"Accompaniment" Can Reform Health Care Around the World

"We don't need to start fresh to create patient-centered medical homes. We just need to look to community-based models of care that are effective but often go unrecognized," according to a Boston Globe opinion piece by Heidi Behforouz, the director of the Prevention and Access to Care and Treatment project, which is based on "a model that Partners in Health pioneered to fight HIV in rural Haiti and drug-resistant tuberculosis in Peru." According to Behforouz, community-based models of care might be overlooked "because much of the care is being delivered by 'paraprofessionals' who have not been extensively schooled in the biomedical model and don't practice office-based care." She notes that community health workers' "schooling and expertise is in the art and science of what we call 'accompaniment.'"

"What do we mean by accompaniment? We mean that you walk with the patient -- not behind or in front of her -- lending solidarity, a shoulder, a sounding board, a word of counsel or caution. Empowering not enabling." According to Behforouz, "Accompaniment is a beautiful thing. As practiced in the central plateau of Haiti, the shantytowns of Peru, or Boston, it may just be what is needed to reform health care, here and abroad" (12/21).

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