It is daunting to plan for a whole medical outreach and this post aims to demystify the process. Nothing helps you better than having a guideline from someone who has participated in more than 20 medical outreaches and has organised about 3. I will be describing the process of planning a medical outreach from the medical perspective.
Some ground work needs to be done. This groundwork is better left to the organisation you are partnering with to carry out as they are more adept at doing this. It will be of immense benefit if this organisation is a religious one as they have a very good community penetration style and will go a long way in making it as hassle-free as possible.
Rationale for a medical outreach
A lot of people living in rural areas do not have access to healthcare and live long years of life with disabilities that could be easily corrected, or sometimes even die uneccesarily from easily diagnosable and treatable medical conditions.
You would be surprised that a village, just 1 hour drive from a city centre like Ibadan, does not have any form of access to healthcare in their communities and have to resort to untrained traditional birth attendants (TBA’s) to take their deliveries and/or use all kinds of herbs in treating whatever sicknesses they may have.
This is where well meaning citizens who have the money to facilitate an outreach come in. You try to do some gap bridging by providing short term high quality healthcare and health education to the community dwellers and refer the ones that have NCDs or require surgical care, you are unable to provide, to a nearby health facility.
Checklist for a medical outreach
- Medical Equipment/Consumables
- Refreshment and transport for volunteers
For the purpose of passing across my points in a really practical way, I will be describing a hypothetical outreach to a village 1 hr away from a city centre.
In this outreach, the population of the village is about 1000 and we are estimating to have a 30% turn out rate – 300 expected participants for the medical outreach. It will be a one day outreach, where we arrive at 10 am, start to see patients at 10:15 am, and leave the village by 4 pm. A religious group has a crusade in this village and will be needing your medical services to add some medical value to the community. The religious group will do community penetration and will also prepare the indigenes for your arrival. The outreach is happening in two weeks.
The most important ingredient to carry out an outreach is financial backing as drugs and supplies are really costly. Also, you should have a plan for the left-over drugs. If you intend to be going on constant outreaches you may purchase your own medical equipment, if not, you may just rent them from a health facility close to you.
What we plan to do at the outreach/Work flow
- Register them at a registration table and give them a consulting sheet
- Measure their height and weight and compute the BMI
- Measure their blood pressure
- See a medical doctor for consultation and referral if necessary
- Do lab tests (using point-of-care devices/Rapid Diagnostic Kits) such as blood sugar and malaria tests at the doctor’s discretion.
- Dispense medications at the pharmacy and retrieve the consulting sheets.
Working with our expected number of participants (300) and work flow pattern we will be recruiting;
- 2 volunteers for registration
- 2 volunteers to measure the height and weight
- 3 volunteers to measure the blood pressure (nurses/pre-trained medical students)
- 6 volunteer medical doctors
- 2 volunteer laboratory scientists
- 3 volunteer pharmacists
An 18-seater bus will conveniently convey your volunteers to and from the outreach.
This is a really cost-intensive part. You need to have an idea of the drugs you want to offer. The most commonly prescribed drugs at outreaches are analgesics, antimalarials, and multivitamins in that order. The table below shows what proportions I suggest the medications for an outreach like ours should have:
|Others (Antidiabetics etc)||2.5%|
FYI: Most of them come for pain medications as they have one pain condition or the other, another group will get antimalarials for keeps sake and those who don’t seem to have any complaints but do not want to go empty-handed will get the multivitamins – this last group makes a very huge percentage of them.
Items needed based on the workflow described above
|Item (No)||Unit Cost|
|Weighing scale (2)||2500||5000|
|Glucometer strips (1 pck)||4500||4500|
|Malaria RDT kit and buffer||1 pck||N/A|
|Facemasks (1 pck)||2000||2000|
|Hand sanitizers (7)||300||2100|
Side Note: N/A means I do not know the prices. You could also rent some of the equipment like weighing scale and sphygmomanometers to significantly cut costs.
These are the items you will need to mark up places to direct participants and for writing things down.
|Items||Number of pcs|
|Ruled A4 paper for registration||10|
|Consultation sheets (A5 sized)||300|
NB: You need to ensure that there are tables and chairs for setting up your outreach and canopies if it will be open-air.
Refreshment and transport for volunteers
Make sure you get a comfortable transport for your volunteers and ensure you provide breakfast before the outreach starts and lunch at the end of the outreach. The breakfast should be filling enough to carry them through the outreach as some outings can be really draining and your volunteers may get worn out before the time you planned to conclude the outreach.
A lot of your participants-turned-patients will need to be referred to the closest hospital facility. Try to find a health center close-by and, if possible, get the phone numbers of the health workers there before commencing your outreach for ease of referral. Newly detected NCDs can’t be completely managed at the outreach and will benefit from a referral and the patients-to-be should clearly understand this.
Crowd control is very important and if improperly managed can ruin your outreach and drain the volunteers. Get one member of your partnering organisation and task him with the duty of keeping the crowd in check and ensuring unidirectional flow of participants.
Train your volunteers before the outreach to ensure they perform optimally. For example, give them tips on how to measure the blood pressure quickly and also how to consult in a directed manner to quickly decipher those needing real medical attention and those who have just come for free drugs. Being able to sieve out the ill from the well will save your team a lot of time and energy.
For our fictional outreach, it will be a good idea to take a break for 30 minutes at 1 pm to enable the volunteers refresh and catch their breath before continuing.
Respect the time of the volunteers, if you have decided to shut down at a particular time that you should have communicated to the them, keep to this time, no matter what pressure you may be under from the indigenes. Tell them you will come back another day, if you intend to (I proposed a model for this on Twitter yesterday).
Download Sample Outreach Documents
Click on ‘download’ to get sample registration sheet, consultation and referral forms for a medical outreach. This link will take you to the Google docs form if you will prefer that.
I hope I have been able to make life easier for at least one person who feels daunted by the weight of planning a medical outreach.
If you have any clarifications or things you feel need to be added to this post, please engage me in the comment section.