Hack

In my previous post, I discussed the need for a more integrated approach to health, recognizing the deep connections between health and socioeconomic factors. Now, I’d like to share a concrete example of how this integration can be achieved at the community level.

This project highlights the crucial role of Community Health Workers (CHWs or kader) as agents of change, bridging health, environment, and food security by leveraging their local knowledge and community trust. As health outcomes depend on addressing environmental and food security challenges, CHWs are spearheading community programs such as maternal & neonatal health post (posyandu) and grow your own food movement (GYOF). The project emphasizes the interconnectedness of these domains.

For years, I worked tirelessly in infectious disease control, specifically HIV. It often felt like a treadmill. We’d make progress, but it never seemed to be enough. Treatment wasn’t optimal - not enough access, improper prescriptions, or patients not adhering to instructions. On the prevention side, we weren’t faring much better. Containing outbreaks, promoting healthy behaviors - all fronts felt suboptimal.

    Pessimist: "Glass is half empty"
    Optimist: "Glass is half full" 
    Realist: "Glass is half water, half air"

We all know the famous “glass half-full or half-empty” metaphor, a classic illustration of optimist vs. pessimist perspectives. But this analogy often overlooks a crucial perspective: the realist. Realists assess the situation as it is, considering both the potential and the limitations. This resonates deeply with my approach to health system strengthening, where I combine realist evaluation, systems thinking, and pragmatism.