IXL Social Enterprise Case Studies Chronic Diseases October, 2013 | Page 10

Improving Chronic Disease Care in Slums by 2019

Are cheaper options available? Because the supply chain can add significant cost to medicine,
labor and other equipment, alternatives need to be available to make healthcare more affordable.
Currently, the price of generic drugs varies dramatically by location but could provide affordable
options to slum dwellers if a profitable market environment can be created for these areas.36

Figure 7. More than half of healthcare
costs in developing countries come
from expensive drugs

Is there insurance/financing available? Medical treatment for families in the developed and
developing world is typically unexpected and expensive (Figure 7). In parts of the developed
world without universal healthcare, however, insurance and financing options enable individuals
to pay in to insurance companies over time before an emergency occurs or in small amounts
after treatment has been received.37 In slums, where access to healthcare can be dependent on
the ability to pay (as it is in Bogota, Colombia), health insurance or financing plays a vital role to
ensuring care.38

Current solutions to address chronic
diseases in slums are not working
Prevention is not a priority
Studies show that even in the developed world, individuals will often ignore or underutilize
preventative health treatments.39 Although some reasons for this trend can be traced to lack of
knowledge or resources, it is also partly because individuals often don’t see the direct benefits
from the cost. In other words, with a limited income, families have a choice to spend their money
on many things. Too often, family income is spent on “emergency” needs – school bills that are
past due, any type of food to fill empty stomachs, or a bus ticket that takes a family member
to work. There is rarely enough money saved to allow families to plan for the future. Even with
enough money, preventative care can be hard to measure in strict economic terms and a difficult
behavior to instill both in rich and poor consumers.
Slums are a challenging place to access affordable and nutritious food supplies and basic
preventative care.40 Slum dwellers also may be unable to access sufficient knowledge about
chronic diseases. Because of these problems, which are exacerbated by the strain and hardship
of living in poverty, slum dwellers are simply unable to prevent chronic disease on their own.
Alternate solutions are preferred, which delay correct diagnosis and treatment
People often favor using conventional wisdom from family members, neighbors or friends to treat
ailments over visiting a hospital or