PACE / ALSO is an international program which pursues a main goal to improve the quality of care, provided by different health services that are assisting maternal and neonatal health. In that way, we seek to reduce rates of maternal and neonatal mortality in the entire Mesoamerican region.
About You
About You
First Name
María Laura
Last Name
Casalegno
Twitter URL
Facebook URL
://www.facebook.com/pacemd.mexico?fref=ts
About Your Organization
Organization Name
PACEMD
Organization Website
Organization Country
Mexico, GUA, San Miguel de Allende
Organization's Country of Operation
Mexico, GUA, San Miguel de Allende
Type of Organization
Non‐profit/NGO
Year of launch of the organization
2002
Years in Operation
Operating for more than 5 years
Has the organization received awards or honors? Please tell us about them
- PACE has been chosen as one of the two centers of excellence ALSO at world-wide level.
- The Secretariat of Health of the Chiapas State has granted a recognition to PACE for its work in reducing maternal mortality.
- Doctor Haywood Hall, director of PACE, have received several prizes for his work in the Emergency Medicine.
We want to hear about your “Aha!” moment. Share the story of where and when the founder(s) saw this solution’s potential to change the world.
PACE is directed by Haywood Hall, doctor of emergency, Ashoka Fellow and a recognized social enterprising. Its inspiration was born after being present at an accident in a highway of Mexico. After observing the handling of the emergency he decided to found PACE with the main goal to train to the assistants to maximize the cares and the quality of the service.
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Innovation
Name Your Entry
Shift of paradigm in the assistance of the Obstetrical Emergencies
Explain what the "innovation" is about, e.g., is it the idea and/or the model you use to accomplish the idea, or your understanding of the target population, etc.?
Because 10-15% of the childbirths have random complications and for each neonatal / maternal death, there was an emergency that was not recognized and/or well handled, PACE promotes a program of training in Obstetrical Emergency. The innovation is the approach of the Program. It consists not only in training health providers, but it also optimizes the results in the assistance of the obstetrical emergency and the neonatal care through institutional alignment (Chain of Survival), based on the critics needs of the mother and her or his child, and on the effectiveness of health providers. PACE provides a TRAINING program of staffs that maintains this model of Paradigm Shift. The project is for women of rural areas and natives of different regions from Mesoamérica and has a goal of an innovating system of integrated interventions that assures that each woman who looks for medical care makes contact with First Obstetric Respondent (PROC). If an emergency is identified, she enters the Critic Route of the Chain of Survival, obtaining that all levels of assistance are related for the women and newly born child’s care.
Describe how your innovation model is distinct from any other organization in your field?
The training moves from programs oriented to providers as individuals towards a training centered in the patients and teams in all the levels of medical education, supported by the respective sanitary jurisdiction to improve the alignment of the assistance. The training is trans-institutional and emphasizes on the use of protocols based on scientific evidence, the use of memory aid, simulations and the certification of competitions. This strategy has demonstrated to be successful in rural contexts of countries like Mexico.
What type of operating environment and internal organizational factors make your innovation successful?
The operating system is training by saturation to all providers of the different assistance levels and within a sanitary jurisdiction. Thus, all share the same language, processes and networks of work, generating strong bonds between all the levels of assistance and integrating the different institutions. This modality occurs through the modular training with the courses of Advanced Life Support in Obstetrics (ALSO), Basic Life Support in Obstetrics (BLSO) and First Obstetrical Respondent for Communities (PROC), a program derived from the programs ALSO and BLSO, that enables the community workers (promoters, auxiliaries, and midwives) so that they offer assistance in the first edge of contact. The courses are supported by highly trained instructors.
How do you make sure you constantly innovate in light of (potential) external challenges, or your growth plan?
Making evaluations and re-evaluations of the Program, finding difficulties and solving them. In that way we avoid the stagnation of the program and assure the innovation and the growth of it. In addition, to assure the growth we generate alliances with governmental organizations, NGOs, Academies and Universities, among others, which aid to expand the project, to give greater diffusion and an important institutional endorsement, allowing a recognition of the authorities of the country. This has put PACE Program always to the vanguard regarding Medical Emergency training.
This Entry is about (Issues)
Business Model
The systemic challenge you are trying to overcome (select one)
Realign the incentives in the public healthcare system in mature markets, or
Health area (target market) where the need is [select only one]
Maternal care
Categories along the health continuum you are covering [select all that apply]
Prevention, Intervention, Social integration.
Please describe in more detail: what problem are you trying to solve in the organization's specific context?
The maternal and neonatal deaths are a global problem. A proper management of obstetric emergencies can make a big difference to the rates of maternal and neonatal mortality. That's why our project’s goal is to optimize care for obstetric emergencies for contributing to the reduction of such rates.
