MoPo Tsyo blog1
Peer Support: Developing a Niche and Demonstrating Value
The NGO MoPo Tsyo Patient Information Centre ‘s office is located in the capital Phnom Penh. It organizes capacity building of diabetes patients to become peer educators. Once these trained patients have passed the peer educator exam, they return to their communities and begin to run MoPoTsyo Patient Information Centres from their own home using basic equipment and materials supplied to them by the NGO based on their activity reports.
In 2005 the first MoPoTsyo project started in Phnom Penh’s slum areas as a “knowledge provider” and was not intended to become involved in medical service provision as there were already 2 charities running medical services for people with diabetes in the area. As a result, MoPoTsyo was able to concentrate on a core mission of finding and helping diabetes patients in the slums that wanted to learn diabetes self management. After a few years the charities ran out of money and ended their projects. Consequently, the prices of medical services quickly rose to unaffordable prices for MoPoTsyo members. This development put MoPoTsyo in the dilemma of deciding whether to continue working in advocacy for the lowering of prices from existing professional medical services providers or to expand the scopes of its own action and begin to organize services.
With a well organized group and agenda MoPoTsyo educators were able to take advantage of their resources and make an impact on multiple obstacles in the community that had previously seemed insurmountable. The peer educators were able to make many positive changes by negotiating at the local level and introducing change in a gentle low key fashion. In these negotiations MoPoTsyo utilized a system approach by establishing a proper regulatory framework and governance at multiple levels. By negotiating and drawing up contracts with its partners from the public and private sector, a set of transparent rules of engagement have been formulated that provisionally fill the policy gap. Besides clarifying relevant practical issues, this creates accountability among those who engage to abide by the rules. Local engagement and support are very strong as a result of the chosen approach. It seems inconceivable to achieve similar ownership if a top down service supply driven approach were suddenly adopted to benefit from perceived cost efficiencies. If given the chance, MoPoTsyo will continue to scale-up by supporting the existing Peer Educator Networks to replicate in response to demand from patients willing and able to take an active role.
Next month, I will share more about integration of Patient Educator Networks (peer support) into the primary care system in Cambodia and scaling up our program.