REACH 1.0

Rural Effective Affordable and Comprehensive Health Care 1.0

45,000+

Population Covered

95%+

Immunization Coverage

TFR < 2.1

Fertility Rate Impact

Overview

Rural Effective Affordable Comprehensive Health Care (REACH) is one of the flagship programs of SHARE INDIA. It was developed as a working model of a proactive healthcare delivery system that offers promotive, preventive, and primary healthcare to rural populations.

The program was implemented across 42 villages in the Medchal Mandal, Ranga Reddy district, covering a population of approximately 45,000, with the aim of bringing healthcare services closer to communities that had limited access to formal healthcare systems.

Background and History

REACH was initiated in 1997 by SHARE (Science Health Allied Research & Education) India, a US-India cooperative non-governmental organization founded by physicians of Indian origin to strengthen healthcare infrastructure, promote medical education, and improve rural healthcare.

At a time when access to doctors and hospitals in rural India was limited, the program was designed to bring healthcare and public health measures directly into the community. It focused on prenatal care of pregnant women, immunization of infants, and family planning interventions, complementing State and Union Government primary healthcare activities.

Aim

The main aim of the REACH project was to provide integrated maternal and child health, family welfare, and primary healthcare services to the rural population, involving the community to achieve reductions in morbidity, mortality, and fertility levels.

Goals of REACH

In line with its vision, the program aimed to:

Provide universal healthcare to the rural population
Ensure effective (not nominal) healthcare
Deliver affordable healthcare within the economic means of the population
Offer comprehensive services including promotive, preventive, primary, and secondary care
Achieve sustainability through accessibility and affordability

Objectives

Further, the program specifically aimed:

To improve the nutrition and health of women, particularly pregnant and lactating mothers, and empower them through increased awareness
To reduce low birth weight babies, premature births, and infant mortality
To improve the nutritional, health, and psychosocial status of children aged 0–6 years
To prevent infections through immunization
To address nutritional deficiencies such as night blindness (Vitamin A), anemia (Iron), and goiter (Iodine)

Qualitative Objectives:

To support these goals, the program focused on:

Reduction in infant and maternal mortality rates in conformity with national goals
Stabilization of population growth
Prevention of vaccine-preventable diseases
Prevention of diseases due to nutritional deficiencies
Control of blindness due to cataract
Promotion of reproductive and child health

Concept of REACH

The essential concept of REACH was that every mother and infant in the target area would be tracked through this system, allowing for timely identification of individuals at risk and those requiring services such as immunization and maternal care.

Core principles

The REACH program was guided by the following core principles:

Effective rural public health measures require reliable tracking of individuals and services.

Community-level workers with basic education can achieve effective outcomes when supported with appropriate data and training.

Strategy of REACH

To achieve these objectives, REACH implemented the following strategies:

Identification and tracking of pregnant, lactating women, and children under six years in every village

Maintenance of demographic profiles and health records through a computer-based system

Strengthening maternal and child health programs through integrated services

Provision of ambulatory care through mobile units

Delivery of proactive healthcare services rather than waiting for individuals to seek care

Capacity building and training of field staff

Health education and awareness through IEC (Information, Education and Communication) activities

Close coordination with public health and medical authorities

Empowerment of women to maintain family and community health

Approach and Implementation

To operationalize this vision, REACH adopted a community-based approach by engaging local residents as Community Health Volunteers (CHVs). Individuals with at least a sixth-grade education were trained by MediCiti staff and assigned specific areas, where they visited each household at least once a month.

During these visits, CHVs collected data on births and deaths and maintained antenatal, postnatal, and immunization records. This ensured continuous engagement with the community and improved access to basic healthcare services.

Key component

A key component of the program was the development of a dynamic, computer-based database to track all households, particularly pregnant women, infants, and children. This database was regularly updated and validated by Health Supervisors and Field Coordinators, enabling an action-oriented monitoring system.

Outcomes

As a result of these efforts:

More than 95% immunization coverage was achieved among children aged 12–23 months

The total fertility rate (TFR) was reduced to less than 2.1