REACH pilot programme in Madurai, South India

In 2007 pilot project employing 10 HCWs was designed and initited by 3 UK health professionals in partnership with 2 local Indian groups – The Bridge Foundation in Bangalore, providing expertise in local project and micro-enterprise management, and the Centre for Rural Education and Development in Tamil Nadu state, an NGO with expertise in women’s empowerment, who employs and manages the HCWs, health camps and ambulance. The primary purpose of the pilot was to demonstrate "proof of principle" that healthcare cabn be sustained entirely through contributions from micro-enterprise communities.

The pilot achieved the following:

• The UK health professionals consulted widely, conceived the model, established the partnership with The Bridge Foundation and raised initial funding.

• A project co-ordinator was employed at The Bridge Foundation in Bangalore, and established the partnership with CRED.

• In April 2007, 10 HCWs were then recruited from the local communities and underwent training at the Meenakshi Mission Hospital, Madurai.

• An ambulance was purchased and funded jointly by the federation of self-help groups, UK health professionals and a member of the legislative assembly in Madurai.

• In July 2007, principally as a result of implementing REACH, CRED was awarded best NGO in Madurai district.

• By April 2008 (one year after initiation), the number of loans given for healthcare needs had reduced by 43% in comparison with the previous year, the number of clean up drives had increased by 57% and the number of individual toilets constructed increased by 78%.

• In September 2008, the number of members making regular contributions had risen to 6,030 and HCWs had made 3,846 consultations. Income generated from contributions represented approximately 50% of operational expenses.

Whilst the pilot did not ultimately achieve 100% sustainability from the contributions made by group members, we felt that sufficient progress was made in the development of the concept that future REACH schemes could be designed to acheive 100% sustainability within a reasonable time frame.