Medicine 6 (12), doi:10.1371/journal.pmed.1000158, http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000158 
26. ^ Zainal, Zakaria (13 May 2009), "Medics without Borders", MyRepublica, http://www.myrepublica.com/portal/index.php/thweek/adminsite/http/slc/index.php?action=news_details&news_id=4975 
27. ^ "The Nyaya Health Wiki: A scalable model for enhanced collaboration in the global health field", net², http://www.netsquared.org/projects/nyaya-health-wiki-scalable-model-enhance 
28. ^ Nyaya Health Listserve Directory, http://groups.google.com/a/nyayahealth.org/groups/dir 
29. ^ Nyaya Health Wiki - Transparency, http://wiki.nyayahealth.org/w/page/35369836/Transparency#NoteonListserves 
30. ^ Acharya, Bibhav (9 January 2009), "The Myth of Beautiful Poverty", Atrium Magazine, http://www.atrium-magazine.com/2009/01/the-myth-of-beautiful-poverty/ 
31. ^ Acharya, Bibhav (28 January 2011), "A Default State", Nepali Times, http://www.nepalitimes.com/issue/2011/01/29/GuestColumn/17882 
32. ^ Acharya, Bibhav (11 March 2011), "Cause of Death", Atrium Magazine, http://www.atrium-magazine.com/2011/03/cause-of-death/ 
33. ^ Rajbhandari, Ruma (4 December 2009), "Unwanted in Achham", Nepali Times (479), http://himalaya.socanth.cam.ac.uk/collections/journals/nepalitimes/pdf/Nepali_Times_479.pdf 
34. ^ Schwarz, Dan; Andrews, Jason; Gauchan, Bikash (2011), "Visceral Leishmaniasis in Far Western Nepal: Another Case and Concerns about a New Area of Endemicity", The American Society of Tropical Medicine and Hygiene 84 (3), doi:10.4269/ajtmh.2011.11-0021, http://www.ajtmh.org/cgi/content/full/84/3/508 
35. ^ "NRN USA calls for capacity building for Nepal's development", Nepal News, 12 April 2011, http://nepalnews.com/archive/2011/apr/apr11/news15.php 

External Links

• Nyaya Health Web site
• Government of Nepal, Ministry of Health and Population
• Partners in Health, Nepal