The Challenge

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How might we use social business to improve health in low-income communities? read the brief

Winning idea

Madre Cuidadora: a Mentor / Village Phone / Vendor lady

Instead of having a vending machine selling all sorts of healthcare-related items (diapers, baby food and clothes, birth kits, cell phones, etc.), we could imagine using community mothers or mentors, or even health care workers. This way, we could reduce the literacy gap, while still keeping a “human” contact that might be reassuring, and having information spread out from within communities, via people who belong to these communities (UPDATED!).
REVENUES

> Mentorship
These ladies ("madres cuidadoras") can share with the members of their communities (esp. expecting mothers, young parents, the elderly) advice and tips on how to deliver safely / grow their children to be strong and healthy and/or take care of one's own health.

> Vending "point"
These ladies can also sell basic medical supplies, nutritional products and food, as well as basic necessities (diapers, sanitary pads, etc.).
The sales point could be either fixed and/or as a door-to-door sales model (the vendor lady would know the pregnant mothers in her community and go to their house for example).
A third channel alternative would be to offer some group health workshops by the network of madres cuidadoras under the impulse of GLC. The sessions will provide a broad minimum of health information, which can be backed up by the sales of medicines that are likely to to purchased widely e.g. deworming medicines, soap, contraceptives, etc. (Thanks SiuSue Mark for this idea!). These group sessions can be followed up by the personalized visits, which offer more in-depth health care advice to families, based on their individual needs.

> Village phone
The vendor ladies could complement their business by selling airtime, to ensure the sustainability of the model (in times where, for example, there are fewer women in need of healthcare items).

COSTS
As far as initial costs are concerned, the Grameen Creative Lab could help buying initial stocks at bulk price and sell them to these ladies in smaller quantities. An initial setup with a microloan could be standardized in order to help creating these businesses.

Advantages
This system would foster local entrepreneurship: the vendor ladies can build local businesses around this activity; manage their own stocks and inventories (using mobile technology to communicate with their suppliers for example) and potentially use microfinance or voucher-based schemes to help locals acquire the health care items they need.
This solution also works in a low-literacy context as the vendor ladies could communicate directly with the members of their communities sharing knowledge via word of mouth.

What role(s) will the Grameen Creative Lab play?
The Grameen Creative Lab could:
  1. act as an aggregator to create a solid network of these ladies;
  2. help the vendor ladies start their businesses, by providing initial investment micro-loans*;
  3. help training them as far as budgeting/managing supplies is concerned**;
  4. provide booklets / knowledge materials to help spreading best health practices in the community.

GCL is doing right now is creating Grameen Caldas, a locally run micro-credit organization / Social Business Fund that also creates Joint Ventures with large companies, thanks Grameen Creative Lab for the information.
"In this case, Grameen Caldas could finance an entrepreneur who would be responsible for designing the business plan for this business, and run it like a social business (in a self-sustainable way, but with profits being reinvested into the business). Micro-loans could be provided to the women, to finance their “starting package” as well as their training."  

On the longer term, las madres cuidadoras might also serve as agents/retailers to sell health insurance products on behalf of Grameen Caldas (thanks SiuSue Mark for this one). 

** "As for the training, an option is to develop a program along with some educational institutions like the SENA (national professional training institution) who offers training at very low costs. Again, this could be financed through a micro-loan to make it sustainable."
This training idea could even be taken a step further by providing a certification to the women who have proved to master the training material, this certification being a condition for their access to a micro-loan (Thanks Anne for this add-on).

_________
Disclaimer
This is a concept I have posted for the former Maternal Health challenge, but thought was still relevant for this challenge (as it's pretty much a social entrepreneurship / social business scheme). Here is the link for the original post: http://bit.ly/gOJYBk
It was highly inspired by Dan’s concept (as well as Emily’s comments on it http://bit.ly/dSHvwr) and Anne-Laure’s contribution (http://bit.ly/gUoTo0) too. 
I can't link these directly to this one as they're from different challenges, but would like to give them credit.
How do you envision this idea making money?
- Selling medical supplies, food, diapers, etc. - Selling airtime -Potentially serving as agents to sell health insurance products
How does this idea create social impact, particularly around improving health?
1. Spreading health best practices in Caldas 2. Helping communities get access to the health care items they need Comment from Grameen Creative Lab: "According to some local nutrition experts, the flaw in education about nutrition of self-care is generally provided through talks and public information sessions, but lacks an actual follow-up on the field. Your idea (...) gets directly to the people, in their homes, so that they can actually learn about what they are doing right or wrong."

Evaluation results

1

How well do you think this concept considers life in low-income communities?

