Care Companion Initiative (CCI)

In 2014, while completing medical school, I co-founded Noora Health, and since then have been committed to driving home a big idea- that “it takes a family” to improve how healthcare is delivered.

I spent a decade of my life acquiring skills in engineering, public health, and medicine. I hold a bachelor’s degree in Biomedical Engineering from Johns Hopkins University, a master’s degree from the Johns Hopkins Bloomberg School of Public Health, and a medical degree from Stanford University. Throughout my academic career, my experiences focused on the health of incarcerated populations in the US and developing low-cost technologies for improved diagnostics in resource poor settings. Rather than pursuing medical practice in the US, I have dedicated myself to leading Noora’s mission, working on the ground alongside our talented and growing team. I currently reside in Bangalore, India with my partner and our two energetic dogs.

In many lower-resource settings, healthcare is broken - with severe lack of providers and preventable diseases causing huge systemic burdens. Noora’s Care Companion Program (CCP) re-imagines the role of the family, training them with high-impact medical skills, making them an integral part of healthcare delivery. Families can play a powerful role in patient care, the full potential of which remains untapped. Since 2014, we have made strides towards our vision of placing families at the centre of healthcare, but we are not satisfied. We know that our impact can go much further and stands to benefit humanity. Empowering family members to care for their loved ones is not a health need unique to any one place; it is a universal challenge. The spread of COVID-19 highlights that supporting families to care for their patients is more important than ever before, and Noora is uniquely placed to drive this idea forward.

India and Bangladesh have critical shortages in healthcare workers, with only 0.4 and 1.7 nurses available per 1,000 people in Bangladesh and India respectively, and a shortage of 2.5 million healthcare workers in India alone (WHO, 2016). Subsequently, the average time a doctor interacts with a patient in a public health facility in India is under 2.5 minutes (Irving et al., 2017). This leaves little time for patients and families to learn about life-saving care, and leads to preventable morbidity and suffering. Worldwide, for example, 70% of deaths under the age of 5 can be prevented through simple health behaviours (UN, 2019).

The larger, more systemic, but less quantifiable problem is the disconnect between the health system and home, and even the disconnect between community health centres and higher levels of care. The professionalization of Community Health Workers begins to address this problem, but families will always play a powerful role in helping patients stay healthy. The impact of family caregivers on alleviating health system burden and improving patient health outcomes remains largely untapped, particularly in places with constrained health systems.

The Care Companion Program (CCP) aims to empower families with the skills they need to best care for their patients. In partnership with health systems, we identify gaps in critical health outcomes and health behavior practice. Our team of designers, technologists, and doctors develop curricula, training, and tools to better equip frontline staff to empower patients and family members.

The CCP is designed to address critical needs of each stakeholder in a patient’s healthcare journey. This begins by engaging with frontline staff to create experiences and supportive communities in which they can effectively implement family caregiver training sessions. Family health behavior journeys are facilitated further through post-discharge mobile phone based engagement services, where concepts and skills from training sessions are reinforced, and families have a chance to ask questions when they are back at home and faced with unforeseen challenges. All CCP materials and services are optimized for medical accuracy, effective messaging. They are highly visual, culturally relevant, and developed into the regional languages of the populations that we serve. Our vision is to have CCP as a health systems-wide initiative, with programs available for all major health conditions, levels of care and populations.

The Care Companion Program (CCP) serves lower-income, marginalized patients and families who are vulnerable to preventable morbidity during their health treatment and recovery at home. They typically fall below the poverty line, and have disparate access to basic services. These patients and families span a diverse range of cultural backgrounds. They often have very nominal savings and no health insurance. 

Noora’s approach is rooted in human-centred design, a methodology that involves a deep consideration and empathy with users at every  stage of development. Through needs-finding activities, our team develops a deep understanding of how various stakeholders (patients, families, healthcare staff, etc.) make decisions concerning health and wellbeing. We engage directly with these stakeholders in their homes and during their treatment to build prototypes, generate feedback, and iterate on our ideas.  

The CCP is a highly adaptive model that can be tailored to the needs of patients and families based on their language, health condition area, and cultural norms – allowing the model to be implemented across diverse contexts.