Stage that best applies to your solution [select only one]
Established (past the previous stages and has demonstrated success)
Core strategies of your business model [select all that apply]
Approaches to behavioral change at the individual level, Patient-centered design, Redesign of the public healthcare system for more efficiency (in terms of processes, structure etc.).
If other, specify here:
Most relevant tools you are using to implement the strategies outlined above [select only two]
New skills, Education/training.
If other, specify here:
Please describe your solution in more detail
The PACE Program / ALSO is based on the critical needs of the mother / son / daughter in the institutional alignment and effectiveness of the providers within the community context. The goal is to optimize the results in the care of obstetric emergencies and neonatal care. It is a training program based on teams that supports this model Paradigm Shift in addressing maternal and newborn health. The training and certification programs move from the providers as individuals towards a centered training / patients and teams at all levels of medical training (PROC, and ALSO BLSO) supported by the respective health jurisdiction to improving the alignment of assistance.
What are your vision and overall objectives?
The PACE program, based on the spirit of multinational humanitarianism and professionalism in Emergency Medicine, has a vision of collaborative mechanisms to develop and improving each and every one of the links related to Emergency Medical Care in Mexico and Latin America through programs that disseminate culture and knowledge to health professionals involved in such care.
The particular goal for this challenge is reaching a saturation training for all providers who care for obstetric emergencies, managing to move from training providers oriented programs as individuals towards a patient-centered training to teams of all levels of assistance.
What is your value proposition?
The MULTILEVEL PACE / ALSO project is aimed at rural women and indigenous people from different regions of Mesoamerica and its goal is to scale an innovative integrated interventions to ensure that every woman who seeks medical assistance, contact the First Obstetrics Responder (PROC). And if an emergency is identified, she enters the critical path of the Chain of Survival. With this, we ensure that all levels of care are in close relationship to provide the MAXIMUM in quality of care.
Who is your customer(s)?
Ultimately, the beneficiaries of this Program and its Model of Care obstetric emergencies are women and their sons / daughters.
In addition, the whole community is benefited since the program allows its empowerment and also values the place that women occupy in society.
Finally, it also benefits the health workers at all levels of care, because through training they are better prepared to assist obstetric emergencies.
What approaches to you use to reach your customers?
The training approach is the saturation of all the providers and levels of care within a given health jurisdiction. Thus all share the same language, processes and networks, creating strong links between all levels of care and integrating the different institutions throughout the Chain of Survival.
This method is through modular training based on the experience of the Advanced Life Support in Obstetrics courses (ALSO), Basic Life Support in Obstetrics (BLSO) and First Obstetrics Responder for Communities (PROC).
What are your primary activities?
ALSO is a course of two days (BLSO is just one day), based on scientific evidence where the use of mnemonics and simulations aims to develop psycho-motor skills. There is an evaluation / simulation and formal certification process. There are strict quality controls and the providers and instructors ALSO generate an "Identity". The First Obstetric Responder for Communities (PROC) is a derived of ALSO and BLSO programs and aims to train community workers as (promoters, auxiliaries and midwives) to provide care in the first line of contact and to activate the whole EmOC system.
Who are your peers and competitors? What problems could these players pose to your success or growth?
There are other organizations and/or institutions that provide the same service of training for obstetric emergency care. What make PACE different is that proposes a model-based training system, ie, training ALL the SYSTEM care, thus strengthening the link between the different levels and, finally, optimizing the care of women and newborns, increasing their survival when they have to deal with an obstetric emergency.
What other challenges - individual, organizational, or environmental – are you currently facing or might hinder future success of your business, and how do you plan to overcome those?
There would be economic, political or cultural challenges. PACE Center has learned to overcome different situations thanks to the presence of volunteers and the efforts of doctors (of Mexico and North America). In addition, we have taken advantage of the help of internal programs to support the finances. We have been recently incorporated as Global and International Health PACE in the United States to apply for national and international grants. Last but not least, we trained staff of the Ministry of Health under contract so that we can follow a replication model of our programs.
Briefly describe your growth strategy going forward
The project is at an advanced expansion stage. However, the establishment of a PACE Center in the country’s south region, would allow our Programs to achieve wider dissemination not only in Mexico but throughout Mesoamerica, thus establishing our innovation paradigm shift in the care of obstetric emergencies.
What dimensions for growth are you currently targeting for your innovation [select all that apply]
New customer group(s), New regions(s), New market(s)/country(ies).
What makes your business "ready" for growth?
The PACE / ALSO Program has shown great impact and success in all Mexico. This is what makes us believe that we can expand to the entire Mesoamerican region, collaborating with achieving one of the main goals of the area, the reduction of maternal mortality.
What are your key growth objectives?
The expansion of the program to the Mesoamerican region, training more providers of obstetric emergency care, and finally, decreasing maternal and neonatal mortality.
What is your timeframe for growth, in the short and mid-term? What are the growth milestones and key activities going forward?
