woman feeds grass to cow
Daphroza Nyiranzoga feeds a cow that was provided to her by Partners In Health as part of the food security program in Burera, Rwanda.
Photo by Cecille Joan Avila / PIH

Social Support

Social Support

If a tuberculosis patient in Peru can’t take strong medication on an empty stomach or afford public transportation to a health facility, that patient likely will miss appointments and fail to reach a cure. 

That’s why at Partners In Health we talk about the five “S’s” that are essential to quality health care—staff, stuff, space, systems, and social support. The fifth is just as important as the first four. We help build strong public health systems that not only provide patients with quality medical care, but also ensure their ability to maintain good health and  thrive in their communities. We treat the whole patient, not just his or her illness. 

Social support  comes in many forms and varies by country, but primarily involves the provision of food, housing, transportation, education, and job security to patients, families, and communities.  

Treating the Whole Patient 

A high-quality health care system isn’t always enough to ensure patients and their families remain healthy, especially in the world’s poorest countries. Patients battling tuberculosis, HIV/AIDs, malaria, non-communicable diseases, malnutrition, and mental health disorders often lack access to amenities that many take for granted. 

Social support is designed to address those inequities.  

In Malawi, for example, PIH staff enroll qualifying patients and their families in the Program on Social and Economic Rights, or POSER.  POSER teams help patients with the cost of transportation to and from clinic appointments, food, housing, educational fees and supplies, and financial support, such as start-up loans for small businesses. They reach 90 percent of 132,000 households in Neno District, contributing to stronger communities and HIV outcomes that have been better than elsewhere in the country. 

PIH teams around the world provide social support in a variety of ways. In Haiti, oncology patients receive transportation vouchers to ensure they can return for regular appointments. In Peru, TB patients receive food packages, transportation fees, and small business loans to help them get back on their feet. 

In Liberia and Sierra Leone, the mental health teams provide food, water, and hygiene products to patients without homes to meet their basic needs before providing them with medical care or counseling. 

Peer Support Groups  

Inshuti Mu Buzima (IMB), as PIH is known in Rwanda, provides a variety of  social support programs, some of which include peer support groups. At IMB-supported Kivuye Health Center in Burera District, members of a self-help group meet regularly with shared goals of overcoming mental illness, improving their emotional well-being, and boosting their finances and resources. Each member contributes to collective savings every month and uses the pooled money to buy livestock, land for farming, other agricultural needs, or to issue small loans to members. Together, they improve their economic well-being as they safeguard their health. 

In southern Rwanda’s Rwinkwavu District, IMB staff started a community rice farming program in which parents of children with malnutrition grow rice on a communal plot, acquired through a local grant, and use their harvests to feed their families or sell excess produce to buy other essential goods with the revenue.   

Support During Quarantine 

Patients who test positive for the novel coronavirus often are asked to quarantine for up to 14 days, but that can be a nearly impossible task for people who are “essential workers,” are part of the informal economy, live in close quarters with extended families, or do not have electricity or running water. 

Providing patients with social support has been key to successful quarantine efforts during COVID-19. Care resource coordinators working for the Massachusetts Community Tracing Collaborative, in which PIH has partnered with several government entities, connect COVID-19 patients and their contacts to local resources, such as food banks and housing assistance, to ensure their basic needs are met while they recover from the virus.  

Since Peru’s national government declared a state of emergency in March 2020, PIH has provided social support in the form of food, cleaning supplies, and personal protective equipment to more than 2,000 households forced into quarantine in and around the capital of Lima. 

In Navajo Nation, one of the hardest-hit regions in the U.S. during early months of the pandemic, PIH’s partner organization, Community Outreach and Patient Empowerment (COPE), supported the setup and use of local hotels as safe housing for patients and contacts in quarantine, brought vital supplies to community centers, helped ensure Navajo residents had access to water and healthy food during extended lockdowns, and much more—proving that high quality health care extends far beyond clinical needs.