2013 Honoree: Microclinic International

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Primary Area of Impact: Healthcare
Geographic Areas Served: Appalachia (US), Jordan, and Mfango Island (Kenya)
Year Founded: 2005
Website: www.microclinics.org

Overview

Founded in 2005 by Daniel Zoughbie in honor of his grandmother who died of diabetes in Palestine, Microclinic International (MCI) is a not-for-profit development organization that seeks to revolutionize how deadly diseases are prevented and managed worldwide. Building on epidemiological evidence suggesting that healthy behaviors are transmittable across social networks, the microclinic strategy leverages human relationships to address both non-infectious and infectious disease epidemics such as diabetes and HIV/AIDS. If negative behaviors like smoking, unsafe sex, and overeating can be contagious, so can positive, healthy behaviors. This is what MCI calls “contagious health.” To date, MCI has established and evaluated over 1,500 microclinics across four continents.

Social Challenge

According to the World Health Organization, chronic diseases are the leading causes of death and disability, accounting for almost 60% of all deaths. The problem is only getting worse. Without an effective strategy to combat these chronic diseases, their contribution is expected to rise to 73% of all deaths by 2020. Furthermore, the social challenge disproportionately affects the poor, with 79% of deaths attributed to chronic diseases occurring in developing countries.

While violence and insecurity have been at the forefront of news in the Middle East recently, the rapidly growing prevalence of diabetes has become a silent killer in the region. Among the top ten countries with the highest prevalence of diabetes, six are in the Middle East.

Although a very different geographical and cultural environment from the Middle East, Appalachia is burdened by similar health and economic challenges related to diabetes and the closely affiliated chronic diseases of obesity and heart disease. These chronic diseases disproportionately affect the poorest parts of the United States.

Once viewed as an acute disease, HIV/AIDS is now predominantly approached as a chronic disease requiring long-term care and management. MCI developed its first HIV/AIDS microclinic program on Mfangano Island, Kenya where there is a staggering 30% HIV prevalence rate, one of the highest on the planet. In places where socio-economic resources are scarce, HIV-risk is induced at the level of an entire social network, not simply at the level of ‘reckless’ individual behaviors.

MCI Case Study

This executive summary and case study was written by four student fellows of the Lipman Family Prize with faculty oversight to highlight MCI’s impact and transferability across various contexts and locations, as well as its scaling potential and future plans.

MCI Executive Summary

MCI Case Study

Accomplishments

  • Using sophisticated cohort studies and randomized controlled trials in partnership with universities such as the Harvard School of Public Health and UCSF, MCI has demonstrated the effectiveness of the microclinic model through statistically significant improvements in participant health indicators across various chronic diseases.
  • In Jordan and Kentucky, MCI has tracked participant improvements in weight, BMI, and HbA1c, as well as through other qualitative indicators related to diabetes, heart disease, and obesity. Moreover, MCI found evidence of social contagion as those who had a higher BMI than the microclinic average lost more weight than those who had a similar BMI as compared to their microclinic average.
  • In Kenya, MCI has successfully launched a groundbreaking microclinic pilot program for HIV/AIDS in partnership with its local partner, Organic Health Response. This ongoing Kenya study tracks participant progress through indicators such as medication adherence, CD4 count, opportunistic infections, and body mass index.