We address the global urgency of the power imbalance between health systems and the populations they serve, and the ensuring preventable morbidity. In response, we propose to elevate families as a critical resource in a patient’s healthcare, and we strive to demonstrate the impact of family training. By developing an initiative through partnerships within health systems, we hope to mobilize stakeholders across healthcare to include better family caregiver training as a standard of care. While we will continue directly implementing throughout the health systems we partner with, we are also working to catalyze a movement beyond our direct reach.

While studying medicine at Stanford, I enrolled in a course at the Design School in which we applied design thinking to uncover needs and solutions for low-resource settings. From my experience in public health and biomedical device development, I believed that this lens was catalytic to create sustainable and impactful solutions. 

 The course assigned me into a project group, and we traveled to India to explore key challenges in health systems. It was there, along with who would later be my co-founders, that we identified compassionate yet untapped family caregivers beside at-risk patients, as well as a desperate need for higher quality care. Our “big idea” was simple and sought to empower this available and willing resource. In 2012, we formed a close alliance with providers and hospitals in India to test the initiative.

What started as a class project soon turned into an obsession - we worked on refining the program, conducting research, and spreading the idea. Our supporters soon grew from families at the bedside to nurses leading wards, administrators in hospitals, and medical directors in state capitals. 

I am driven to improve the well-being of marginalized populations. Although I grew up in the US, I spent much of my childhood in Bangladesh. In hindsight, it was likely the images of poverty and inequality witnessed there that impacted my memories and led me to make the professional choices I did. Prior to the founding of Noora, my professional experiences centered around improving healthcare of incarcerated populations and developing microfluidic technologies to address micronutrient deficiencies. Both furthered my passion to serve, but it wasn’t until I met my fellow co-founders and uncovered the importance of our shared mission that I recognized my true passion.

My belief in our work is both personal and systemic. In every caregiver we train, I see the struggles and triumphs of my mother, who cared for my ailing grandmother through a degenerative neurological condition. On a broad level, I know this idea can systematically transform global health.

The pursuit of this big idea pushed me to leave my career in academic medicine in the US for which I had prepared my entire life, and live thousands of miles away to immerse myself in the epicenter of our work in India.

We have developed trusting and meaningful relationships with health systems stakeholders, including the Government of India and Bangladesh, 3800 frontline health providers, and the communities we serve. Through these engagements, we have unique access to connect with patients, families, and stakeholders across various healthcare levels in order to deeply understand key drivers of health behavior practice. Furthermore, we have been able to demonstrate promising impact. Our research partners include global leaders in health systems research, including Ariadne Labs at Harvard University, and UNICEF – all of whom are dedicated to demonstrate the efficacy of family caregiver training on health outcomes. 

We have a talented and diverse team of 156 – including nurses, doctors, designers, coder, researchers - hailing from all corners of the globe and throughout the subcontinent. The cultural and technical diversity on our team has allowed us to be uniquely impactful. As a result, we have gone from establishing a strong proof of concept and grown that across many dimensions - geographic expansion, product improvement, and evidence generation.

I have spent my academic and professional career honing a skill set at the intersection of design, public health, healthcare, and research. These experiences and my personal conviction for the work will help drive our impact. Along with my fellow co-founder, we are guided by a Board of Directors composed of leaders from organizations that understand the core pillars of our work such as IDEO (design) and JPAL (research).

We are almost completely dependent on the public health system for our operations and impact. During the early stages of the COVID-19 pandemic, these institutions were completely shut down or refocused to handle the pandemic. In parallel, many government and frontline organizations were reaching out desperately for quality COVID-19 content, training and tools for communities at large.

It was my responsibility to ensure our team’s safety and drive our mission to meet the global urgency. In two weeks, we pivoted our work to remain relevant and useful to our partners. Roles and responsibilities shifted based on abilities and skill sets, and in the process, many were working long hours outside their job descriptions. I struggled to implement an action plan and  effectively communicate to the team our priority shift.

 What helped me navigate this situation most was to stay true to our values and model and to lean on the strong relationships I have with my teammates. I began linking our actions to the core tenets of our organization to draw clarifying parallels, and as a result, we created comprehensive services that have been used by central governments in India and Bangladesh, reaching many citizens in both countries

In 2017, I left Noora Health in the care of my co-founders, with whom I helped build the organization over the previous three years and returned to medical school in order to fulfil my dream of practicing medicine. Soon after, I completed my studies and applied to residency programs, to which I received interviews at all my top choices.

 Somewhere in the process though, I realized that furthering the Noora mission was the passion I held all along. I returned to India in 2018, leaving behind a respected and secure life which I had worked so hard from the first day I entered college. 

