A Framework for Applying Global Learning to Improve Primary Health Care in the United States

GLOBAL EXAMPLE	U.S. ADOPTION OR ADAPTATION
Specific Program: The Friendship Bench is a program developed in Zimbabwe that trains lay workers to deliver care to people with mild to moderate behavioral health disorders. A primary driver for the development of the Friendship Bench was lack of access to professional mental health workers—a circumstance present in many US communities as well. In Zimbabwe, the lay workers are primarily grandmothers who deliver a talk therapy intervention customized for the local language and culture.	The Friendship Bench model was adapted for implementation by peer counselors and CHWs in New York City as part of ThriveNYC, a city-sponsored mental health initiative [36].
General Strategy: The “accompaniment” model, developed and used in several LMICs, combines clinical care and social support delivered through CHWs (accompagnateurs in Haiti and Rwanda; acompañantes in Mexico)[37]	Partners in Health’s Prevention and Access to Care and Treatment (PACT) program applied the accompaniment model to address medication adherence, health education, healthcare navigation, and access to behavioral health services to people with HIV/AIDS in Boston [38, 39].
Inspiration: Cuba’s primary care system includes neighborhood consultorios—clinics staffed by nurses and physicians living adjacent to the clinics and among the patient population —which allow a deep connection between health care providers and the neighborhood they serve, contributing to highly effective patient- and community-centered care [40].	A delegation of New Mexico healthcare providers and community members focused on improving the health of residents of Albuquerque’s South Valley traveled to Havana on a trip to better understand the Cuban healthcare system. Inspired by the community connectedness of the consultorios, but unable to duplicate the model directly, the South Valley Community Partnership for Health Equity started a weekly walking group in which health professionals gained a greater understanding of community needs by joining residents for hour long walks around neighborhoods surrounding the clinic [41].

Table 2

Selected Web-based Resources to Scan for Global Health Innovations Potentially Transferable to the US.

RESOURCE	DESCRIPTION	NAVIGATION TIPS
Consortium of Universities for Global Health: Link Library [42].	A compendium of >180 global health-related websites. The content resulted from a Google search of the term “global health” that vetted ~18 million hits down to > 180 sites.	The “link library” divides content into four types: (1) informational resources; (2) journals and ports with high relevance to global health; (3) job and field placement opportunities; and (4) language training programs. Click on a hyperlink to go directly to that webpage.
Primary Health Care Performance Initiative (PHCPI): Improvement Strategies [43].	PHCPI developed an interactive tool that comprises modules essential for strong PHC systems, inputs, and service delivery. Drawing on evidence-informed strategies globally, each module includes an evidence review, case studies, key questions, and infographics to guide selection of strategies.	PHC improvement factors are divided by type to facilitate easy browsing. Resources include infographics, PowerPoints, downloadable PDFs and peer-to-peer learning opportunities.
National Association of County and City Health Officials Global-to-Local Public Health Exchange [44].	The Exchange includes resources such as a blog and podcast series, white papers and reports describing how successful approaches in other countries can be adopted by US local health departments.	Guidance tools are divided into three categories: “implementation”; “success stories” and “resources”. Scroll through these tabs to identify relevant tools.
Global Innovation Exchange [45].	This open-source database highlights over 5,000 examples of innovations in 13 health focus areas from over 135 low-and-middle-income countries.	Search innovations by implementation location, focus areas (sector or topic), stage (ideation through sustained scale), funder type, and recognizing organizations.
Center for Health Market Innovations (CHMI) Database of Programs [46].	The CHMI public database provides information on 1,400 innovative health enterprises, nonprofits, public-private partnerships, and policies in low- and middle-income countries that are advancing health care quality and affordability.	Browse the database for health innovations by health focus, approach, country or theme.
Innovations in Healthcare (IhI) [47].	As of 2021, the network included 90+ innovators in nearly 90 countries, with primary goals of sourcing, strengthening, scaling and studying innovations in healthcare.	Search the database by country of origin, target population, target income level, geographic reach, target settings, health need, continuum of care, offering, and organization type.
Grand Challenges Canada [48].	Lists over 1,300 innovations in 106 countries aiming to accelerate the achievement of the United Nation’s Sustainable Development Goals, with a particular focus on seven areas having the greatest potential for impact using innovation: maternal, newborn and child health; early childhood development; mental health; safe abortion; sexual and reproductive health; sanitation; and gender equality.	This database includes a search engine that filters by geographic region, program, institution, priorities and platforms.
Global Ideas for U.S. Solutions[49].	The webpage includes links to descriptions of initiatives from abroad that can be applied to advance health and health equity in the US.	Users can filter and scan resources by topic or content type.