PhD defence L. (Lisanne) Szewczyk – van Rijn

Below is a brief summary of the dissertation: 

The United Nations' Sustainable Development Goal 3 aims for good health and well-being for everyone, but accessing healthcare remains a challenge in rural areas of low- and middle-income countries. To bridge this gap, non-traditional healthcare delivery models are often used. This thesis explores two such models: mobile outreach teams and community health entrepreneurs.

-    Mobile outreach teams are healthcare workers who travel to rural areas to provide services. In Chapter 2, we focus on the assignment of outreach teams to outreach sites. We find that small groups of teams can make these decisions effectively, performing almost as well as a central planner—and sometimes even better, particularly when central planners lack accurate information.
-    In Chapter 3, we investigate what influences the demand for contraceptive implant removals by these teams. Factors like poverty and the availability of other providers play a role, as do decisions such as how often the teams visit specific sites. This research helps make services more equitable and accessible.
-    Community health entrepreneurs (CHEs) sell health products in their villages but often struggle with limited cash to buy stock. In Chapter 4, we test two ideas to help: creating local "stock-hubs" for easier resupply and a training game to improve financial management. Both solutions worked, but only under specific conditions, such as good coordination between CHEs and low access costs for the stock-hubs.

This thesis shows how innovative approaches can make healthcare more accessible in rural areas.