Despite the stunning advances in medicine during the last half century, over 25,000 children die each day for want of medicine that costs less than a cup of coffee.
A short list of infectious diseases treatable with inexpensive generic drugs accounts for 70-90% of all childhood illness and death in the developing world. Existing access to essential medicines for much of the poorest is woefully inadequate. A frightening percentage of the most vulnerable populations live hours, if not days from the nearest source of life saving medicines. Moreover, the current limited distribution often suffers from weak supply, a lack of rigorous quality control and unfair or simply inaccessible pricing. To address this yawning healthcare gap Scott Hillstrom and Eva Ombaka, Ph.D. founded The Child and Family Wellness Shops network (CFWshops) in 1997, adapting a traditional franchising model to the problem of distributing essential medicines in remote communities.
The Micro-Franchising Model - An Effective, Scalable Solution
The HealthStore Foundation's CFW model is a network of micro pharmacies and clinics whose mission is to provide access to essential medicines to marginalized populations in the developing world. The CFW outlets target the most common killer diseases including malaria, respiratory infections, and dysentery among others. They also provide health education and prevention services.
Why a franchise model? On average the 20 poorest developing countries spend less than $33 per person each year on health care compared to over $2,500 in the 20 most developed countries and $4,500 in the US. Even a doubling of public health funding would fall short of meeting the need. While public funding will always be needed, at least part of the full solution to the distribution of medicines must incorporate a sustainable market-based model with effective incentives. The CFW model incorporates all the key elements of successful franchising: uniform systems and training; careful selection of locations; and most importantly, strict controls on quality backed up by regular inspections. And importantly HealthStore uses the combined buying power of the full network to obtain quality medicines at the lowest possible cost.
The network operates two types of outlets; basic drug shops owned and operated by community health workers, and clinics owned and operated by nurses who provide a deeper list of essential medicines as well as basic primary care. As the franchisor, HealthStore can revoke a franchisee's right to operate an outlet if the franchisee fails to comply with the franchise rules and standards.
HealthStore's customers are primarily lower or middle-income women and children subsisting on agriculture, although people of all ages and incomes are treated. CFW outlets are located at market centers in agricultural areas of approximately 5,000 people.
The essential components of the HealthStore Foundation's CFW model include:
A New Way Forward
The HealthStore Foundation® has combined established micro-enterprise principles with proven franchise business practices to create a micro-franchise business model called CFWshops.
Franchisees operate small drug shops or clinics strategically located to improve access to essential drugs. HealthStore clinics and shops enable trained health workers to operate their own businesses treating the diseases that cause 70-90% of illness and death in their communities while following HealthStore drug handling and distribution regulations calculated to ensure good practice.
A short-list of inexpensive generic drugs can effectively treat 70-90% of the children suffering and dying from infectious diseases in the developing world. Too often, people do not have access to these drugs. HealthStore seeks to improve access to these essential drugs using its micro-franchise business model.
The major goals of the CFWshops project are:
Franchisees enjoy the benefits of owning a valuable profit-making business but may retain it only by compliance with CFWshops drug handling and administration regulations. It is in their own self-interest for franchisees to follow the regulations. HealthStore believes that franchisees acting in their own self-interest will achieve more than a centralized command-and-control bureaucracies can.
The franchise model has delivered a wide variety of high quality, low cost goods and services throughout the world—including medicine—and has proven to be an effective method of mass distribution across a wide diversity of economic and cultural conditions.
The CFWshops franchise operating system includes an operating manual complete with policies, procedures and forms constituting a turn-key management system which, if followed, enables franchisees to conduct business and provide necessary compliance reports to The HealthStore Foundation®.
Franchisees are entitle to receive a supply of high quality, low cost drugs, management support, training and other valuable benefits from HealthStore. But, if the franchisee fails to comply with rules and reporting requirements, the franchise may be revoked. The system is designed to make the long term benefits of retaining the franchise worth too much to risk losing by breaking the rules. The rules are calculated to assure good drug handing and administration practices.
The system includes, among other things:
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