The HPN Project is shaped by the preferential option for the poor.  Certainly the device is designed specifically for patients without access to readily available and effective medical treatments.  As importantly, the project itself seeks to be shaped by collaboration with those who live and work among the world’s poorest communities—patients, community members, health workers, NGOs, and local Ministries of Health.

To be effectively deployed, the HPN will need to be integrated into diverse settings, settings offering different levels of healthcare infrastructure and presenting different cultural questions.  Who best ought to oversee the device—patients’ family members, community health workers, or clinic-based nurses?  In countries with strong health delivery infrastructures, the HPN Project hopes to work within those structures.  Where delivery systems are less developed, the HPN Project envisages community health workers as a key component of implementation.

How might cultural variations require modifications to device design or implementation strategies?  The HPN Project recognizes that attending to cultural differences by listening to stakeholders is crucial to the success of any international project.  As a result, listening to stakeholders has been a key component in our work in El Salvador.  Beginning in summer 2010, the HPN Team began studying patient and provider perceptions of the device by conducting structured group interviews and one-on-one conversations physicians, nurses, public health officials, health promoters, and community members to collect feedback on cultural acceptability, appropriateness of design, and suggestions for optimal deployment.  We consider this an essential component of our ongoing work.  These conversations led us to develop the hand-cranked (molino) version of the HPN — an outcome that wouldn’t have happened without the input of Salvadoran women.