Barefoot nurse project: A micro-entrepreneurship health model for universal access to the screening of diseases, ensuring self-sustainability in India

Context: There is still a substantial service gap in India, especially in preventive screening and referral of noncommunicable diseases. There is a growing evidence supporting the role of community health workers (CHWs) in screening diseases and their effectiveness in averting noncommunicable diseases. Aim: The aim of this article is to describe a model of CHW-barefoot nurse (BFN) (concept, design, recruitment, training, services, products, and evaluation) and share some initial findings. Setting and Design: This study was implemented in seven locations (Doddaballapura, Nelamangala, Magadi, Bidar, Aland, Hadagali, and Aurad) of Karnataka. Materials and Methods: The model of BFN, design, intervention development, and implementation is carefully documented and elaborated in this article. Statistical Analysis Used: The preliminary findings of the intervention were analyzed using descriptive statistics. Results: The concept of BFN model is a preventive health delivery model where local women from the community get trained with skillsets required for screening several diseases and provide health promotion products at the doorstep of the community. BFNs are young (25–45), from community, completed basic education (10–12 years), digitally literate, and speak local language. Self-sustainability is embedded in the model as it ensures that the BFN earns livelihood from their services by charging a nominal fee with no investment, just using a kit donated by philanthropic organizations. The screened beneficiaries of BFN suggest relatively higher prevalence of hypertension (22.2%) than diabetes (14%). The female beneficiaries and those in the younger age group are relatively more hypertensive. Conclusion: There is high acceptability of the BFNs reflected from the screened number reflecting the willingness of the community to pay a nominal fee for the BFN services. This study has generated evidence supporting self-sustainable model of funding CHW which is crucial in improving access and strengthening the health system in India.