 I returned to Noora with a renewed purpose. On my first day back, I told the team of my conviction – that I left a life as a physician in the US and decided to dedicate my life to our mission. I wanted my team to know that what we are working on is no longer a project but a movement that is worth investing time and energy. And it was my hope that through my honesty and vulnerability, that others were inspired to commit part of their life journeys as well.

Our work is innovative because it is focused on improving upon the status quo from within. This marks a shift away from traditional health care models, which often look to “experts” to overcome major challenges. We are reimagining healthcare and redefining the patient care team to include a patient's own family members. Our proposal to integrate family caregiver training as part of a comprehensive healthcare agenda involves making appeals to untap previously ignored potential, and effectively utilize precious bandwidth and resources. 

The Care Companion Program (CCP) is also innovative because it is comprehensive. Every element of the model - from partnership development, to training, product dev, and research is thought through the lens of empathy. Two of our most important stakeholders are the frontline providers, and of course family members. First, it is focused on creating a delightful experience for the frontline provider, typically nurses. Many initiatives and programs are “implemented” through these providers, but few engage them as users and partners in the approach like CCP. We build and nurture relationships with our frontline providers, and support them in their day to day tasks, personal and professional growth. For our family members, we focus on meeting them just in the right moment with the support they need to care for their patients. It is the timeliness and the design of the approach that allows them to adopt these practices effectively with confidence and love.

Noora’s theory of change is that skill-based training to family caregivers on critical topics delivered through customized in-facility sessions and reinforced through follow-up platforms increases knowledge and provides behavioral nudges. In turn, health behaviors improve, driving positive outcomes.

Each time the CCP is adapted to a new setting or health condition area, several key inputs are involved. Our team conducts needs-finding research based on HCD methodology and accordingly, develops training and tools that respond to the needs of patients and families. Noora then trains frontline providers on the medical knowledge and soft skills they need to educate families using these materials. Noora also works with every level of the health system to ensure that then CCP sessions are integrated within the care delivery framework. After a family member is empowered in the facility by a trained provider, they are enrolled in receiving follow-up support through their mobile phones (WhatsApp), reinforcing key behaviors. These platforms also allow the families to ask questions and engage in a dialog with our team of trainers. 

As a short-term outcome, family caregivers are able to provide preventative care; support and encourage healthy behaviors; and recognize and manage problems as they arise. In the long term, this translates to reductions in post-discharge complication rates (the most severe of which result in inpatient readmissions), as well as the timely management of post-discharge complications.  

Overall, the impact of engaging family members as skilled caregivers translates into profound, meaningful change. Health outcomes improve and frontline health staff have reduced loads due to the prevention of adverse health outcomes.

The outcomes of the CCP are documented in a study of cardiac surgical patients that was published in the Journal of Global Health Reports, where the results demonstrated a 71% reduction in post surgical complications and 23% reduction in hospital readmissions. In a similar study of newborns and new mothers across 11 hospitals, the results demonstrated that the CCP is associated with improved key health outcomes (53% reduction in hospital readmissions) and self-reported behaviors (18% decrease in postnatal complications and a 90% increase in performance of kangaroo mother care).

As of Q1 2020, 771,307 patients and families have been trained through Noora Health’s CCP across various health condition areas, including Maternal and Newborn Health, Oncology, Cardiac Surgery, and General Medical and Surgical Care.  132,741 people were trained in Q1 2020 alone, reflective of our ambition to reach more geographies and patient populations.  In the wake of  the COVID-19 pandemic, we expanded our offerings and services and amplified our reach by leveraging digital platforms as well as establishing many new local and national partnerships. Our mission to equip families with the skills they need to care for their loved ones during this time remains as clear and as relevant as ever.  We have already reached over 11,000,000 people with our COVID-19 efforts. 

COVID-19 does not stop people from having babies, heart attacks, or other serious medical needs, and so our goal remains to provide CCP training to more than 1,000,000 family members across 159 hospital partners by the end of 2020  – focusing first on populations that are marginalized and at highest risk. By the end of 2022, we aim to have cumulatively trained 3,000,000 patients and families across all programs and geographies. By 2025, we aim to reach over 10,000,000 patients and their family members directly through our health systems based training programs and 50,000,000 (conservative estimate based on current traction) through our content dissemination and mobile service offerings that we launched during this COVID-19 pandemic. 

