The care model
The model is a chain, and it is only as strong as the weakest link. Break selection and you train people who will leave. Break logistics and you deploy people who will burn out. Break supervision and you lose them in year three.
Step 01
Candidates are drawn from the local government areas the cohort will serve, with weighting for applicants from communities that currently have no resident clinician at all. Someone with family, land and worship in a place is not deciding every year whether to stay there.
Step 02
Rotations run through partner teaching hospitals with visiting faculty and structured remote instruction. The disease burden trainees learn on is the burden they will treat: malaria, sickle cell, hypertension, obstetric emergency, tuberculosis, an accelerating diabetes and stroke caseload.
Step 03
Every clinical cohort trains alongside the chaplaincy cohort. Clinicians learn to recognise spiritual distress and refer it; chaplains learn where the clinical line is and do not cross it. Both learn to work with the pastors, imams and traditional leaders who are already the first call in most communities.
Step 04
A clinician arrives to a site already running AMDana on IPMS, with a stock line, a referral pathway, a named supervising physician and a salary that is actually paid on schedule. Most retention failures are not vocation failures. They are logistics failures.
Step 05
Deployment is to the home community or its catchment, on a service commitment matched to the training investment, with the practice, housing and progression to make staying the rational choice rather than the sacrificial one.
Step 06
Monthly case review, remote specialist backup, funded continuing education, and a route to teaching in the next cohort. Year three is when isolated clinicians leave; year three is where this model spends its attention.
Where it runs
Select a hub to see what it carries. The layout is a network diagram, not a map — the geography that matters here is who is connected to whom.
Founding hub · Phase 1
Teaching hospital, chaplaincy formation, and the first three clinician cohorts.
The southeast is where the name comes from and where the first cohort trains. Enugu anchors the residency partnership, the simulation lab, and the chaplaincy formation that every cohort passes through.
Policy and accreditation · Phase 1
Regulatory alignment, accreditation, national partnerships.
Curricula are worthless if they do not articulate with MDCN registration and the Federal Ministry of Health. Abuja is where accreditation, licensure pathways and government partnership are held.
Platform and diaspora · Phase 1
AMDana engineering, diaspora faculty, private-sector partnership.
Engineering and data operations for AMDana, plus the diaspora faculty rotations that let Nigerian-trained physicians abroad teach without anyone having to relocate permanently.
Northern expansion · Phase 2
Maternal health, Hausa-language care, imam and chaplain partnership.
Northern deployment is designed with Muslim faith leaders from the first planning meeting, not consulted afterwards. Maternal and child health carry the clinical priority.
Delta corridor · Phase 2
Occupational and environmental health, riverine outreach.
Riverine communities are reached by mobile teams whose records sync when they come back into coverage. Occupational exposure and respiratory disease lead the caseload.
Regional partnership · Phase 3
Ghana pathway — shared curriculum, reciprocal faculty.
The second country. Shared curriculum and reciprocal faculty rather than a franchise: the Ghanaian partner institution owns its own accreditation and cohorts.
Regional partnership · Phase 3
Sierra Leone pathway — post-outbreak systems strengthening.
Health systems that have survived an outbreak know things the rest of the region needs. The Sierra Leone pathway is as much about what CHHI learns as what it brings.
Sequencing
Phase 1 proves the model works where CHHI is from. Phase 2 proves it travels across language, faith and a different disease burden — which is the only thing that makes Phase 3 honest.
Founding hubs, first cohorts, AMDana in production, chaplaincy formation running.
Northern and Delta deployment; the model proves it travels across language, faith and disease burden.
Partner institutions run their own cohorts on shared curriculum and shared infrastructure.
Services
Resident clinicians in communities that have had none: diagnosis, chronic disease management, antenatal and child health, and the outreach days that reach people who cannot travel to a facility.
Skilled attendance, obstetric emergency readiness and referral that works at 2am. The single highest-yield place to put a trained clinician in the region, and the clearest test of whether a health system functions.
Built with global surgery partners: safe surgical capability at district level, structured referral for what district level cannot safely do, and the anaesthesia and perioperative staffing that make both real.
A trained, credentialed chaplaincy service inside the clinical team — for patients, families and the clinicians themselves. Present for every faith and for people of none.
Physicians, nurses, midwives, community health workers and chaplains trained in cohorts that deploy together and stay in contact for the length of their careers.
AMDana and IPMS: the records, scheduling, supply, follow-up and reporting layer that lets a small team run a real service without drowning in paper.
The projection page turns the model into arithmetic you can argue with — and change.
