NextBillion.net - Development Through Enterprise - Taking BoP Strategies To Scale Pt. 3: World-Class Healthcare for the World’s Poor - Comments

Re Paul Rigterink

Allen Hammond — Wed, 14 May 2008 11:18:11 -0500

Paul Rigterink's comment is fascinating and adds a deep insight to the potential of micro-pharmacy model. Since agriculture is still the abiding livelihood and critical to household food budgets in rural areas, simple means of improving animal husbandry can be important. His suggestion that micro-pharmacies, a pharmaceutical distribution infrastructure, could also serve to distribute veterinary medicines and animal care knowledge makes a lot of sense to me. It also shows the value of the distribution platform—that it can be leveraged to meet other needs, and that it can boost incomes as well as save lives. —Al Hammond

Healthcare for BOP poultry stock

Paul Rigterink — Fri, 09 May 2008 10:36:04 -0500

As strange as it may sound, I believe that the sale of veterinary poultry medicines at the pharmacies described in this article can dramatically increase the health of personnel at the BOP. Backyard producers value chickens for their adaptability, contributions to the family’s income and general welfare, and for insect control and fertilizers in the garden. In most family flocks, chickens scavenge plant or food residues and insects around the home. With minimal care, family flocks can hatch and raise chicks, produce high-value meat, and supply eggs. Eggs can be a particularly important source of food for children with protein malnutrition who are between six months and three years of age. Live chickens sold for meat bring a good price and a primary source of income for poor farmers. Inexpensive disease control markedly increases the survival and productivity of a family poultry flock. The following four preventive practices, given every three months, will eliminate most health problems in poultry flocks: 1) Vaccination for Newcastle disease, 2) Deworming for roundworms and tapeworms, 3) Dusting under wings for irritating external parasites such as lice, and 4) Treatment for chronic respiratory disease to increase production. BOP personnel can easily raise up to 50 healthy chickens. To feed the chickens and obtain maximum profit on a small farm, BOP personnel can use: 1) Excess and/or unusual food crops, 2) Crop residues, 3) Household refuge and 4) Scavenger feed (e.g., weeds, seeds, insects, worms, etc). Once BOP personnel have met this “from 5 to 50 challenge”, they will be ready to move-on to learn the technology of “transitional” poultry systems of 200-300 birds and finally full commercial production of 500-10,000 birds.

Taking BoP Strategies To Scale Pt. 3: World-Class Healthcare for the World’s Poor

Al Hammond — Thu, 08 May 2008 08:16:48 -0500

This post is the third in a five part series on a radical new approach to scaling BoP business models, what we call a transformative sector strategy. In this segment, I describe how this strategy could transform the health sector in emerging economies.

Last Mile Health Care Delivery

Talk to people in the rural communities of southern Mexico, in the new urban communities on the southern edge of Bogota, or in almost any village in rural Africa about getting decent access to healthcare, and their answer is the same: it usually costs more to get to a clinic, a doctor's office, even a pharmacy, than the cost of the service itself. In Bogota, most of the government-supported health services are in the north of the city, such that it can cost people in these new refugee communities a day's work plus bus fare across town and back to get help. Lack of access defines part of the last mile health care dilemma, and that means distributional business models, such as franchising, can be important.

Talk to Health Stores in Kenya, an enterprise trying to staff small pharmacies with nurses, and another part of the problem becomes clear: the sheer lack of doctors, nurses, and pharmacists in emerging markets. There are not anywhere close to the number of skilled professionals needed to cover rural areas, and these health workers overwhelmingly refuse to live either in rural areas or in urban slums. So technologies, organizational models, and legal changes that enable local diagnosis and remote practice by doctors and pharmacists could play a critical role.

Still a third factor leaps out from the data in The Next 4 Billion report that shows clearly that low-income households spend between a third and a half of their out-of-pocket health care expenditures on drugs. They typically don't go to doctors or clinics or hospitals, but rather to pharmacies or some other source of medicines and seek to self-medicate. That means they often get a guess as to what's wrong with them instead of a diagnosis.

(This post continues past the break; click "Read More" to continue)