Our vision is of a world where patients and their families are a core component of healthcare delivery and where better family member training is the standard of care. Over the next year, we will continue to grow our COVID-19 related efforts in partnership with the government to reduce the spread, keeping COVID-19 patients safe at home, and adapting our response as treatments and vaccines become available. Although the pandemic poses new challenges, it also presents a defining moment for innovation that could catapult us towards increasing our capacity and reach. Accordingly, we plan to continue expanding our work across more patient condition areas over the next 5 years. 

Geographically over the next year, we plan to expand across all government facilities in 2 more states in India. Additionally, we plan to scale our program in Bangladesh. By 2025, we intend to continue expanding in the countries we operate and globally -  to a total of 14 states in India, across all divisions in Bangladesh and in 1-2 more countries globally. We will also be better equipped to approach national-level governments for health system-wide implementation and advise health systems to adapt the approach without our direct support. We aim to continue generating strong evidence on the impact of the program on behavior change and health outcomes and advancing the big idea of family caregiver training through policy and advocacy.

In the next year, we will need to continue adapting our response efforts to the impact from the COVID-19 pandemic. While COVID-19 only increases the need for our work, the valuable “in-person” aspects of our CCP are affected - specifically the valuable human interactions of the doctor, nurse and patient when delivering health information. We must take steps to adapt to find innovative ways of reaching patients and families. This is especially important given how crucial behavior change communication and support for patients and families will be in curbing and managing the spread of the virus as the world awaits a vaccine. The COVID-19 pandemic has also brought about a global financial crisis, and we anticipate that our revenue sources will experience strain in the months and years to come. At such a critical moment for public health, Noora recognizes the importance of re-examining its revenue model to suit the changing global economic landscape.

 In the next 5 years, we are positioning for widespread scaling and we anticipate implementation challenges of replicating our model within new contexts and geographies. Administrative changes and existing high workloads (which have increased alongside the pandemic) in health facilities and the government system can pose challenges to implementation. We have found this to especially be the case in hard-to-reach areas, where patients are especially vulnerable. Cultivating strong relationships with government partners and institutional leadership will be critical, as we anticipate global healthcare systems to be strained as the pandemic intensifies.

In response to the physical limitations and logistics challenges that our programs and its expansion have faced during COVID-19, we have added new partners and products. While our programs have traditionally operated through public health systems, we are now partnered with 30+ NGOs and other government institutions to leverage their trusted networks to reach populations with crucial health information. We have also invested further in simple digital tools, such as WhatsApp and IVR. 

While there are many competing priorities, we have also placed family caregiver training into our government partner’s COVID-19 strategy, by creating programs to train caregivers of patients under home quarantine. This is an opportunity to further advance the big idea, and we are grappling with the strategy of how to best do this.

In examining our revenue model, our team has been exploring whether there is appetite for monetizing some of our offerings. We want to stay true to our mission, however understand that for our longer term sustainability we may need to add customers.  We recognize the importance of gaining increasing exposure to build these new partnerships. I feel strongly that the Elevate Prize offers an important opportunity for mentorship in these areas.

Noora has and will continue to invest in building strong relationships with our governments partners,. Within Noora, I recognize that mentorship and coaching for myself as a leader will be crucial for cultivating relationships at this especially challenging moment. Support from the Elevate Prize in this area would be invaluable. 

In both India and Bangladesh, Noora’s approach to partnerships has primarily been driven by developing close collaboration with state and central government agencies with the aim of implementing our programs and scaling our reach broadly. We also negotiate the program into their health budgets, thereby cost-sharing the implementation of the CCP. We partnered with UNICEF to develop and implement the CCP adapted for SNCU units in 2 Indian states and potentially other geographies as we scale. Rooting our work in evidence based practice is a key component of our ethos, reflected in our partnerships with leading global research organizations such as Harvard’s Ariadne Labs and the Stanford Center for Health Education (SCHE). They help bring together global experts to improve our curriculum, build capacity within our research team, and ensure that our programs are outcomes-focused.  We pursue key partnerships to apply learnings from our work and advise health systems in adapting our model for other contexts ( e.g. The Henry Ford Health System, The Medtronic Foundation). Our technology partners are Turn.io, Facebook and WhatsApp. 