It is highly relevant to low-income communities
It is somewhat relevant to low-income communities
It does not significantly consider low-income communities
2

How effectively does this concept use social business principles (that is, it has social benefits for the community but does not pay dividends?)

This concept uses social business principles very well
This concept could be easily modified to incorporate social business elements
This concept does not connect with social business very well
3

How easy would it be to implement this concept?

Easy! This could be started immediately
It would take some time and planning – but I bet I could see progress in the near future
This concept would need extensive planning, partnerships & resources in place to get going
4

To what extent will this concept improve people’s health?

This concept would significantly improve people’s health and wellbeing
This concept seems like it might improve health, although maybe indirectly
This concept doesn’t really have much to do with health
5

Overall, how do you feel about this concept?

It rocked my world!
I liked it but preferred others
It didn’t get me overly excited

Comments

Join the conversation and post a comment.

OpenIDEO

April 04, 2013, 20:18PM
Exciting news from Caldas: http://www.linkedin.com/today/post/article/20130404181636-10842349-inspiration-for-innovators-openideo-and-grameen Transforming your idea into real world action!

Sarah Fathallah

April 04, 2013, 23:15PM
This is so exciting! Thanks OpenIDEO :)

Vesna Misanovic

July 26, 2011, 22:58PM
Congratulations!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Sarah Fathallah

July 26, 2011, 23:12PM
Thank you Vesna!

Vesna Misanovic

July 23, 2011, 21:22PM
Keeping thumbs!

SiuSue Mark

July 22, 2011, 22:48PM
Write a comment

SiuSue Mark

July 22, 2011, 22:57PM
Sorry, my comment posted accidentally before I wrote it. To add on to your concept, what I wanted to say is that:

a) have you considered the increasing the cost-efficiency of using door-to-door outreach of health information (which could be very effective) by also offering some group health workshops that cover broad themes such as deworming or basic sanitation? These group sessions can be followed up by the personalized visits, which offer more in-depth health care advice to families, based on their individual needs. The sessions will provide a broad minimum of health information, which can be backed up by the sales of medicines that are likely to to purchased widely e.g. deworming medicines, soap, contraceptives, etc.

b) in order to cover the costs of this initiative for the "madres cuidadores", consider having them not only sell airtime, but also health-related products and services that generate a regular income such as health insurance (offered in partnership with national insurance programs negotiated by Grameen).

Good luck with taking this forth!

Sarah Fathallah

July 23, 2011, 01:33AM
Thanks for your input! Great great ideas here!
I like the a) idea. I guess this could be a complementary service organized by the network of madres cuidadoras (under the impulse of GCL).
As far as b) is concerned, I think this will depend a lot on the regulatory environment in Colombia. Very few countries allow non-Financial Institution entities to sell financial products. Although, I could see the madres cuidadoras being a network of agents (kind of like retailers) of micro health insurance products designed by the newly created Grameen Caldas (or at least the micro-credit organization part of it).

Milo

July 21, 2011, 19:01PM
:)

Sarah Fathallah

July 17, 2011, 15:58PM
Question to the native Spanish speakers amongst you: How would you name these ladies?

Sarah Fathallah

July 22, 2011, 03:12AM
I've named them simply: "Madres cuidadoras" (caring mothers)

Juan Cajiao

July 16, 2011, 12:03PM
Hi Sarah,
This concept reminds of "Amway" and it connects with the previous Latin American version which is people distributing and selling local clothing. I am not sure if the tradition persists but I am sure that this methodology could ground in Latin communities.

Sarah Fathallah

July 17, 2011, 15:25PM
Thanks Juan! I don't have an extensive Latin American experience, so I really appreciate your comment.

Grameen Creative Lab

July 15, 2011, 17:53PM
Sarah, this is really a great idea. According to some local nutrition experts, the flaw in education about nutrition of self-care is generally provided through talks and public information sessions, but lacks an actual follow-up on the field. Your idea is simply awesome in the way that it gets directly to the people, in their homes, so that they can actually learn about what they are doing right or wrong. Besides, I really like the way you make it self-sustainable.
I just felt like clarifying a bit what the actual role distribution could be. What GCL is doing right now is creating Grameen Caldas, which will be locally run. It will have a micro-credit organization, a Social Business Fund and will create Joint Ventures with large companies.
In this case, Grameen Caldas could finance an entrepreneur who would be responsible for designing the business plan for this business, and run it like a social business (in a self-sustainable way, but with profits being reinvested into the business). Micro-loans could be provided to the women, to finance their “starting package” as well as their training.
As for the training, an option is to develop a program along with some educational institutions like the SENA (national professional training institution) who offers training at very low costs. Again, this could be financed through a micro-loan to make it sustainable.
I hope this helps :) Keep on with these great ideas!

