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Navigating the System: The Rise of Health Coaching

Mwihaki Kimura Muraguri — Former Sr. Associate Director, Health, Africa Regional Office

The following post is part of a series based on research conducted around the health of the urban working poor

Health Clinic
Photo credit: Arne Hoel/ World Bank

Despite many recent gains in public health, large sub-sets of the population in lower and middle-income countries are unable to access traditional forms of healthcare. While patients try their best to keep up with healthcare systems, the systems themselves rarely take the time to understand each patient’s history, motivations, and context while delivering care. Limited health literacy and awareness, an ingrained lack of trust in the health system, and increasingly unhealthy lifestyles also add to patients’ inability to access appropriate health care, and puts them at an increased risk for chronic health conditions.

One promising solution to this challenge—an approach that many organizations are increasingly employing—is the creation of “health coaches”. Health coaches are trained professionals who can assess individual health needs, customize recommendations, and help patients navigate the health system.

“When it comes to managing patient health, trust matters.”

While they are known by different names in different contexts—such as “peer educators” or “community health workers”—the role of the health coach remains the same all over the world. They commit to helping people in low-income communities manage their specific conditions through strategies that work best for their individual needs and constraints.

Though many health coach programs are still in the early stages, there has already been some impressive results across geographies. A study in Malaysia, for example, found that health coaching helped individuals significantly lower their cholesterol levels. Meanwhile, in the United States, peer health educators helped patients better manage their diabetes than ever before. The success of these programs, and positive reviews from local patient populations, have generated much excitement among policy makers and healthcare professionals across the globe.

Based on our research, successful health coach programs exhibit three key characteristics.

  • They source locally: Health coaches have proven to be most effective when they come from a similar background, culture, or ethnicity as the patients they are working with. Their knowledge of the community allows coaches to assess and influence the patient’s behavior more effectively.
  • They train extensively: While it’s critical to recruit members from the community regardless of their medical background, coaches need to be provided with significant training in the specific health needs of the population (e.g., diabetes testing, healthy eating based on local agricultural/ grocer landscape, and dietary constraints). One successful health coach program puts its coaches through six weeks of intensive training, as well as multiple “refresher courses” throughout their time as coaches.
  • They commit fully: When it comes to managing patient health, trust matters. While locally sourcing coaches instills initial trust, health coaches have found that establishing long-term relationships with patients is the best way to provide them with consistent care that truly improves their well-being and health literacy.

Health coaches are making a critical difference in the lives of many low-income individuals and communities who suffer from chronic and preventable illnesses by being a consistent part of their lives, and guiding them through the complex web of health care systems. In addition, data and insights that health coaches gain from their interactions with patients has the potential to revolutionize the way we think about and deliver health care.

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