For our COVID-19 work, we have both strengthened existing, and formed 30+ new partnerships with government and non-government organizations, large scale social enterprises, implementers, and nonprofit partners to get life-saving information into the hands of the vulnerable populations they work with. We are also collaborating with national COVID-19 platforms (e.g. COVIDAction Collab, Swasth and MyGov).Through these efforts, we have the opportunity to reach ~200 million people. 

Our clients are state governments and private facilities in low-resource settings who are responsible for the health of their vulnerable patients, who are ultimately our beneficiaries.

Accordingly, our current revenue model involves a hybrid of private and public sources. Our core costs are supported by private philanthropic giving, foundations, and corporate giving. The CCP is partially financed through public funds, which are mobilized through cost-sharing with our government partners. We have seen that the CCP is most successful when governments take ownership of the CCP in their healthcare system through cost-sharing for initial implementation, programming and monitoring activities.

 Specifically, when launching a new partnership, Noora partially covers the costs of R&D and up-front implementation activities, including HCD research and design, executing baseline research, and conducting partnership meetings and training. Concurrently, government partners cover the cost of running the CCP in perpetuity, with the necessary costs incorporated into state budgets. In total, our government partners absorb roughly 30% of the costs associated with launching CCP while Noora assumes the remaining 70% of the cost. Noora continues to absorb some costs associated with monitoring the program, however, over time, that cost decreases and eventually, Noora’s costs become negligible. To ensure the sustainability of the program, we sign cost-sharing agreements with our governments and outline an exit strategy and plan to ensure a strong transition plan.  

Our business model is best described as “free-for-service”. The costs of the CCP are charged to governments and private health facilities (third-party providers), who in turn, utilize our services to reach patients and families (clients) directly. Through this model, Noora Health provides services at no cost to patient families, and can focus on providing access to care for those who typically could not afford this service.

 A large component of our approach to financial sustainability involves cost-sharing with our government partners. We achieve this by signing cost-sharing agreements from the onset, which also incorporate a defined exit strategy. This financing approach is also integral to achieving sustainable results, as it allows the CCP to eventually continue operating without direct support from Noora, with only funds required to support the core team. The success of this approach is best exemplified by our partnership with the Government of Punjab, of which 90% of the CCP has already been handed over to the government.

For the foreseeable future, we envision funding our work through a combination of sustained donations and grants, and cost-sharing with government partners. The COVID-19 pandemic has brought about new opportunities for our program, and we are also exploring ways to monetize certain components of our skills and offerings. In the long term, we aim to phase out our need for grant and donor-based support, and are eager to explore opportunities on how best to achieve this.

Noora’s work is supported by cost-sharing with our government partners, private philanthropic giving, corporate giving and foundations with a focus on social innovation and global health.  In the last 12 months, our largest donations have come from the following foundations/ family funds as grants:

$ 186,827  - The Lucille Foundation- 06/2019  

$ 150,000 - Anonymous 08/2019 

$100,000 - David Weekley Family Foundation- 08/2019 

$150,000 - The Horace W. Goldsmith Foundation - 10/2019

 $30,000 - RA5 Foundation- 11/2019 

 $2,000,000  -  NPT Transatlantic Family Foundation (via Paul Graham)-12/2019 

$200,000  - Mulago Foundation- 12/2019

$15,000- Karuna Charitable Fund- Vishal Saluja- 1/2020

$65,000- Campbell Family Fund - 1 /2020

$100,000- Peery Foundation- 1/2020

$33,049 -Motivation for Excellence - 3/2020

$300,000- Jasmine Social Investments- 5/2020

$50,000- Jester Charitable Fund- 5/2020

$300,000- Yajilarra- 6/2020

$150,000- David Weekley Family Foundation- 6/2020

$47,485 - UNICEF (this is a collaboration for CCP and COVID-19  in 2 Indian states) -  2019, 2020

Additionally, we are currently raising support for our COVID-19  response efforts and the following organizations have generously donated:

$100,00- Open Road Alliance- 4/2020

$25,000- RA5 Foundation- 4/2020

$100,000- Peery Foundation- 4/2020

$50,000- David Weekley Family Foundation- 5/2020

$25,000- Mulago Foundation-5/2020

$200,000- Skoll Foundation- 6/2020

$31,248- The Lucille Foundation- 7/2020

We also have supporters who make individual gift contributions - we have not listed these details. 

