Creating demand where there is need by developing community-owned village micro-clinics to address acute medical needs in a culturally focused manner.

Problema

An Ethiopian baby is 30 times more likely to die before age 5 than a Western European child (UN). A woman in Sierra Leone is 62 times more likely to die in pregnancy or childbirth than a woman in the USA (Lancet). Every year in developing countries, 8 million noncommunicable disease deaths are premature and could be potentially prevented (WHO). Many of these medical conditions were solved decades ago in the developed world. Donor countries have attempted to address this injustice by pushing supply side solutions into Africa with only tokenistic nods to creating demand and working alongside traditional medicine. The result: 80% of the population in some African countries rely on traditional medicine (WHO). Known solutions are not getting to people who need them - we need a new approach.

Solução

Our model aims to create a sustainable model of healthcare that integrates medical and traditional approaches at the point of delivery. Recent reforms to primary care provision in England’s NHS have created employee owned co-ops that engage patient populations to design service offerings. COVER replicates this strategy but instead turns community members (customers) into profit-sharing owners. This approach transforms the traditional conflict between western and traditional medicine into a synergistic union that extends known solutions where they are needed most. Services are better tailored to community needs, which creates customer demand and lowers costs. This will yield profit that can be distributed back to the ownership base or used to finance the growth of the model. Generating a profit can both aid sustainability and widen the variety of financing mechanisms available. This includes tools like project finance, that offer investors financial returns and fuel scalability.

Exemplo

We will engage cultural leadership in health hotzones to design service centers. This guided process will aim to understand perceived needs and shape demand. We will develop a bespoke governance structure drawing on the best examples of co-operatives and tailoring it to the needs of each community. Community members will become ‘co-owners’ of the centre with plans for them to take on full ownership in the longer term. We will build the facility and design the pricing plan with the community to ensure sustainability and equitable access. We will incentivize people to become co-op members, take up services, and volunteer through profit-sharing and service vouchers. The clinic will be staffed by broadly skilled technicians who live on site. These individuals will be trained in management, customer service and in understanding the principles and application of participative healthcare - qualities widely identified as absent in many public health professionals in Africa. Health services will be designed to provide preventative and primary care services (non acute or tertiary care). This will include measures to integrate and improve existing traditional practices. For example, traditional birth attendants (TBA) who work outside the formal health system can perform semi-assisted births in the clinic, mentally improving performance and providing a safety net should adverse circumstances occur. The centre will develop a comprehensive network of referral partners in each local setting to provide complimentary and specialist services when required.

Ofertas e demandas

CLUSA, the international program of the National Cooperative Business Association, created 2,000 village health associations and trained 4,000 village health workers in Kenya. But these volunteer-led efforts have no physical plant and are not structured as co-ops. The Uganda Health Cooperative (UHC) is essentially a mutual insurance company, purchasing access to services as a group. While we have seen multiple examples of community ownership of enterprises in Africa (Githunguri Dairy and Kuapa Kokoo), we have not seen examples of co-operative models of healthcare ownership. In England, co-operative models of delivery are an important part of health policy. By involving patients and staff in running and governing the organisation, service levels improve and efficiencies materialize.