REACH

Rural Effective Affordable and Comprehensive Health Care

45,000+

Population Covered

95%+

Immunization Coverage

TFR < 2.1

Fertility Rate Impact

Overview

Rural Effective Affordable Comprehensive Health Care (REACH) is the flagship program of SHARE (Society for Health Allied Research & Education) 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, to bring healthcare services closer to communities with limited access to formal healthcare systems.

Aim

The program aimed to:

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.
Provide universal healthcare to the rural population.
Ensure effective healthcare.
Deliver affordable healthcare within the economic means of the population.
Offer comprehensive services including promotive, preventive, primary, and secondary care.

Objectives

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 reduce vaccine preventable diseases.
To address nutritional deficiencies such as night blindness (Vitamin A), anemia (Iron), and goiter (Iodine).

Background

REACH was initiated in 1997 by SHARE INDIA, a US-India cooperative non-governmental organization founded by U.S 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 to people's doorsteps.. It focused on , prenatal care for pregnant women, immunization of infants, and family-planning interventions, complementing the state and union government’s goals of improving public health metrics.

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

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

Maintenance of demographic profiles and health records through a computer-based system
Identification and tracking of pregnant, lactating women, and children under six years in every village
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
Coordination with government authorities to improve immunization rates via doorstep delivery of child vaccines in hard-to-reach areas.

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.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.

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

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.