1. Persistence 2. Business acumen
In 2003, the decade-long civil war
in Liberia ended. But the country’s
health system was destroyed and
very limited capacity remained in
the community level. The whole
country only had 50 doctors
who had to take care of 4 million
people. People would die of
treatable conditions such as
complicated childbirth or malaria,
due to the far distance from the
closest clinic. Healthcare is a kind of service
that can bring profits to healthcare
practitioners even if they work
for the low-income population.
In some cases, an appropriate
business model could scale up
essential services toward universal
healthcare coverage.
It was really challenging to get any
programs running in that situation.
If there is anything special to note,
it is the persistence in making
changes happen. In 2007, a group
of civil war survivors and health
workers co-founded Last Mile
Health, and began Liberia’s first
rural public HIV program with only
$6,000 seed money.
One Family Health is an innovator
that combines micro-enterprise
and franchise models to provide
qualified nurses with a chance to
have their own clinic and improve
their economic status.
One Family Health support
franchisees with capacity
development for business acumen
and other financing skills. The
business model created largely
incentivized trained nurses to
provide quality healthcare services
and essential medicines.
The vision of Last Mile Health
is to “save lives in the world’s
most remote communities”. A
solid business model is almost
impossible to build up in such
tough situations, but the initiative
has strived to recruit, train, equip,
manage and provide lifesaving
health services to the grassroots
people. The dedicated staff have
continued to work despite the
Ebola outbreak and provided
essential assistance for people
with medical emergencies. If you
have similar passion and run a
health initiative, your situation
would be much better than what
Last Mile has faced.
6
Change Magazine January 2018 www.changemag-diinsider.com
3. Public-Private
Partnership
It is difficult to scale up your health
start-up with a single effort. In fact,
resource mobilization from public-
private partnership has been an
increasing trend. Possible Health
is just the perfect example. Started
by a young Peace Corps volunteer
of US to Nepal, Possible Health has
adopted an integrated approach
to connect community healthcare
workers with government hospitals
and clinics, which ensured high-
quality and affordable healthcare
from hospital to home. An
individual can get all kinds of
healthcare services covered with
less than 25 USD per year.
Possible Health has partnered
with Nepal’s Ministry of Health and
received over 900,000 USD from
the government. Its proven model
has treated over 500,000 patients
since 2008. The partnership with
the government is based on both
the proof of efficiency and the
efforts to build good partnerships
with the public sector.
4. Design your product
There are still millions of people
in the world living without in-
home toilets. A few good options
exist for rural people living in the
remote areas. The lack of qualified
hygienic conditions can result in
various diseases potentially. If you
have a big dream to be part of the
solution and have some creative
skills, you can try to design your
own product!
One of the examples you can refer
to is the Clean Team, initiated by
IDEO.org and Water and Sanitation
for the Urban Poor (WSUP). Clean
Team is an integrated sanitation
solution that delivers and maintains
toilets in subscribers’ homes. The
main component of Clean Team
is a custom-designed stand-
alone toilet, but the uniqueness
comes from its human-centered
design. Clean Team works with
partners to fully understand the
sanitation situations and behavioral
factors, then design the system
that comforts a particular
population most. An integrated
delivery, removal and maintenance
system was born out of Clean
Team and it now serves 4500
people in Ghana currently.
We hope that with these strategies,
you are now set to go and build
your start-up. Moreover, at the end
of the day, never forget the reason
you’re doing the work that you
do, and that is to provide better
access to healthcare which is a
human right after all.
About the Author
Bolun Li is the co-founder of Development Innovation
Insider. He is passionate about creating social impacts in
the grassroots level. He has worked with Grameen Bank in
Bangladesh, Maddox-Jolie-Pitt Foundation in Cambodia,
Rural Action Program in China, and Network for Voluntary
Services in Kenya.
About the Author
Gladys Llanes is a Documentary filmmaker based in the
Philippines. She is also the editor-in-chief of Change
Magazine and co-founder of Development Innovation
Insider.
www.changemag-diinsider.com Change Magazine January 2018
7