Currently we are actively seeking grant funding to support our ongoing COVID-19 response efforts in India and Bangladesh, our planned expansion to new states in India, and our planned  global expansion starting with Bangladesh where we have already begun piloting this year. While we had a clear fundraising target for these ambitions, our work has now completely evolved as we respond to the pandemic as we launch novel solutions and realize there will continue to be a need for Noora’s solutions in the under- resourced public health system even beyond the pandemic.  For example, we had a WhatsApp offering prior to the COVID-19 outbreak, and we leveraged that experience to launch multiple WhatsApp platforms in response to COVID-19 for vulnerable populations and frontline healthcare workers. In the post-pandemic context, these will continue to service the healthcare needs of patients and their families outside hospital settings. We expanded our modes of training of frontline healthcare workers with COVID-19 through  interactive live webinars, chatbots, AR based tools and apps for online training  While we are rapidly incorporating innovations in our CCP model to suit the new reality, this will only help us form lasting relationships with new partners to reach out to a wider pool of vulnerable populations and frontline healthcare workers.   As such, we will need to revise our fundraising goals and are not in a position to finalize the monetary amount we are seeking  -  we are learning everyday from responding to the needs of the communities we work in.

Our budget that we had created at the beginning of the year for 2020 is $2,803,311  -  this includes the necessary costs of Direct Program Expense, Monitoring & Evaluation, Payroll, and critical scaling activities for our expansion in India and Bangladesh.  From an impact perspective, this budget reflected the cost of reaching an additional 427,500 patients by the end of 2020. This budget does not incorporate the cost-sharing contributions from state governments, as these funds are managed entirely by our partners.

Noora Health has stepped up and redirected efforts towards COVID-19 response, and our work is evolving every day as we create relevant content and health training models, forget new partnerships and continue supporting the work of our government partners in India and Bangladesh. As the budget was created in the beginning of the year, it is not reflective of the changes to our work because of the pandemic.  We are actively raising additional funds to support our COVID-19 work and have raised ~$533,000 to date.

The effectiveness of Noora’s approach is evidenced through our growth and evidence, but we are not satisfied. We know that our impact can go much further, faster. We want to learn from experts on striking a balance between scaling efficiently, maintaining quality, all while also ensuring a sustainable funding and revenue model. 

The funds and support offered through the prize grants a catalytic opportunity to dive deeper into understanding what we can do to reach more patients and families in need, and how we can hone our revenue model as we continue to grow.

As we move on from our growth in India and begin to broaden our reach in Bangladesh and beyond, we also recognize the importance of gaining a seat at the table. In the long-term, we hope to continue as a technical partner that creates standard-setting trainings, facilitates the model’s adoption globally, and researches the impact. We hope that the Elevate Prize can offer us the opportunity to amplify our presence and exposure to our powerful “big idea,” and in turn, expand our coalition of partners. 

Finally, in order to propel Noora forward, I have a responsibility to reflect on and advance my skills and acumen. As Noora grows, I and my co-founder must also grow as leaders. For us to be impactful, our team needs to feel safe, satisfied, and effective. I am certain that the mentorship I would receive as a part of the prize would prepare me to meet that role.

In order to truly achieve the scale we hope to by 2025, it is imperative that Noora engages more substantively with large-scale national level government programs led by the National Health Authority (NHA) such as Ayushman Bharat (India’s national healthcare insurance scheme), and the nation-wide implementation of primary care centers. These efforts will augment and catalyze Noora’s engagement with Indian states and growing community of partnerships in the social sector.

Globally, Noora will continue to prioritize coalition building with the aim of serving as a thought leader on family caregiving by establishing global partnerships with organizations like the Bill and Melinda Gates Foundation, and the WHO to advance the agenda of  establishing family caregiving as a global standard of care, and its inclusion in global policy. 

 We will continue establishing partnerships at the national level in South Asia with global organizations (e.g. USAID, JHPIEGO) and technology partners (e.g. WhatsApp, Facebook, YouTube) that will enable us to reach more vulnerable populations, reach new areas with poor health outcomes, and those with worsening outcomes due to COVID-19. We will grow existing collaborations to bolster our research capabilities (e.g. JPAL, Public Health Foundation of India). These partnerships will enable Noora to showcase the evidence, value, and impacts of family caregiving in varied settings and locations, across different health conditions, and at different levels of the health system, ultimately adding to the mandate for implementing and strengthening family caregiving based approaches globally.