Ihangane Project

Results: In 2012, the medical community in Ruli, Rwanda requested assistance from The Ihangane Project to reach their goal to eliminate HIV among HIV-exposed infants and strengthen their response to malnutrition for all children in their communities. This flagship initiative has been a resounding success. The Ruli community decreased rates of malnutrition by 60% in their most vulnerable children and eliminated mother-to-child transmission of HIV (zero cases for >12 months) in a three-year period. We accomplished this by co-designing a comprehensive initiative that began with fortified porridge as a gateway opportunity to bring health care workers and their patients together, improved the quality of clinical care, strengthened linkages to community health, built capacity for operational management and addressed long term sustainability both for the system enhancements and for the families served by the initiative. Our prototype has allowed us to refine our methodology, clarify our organizational expertise, and identify a path for expanding our reach while maintaining our core values of integration, evidence, and collaboration. Although TIP is most known for our impressive impact on rates of mother to child HIV transmission and malnutrition, we have achieved success across all domains of our work. In the past four years, The Ihangane Project has created multiple innovative resources to reach health goals at the local level in resource-scarce settings. Below we describe our progress indicators to date, organized by our core expertise: Clinical Care • 260% drop maternal mortality among HIV+ mothers • 50% increase in nurses' ability to effectively provide health education • 100% increase in nurses' ability to accurately assess nutrition status • 1100% increase in appropriate HIV testing • Nurses, mothers, TIP staff, and professional designers collectively create design of new Digital Health Record Community Health • 603 Community Health Workers utilizing TIP Education Model and Continuous Quality Improvement Program • Mobilized 6 communities to construct health buildings in Ruli Sector • Gataba Village receives national award and $2500 USD for community engagement & building effectiveness Health Systems Management • Average patient wait time decreases 230% to 21 minutes • 42% decrease ER wait times • 86% drop in lost revenue due to billing errors Social Enterprise • Elimination of severe underweight among HIV-exposed infants • 75% costs of or clinical program subsidized by social enterprise • 514,180 servings of fortified forridge sold in 2016, preventing malnutrition for over 8,500 children

Target demographics: resource limited communities

Direct beneficiaries per year: Nearly 30,000 children

Geographic areas served: Ruli, Rwanda and we will expand our approach across Rwanda and East Africa

Programs: Aheza Fortified Food, a social enterprise launched by The Ihangane Project in 2015 to ensure
 that fortified food products known to prevent childhood malnutrition
are accessible to low income and rural families. Our program provides low cost access to fortified foods for the entire community, subsidizes the cost of porridge provision to the most vulnerable children and generates revenue to be invested into additional clinical health services. We currently work with seven health centers and provide fortified food distribution during the crucial 1000 days between conception and 24 months post-partum to prevent both HIV transmission and malnutrition among HIV-exposed infants. Our Health Care Worker-Centered Digital Health Record is a low-cost, quality-driven digital health record designed by clinicians. This user-friendly clinical data collection system will allow health care workers to optimize their patients’ care and to continuously improve the systems of care to their community. This application will be the first point-of-care electronic medical record in Rwanda. It will enable health care workers who provide care across the spectrum of perinatal care, Prevention of Mother to Child Transmission of HIV, and infant care to enter individual data, track both individual and family results over time and allow for aggregation of data to analyze community-level trends. It will improve health outcomes by enabling health care workers to show immediate and long-term health data in real time.