In the short term, the main goal is to establish a PACE center in southern Mexico, in the state of Chiapas. From there, the long-term goals would be the expansion of the program to rural and indigenous regions of Mesoamerica, establishing different points from which would expand the program in the region. As a general and final purpose we propose the establishment of a paradigm shift model in the assistance of obstetric emergencies.
Social Impact
What has been the impact of your solution to date?
The program has had an impact from the point of view of the number of the trained providers. During these 7 years it has trained over 4000 providers throughout the Mexican territory. Besides the PACE / ALSO Program, Mexico has helped develop ALSO Program in different Latin American countries, including Chile, Argentina, Panama and Costa Rica.
The program has also been recognized by different entities as one of the obstetric emergencies training programs that has had more impact on reducing maternal mortality. Among them is the recognition of the Ministry of Health of the state of Chiapas and Mexico and the mention to the ALSO Program in the Comprehensive Strategy to Accelerate the Reduction of Maternal Mortality in Mexico drafted by the National Center for Gender Equity and the
Reproductive Health of the Ministry of Health of the Federal Government of Mexico.
What methods for quantification of social impact are you applying (if at all)?
The methodology to assess and monitor the impact is based and will be based on:
1) Interviews to ALSO, PROC and BLSO providers and instructors, and on experiences in managing obstetric emergencies.
2) Quantitative indicators such as obstetric morbidity (near miss), mortality, use of magnesium sulfate, use of blood products, rate of cesarean delivery, Apgar score at 5 minutes, APEO (post event contraception obstetrics), and admission ICU and NICU, use of vacuum or forceps.
3) Qualitative indicators to measure the efficiency of the process: activation of the chain of survival to resolve obstetric emergencies.
Could your solution work in other geographies or regions? If so, where?
Mexico has 110 million inhabitants, of which 17% live in rural areas. These 19 million people live mostly in southern states like Chiapas, Oaxaca and Guerrero and are indigenous and poor. The same happens in other regions of Mesoamerica, where a large percentage of the population is indigenous and poor. This is where we bring our solution because we are convinced that it will bring what it needs to reduce maternal and neonatal mortality in the region.
What is your projected impact over the next 1-3 years?
We plan not only doubling or tripling ALSO, BLSO and PROC providers in the region, but also the decreased of the rates of maternal and neonatal mortality in different countries of the region.
We believe that by setting the PACE Center in southern Mexico, in the state of Chiapas, and through linkages with various regional and national governments, the program can be expanded thorough all countries of Mesoamerica. We already have the support of various institutions both governmental and non governmental organizations to achieve the goal of generating a change in the assistance of obstetric emergencies.
Sustainability
Elaborate on your current financing strategy
The PACE Center is supported by internal programs and conducting courses for state and federal government and private and public entities as Academies and / or universities, so it can sustain replication and sustainability model that allows the expansion and dissemination not only of Maternal and Neonatal Health Programs but also of all Emergency Medical Training Programs.
Share of revenue generation in total income of organization (in percent)
Selling products or services: 100%
Direct sales to patients or other beneficiaries (in percent)
0%
Of the possible sources of these sales listed below, check all that apply to your current strategy
Individuals, Caregivers, Private businesses.
Licensing fees, e.g., for technology/franchise model (in percent)
0%
Of the possible sources of these licensing opportunities listed below, check all that apply to your current strategy
NGOs, Private businesses, Regional government, National government.
Service contract with organizations, e.g., government, NGOs (in percent)
100%
Of the possible sources of the service contracts listed below, check all that apply to your current strategy
NGOs, Private businesses, Regional government, National government.
Explain your revenue generation strategy in more detail
Internal programs and selling courses to the state and federal government and toprivate and public entities as Academies and / or universities.
Share of philanthropy in total income of organization (in percent)
Instructores: 60%, Vuelos y Hospedajes: 15%, Viáticos: 10%, Gastos Administrativos: 15%
Philanthrophy strategies you are using
Diversified strategy.
Explain your philanthropic approach in more detail
The PACE program, based on the spirit of multinational humanitarianism and professionalism in emergency medicine, aims to provide mechanisms for collaboration to develop and improving each and every one of the links related to Emergency Medical Care in Mexico and Latin America through programs that disseminate culture and knowledge to health professionals involved in assistance. While it is an organization that is supported through the sale of courses, it is also an organization that holds a philanthropic perspective as it promotes human values and quality improvement in emergency services to ensure that all people have access to a better service and, finally, a better quality of life.
Expand on your selections; explain how you will sustain funding over the next 1-3 years.
By establishing a PACE center in southern Mexico, in the state of Chiapas, and making the necessary links with governmental and non-governmental entities, will sustain the program. These links already available allow us to develop the courses but getting the financing to establish the PACE center in the region mentioned before, would strengthen the links and would replicate the efforts to achieve the main goal of reducing maternal and neonatal mortality .