Sarah Fathallah

July 17, 2011, 15:24PM
Thanks for the feedback! Your comment brings in many helpful details, and it reassures me as far as the feasibility of this concept is concerned. I will include those details in the concept, and I'm really looking forward to seeing what Grameen Caldas will be working on once it's created!

Anne Kjaer Riechert

July 14, 2011, 18:06PM
Hi Sarah, I really like how your concept draws on the heath knowledge of local elders. This is a system which has worked across cultures for centuries, and with a little tweeking, it could be updated and help solve health issues effectively on a local level.

I however, have one little alarm clock going off, which I would love to hear your thoughts about. Having lived in South Africa and worked with HIV/AIDS related issues, I have experienced how much much mis-information there is about the spread of disease and how to cure them. The spread of wrong information can be really damaging for the overall health in the community!

I am therefore wondering how your concept can insure the quality of the advice provided and appropriateness of the medicine given, so we avoid health workers for instance promoting 'abstinence' as a mean to avoid the spread of sexually transmitted diseases.

Maybe there should be some certification system.

Sarah Fathallah

July 14, 2011, 18:36PM
You're pointing out a very important issue Anne. Even though in my mind the mentor ladies are somehow "trained", I haven't given it much thought earlier... I guess this is something the Grameen Creative Lab could (or Bienestar?) play a role in, taking the aggregator role a step further to making sure the network of mentors is getting (and then spreading) the right information.

I am also thinking that, since these women could use microloans to start their business, one of the conditions of getting the loans would be, aside from their solvability, to go through a certain decided training. I have seen examples of this before (in Malawi, agricultural loans wouldn't be given to tobacco farmers unless they've had training to understand which fertilizers to use for which crops).

I like the certification system idea, although there is always the problem of the certification boy credibility and reputation. Who would you think should be responsible for this?

Anne Kjaer Riechert

July 14, 2011, 22:26PM
I completely agree that training is crucial, before micro-loans are given out. (My friend in Denmark created a fascinating business training program for illiterate Masaais in the Rift Valley in Kenya, which might serve as an inspiration for you and Grameen Creative Lab: http://tin.dk/projects/lorika/).

I believe Grameen Creative Lab could be the right anchor for the concept in the beginning by providing (basic business and health) training. Once a lady has gone through the training she could be certified, and this certification would give her access to micro-loans.

Grameen could sub-contract a local nurse, or more likely a group of nurses, who could provide the health training and certification of the 'Vendor Ladies'. Over time the certification process could become a social business in its own right (-thus living up to the idea about 'social value creation at every step of the process').

Sarah Fathallah

July 15, 2011, 00:15AM
Great ideas! Thanks Anne, this conversation is very helpful. Will add these thoughts to the concept later on.

Didi Quimpo

November 29, 2011, 06:44AM
Hi Sarah and Anne, I agree with you both that training is crucial. Here in the Philippines, microfinance organizations are also very active. We usually have weekly meetings when loan collections and loan applications are being done. It is during these weekly meetings that health issues are discussed. We train loan officers and the mothers/group leaders on specific health issues such as dengue (which is a problem here). We give them a basic "lesson plan" or specific information/messages so that will be discussed just to ensure that they give the correct, relevant message.

Sarah Fathallah

November 29, 2011, 12:50PM
Thanks Didi, it's great to share your experience.

Meena Kadri

July 13, 2011, 23:16PM
Sarah rocks the house yet again! Loving the mash up of so much local and socially innovative goodness on this one.

Sarah Fathallah

July 14, 2011, 14:09PM
Thanks Meena! I was not sure whether it was fully 'fair' to re-post contributions...

Meena Kadri

July 14, 2011, 21:35PM
Obviously the answer is 'yes' given you've been shortlisted ;^)

Vesna Misanovic

July 13, 2011, 22:21PM
Hi Sarah,

Have you seen our inspiration Mothers as Doctors. Very similar! It is a good sign,

Cheers,

Vesna

Sarah Fathallah

July 13, 2011, 22:46PM
I haven't seen your inspiration before but it is definitely something I truly believe can be powerful within this type of rural communities. I've linked it to this concept!

Diana Carolina Quintero Giraldo

July 22, 2011, 23:32PM
Hi Sarah,

I'm Diana from the entrepreneurial team of BIENESTAR, it is a great idea for introducing in our value chain. Congrats!

Sarah Fathallah

July 23, 2011, 01:33AM
Thanks Diana, I really appreciate your comment.
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