Stealing from Avon to Serve the Poor Collaborating with BRAC under the BRAC-Living Goods Partnership
CORE Spring Conference May 2016
Panel: CHW Models, A Focus on Sustainability
Molly Christiansen, Director Impact & Advocacy
Living Goods supports networks of Community Health
Promoters who go door-to-door teaching families how to
improve their health and delivering life-saving products and
services.
Living Goods community health program reduces child
mortality by 25% for an annual cost of under $2 per person.
1. Sustainable funding for
CHW compensation, and
some of operating costs.
CHPs are neither volunteers nor salaried workers, they’re paid for results CHPs earn a modest margin on what they sell, solving the great challenge of how to motivate and pay community health workers LG recovers 100% of product costs LG earns a modest wholesale margin that covers some of operating costs making net cost to funders under $2 per capita annually
“Living Goods solves two of our biggest
challenges in the health care sector:
How to keep vital medicines in stock, and
how to compensate and retain community
health workers.”
DR. RUHAKANA RUGUNDA Prime Minister Uganda
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2. Integrated Health Delivery to the Last Mile
Our integrated platform avoids the inefficiency of single-issue health strategies.
Malaria Diarrhea Pneumonia Worms
Childhood Diseases
Prenatal checks SMS reminders
Nutrition Delivery in facility
Family Planning
Healthy Pregnancy
Postnatal Checks Kangaroo Care Preventing Infection
Newborn Survival
Pregnancy supplements Breastfeeding
6-24 month nutrients
Nutrition
3. Broad Product Mix Drives
Impact and Sustainability
• Oral contraceptive, condoms
• Clean delivery kit • Prenatal vitamins
• ACTs • ORS/Zinc • Amoxicillin • RDTs for Malaria • Deworming
• Fortified porridges • Iodized salt • Sprinkles • Nutributter
• Solar lights • Clean burning cook stoves • Water filters
Maternal & Newborn
Health
Childhood
Diseases Health Tools
The more CHPs have to sell, the more income they earn,
the more time they invest... and the greater impact they deliver.
Nutrition
4. Always-in-Stock Distribution System
Branches are always in stock,
tracking inventory electronically
and restocking monthly
CHPs restock weekly Branches can deliver to
CHPs via motor bike saving
CHPs time and money.
5. Best in Class Performance Management
LG selects and actively manages the performance of its CHPs
CHPs earn a performance-based income while serving the needs of their community.
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Select! Train! Equip! Manage! Incent!
Community Referrals
Literacy and Numeracy
Interviews
Replace Low Performers
3 Weeks Initial
Monthly in Services
Hands-on Learning
Mobile Tools
Business in a Bag
Uniform
Smart Phone
Inventory Loan
Targets
Real-time Data & Dashboards
Field Supervision Checklists
Random Quality Checks
Retail Margin On Sales
CHW Performance Incentives
Performance based Compensation for all Staff
6. Living Goods Smart Mobile Tools
Every CHW uses a smart phone with best in class health apps New LG Android application does ICCM assessment, flags acute cases, and spots high- risk pregnancies.
Smart Apps Increase Treatment Accuracy & Improve Quality LG “Smart Health” application automates ICCM assessment, flags acute cases, and spots high- risk pregnancies.
Delivers Health Education by SMS Tailored text messages educate clients on vital health behaviors and provide timely reminders for pregnant moms. ‘CHPs on Call’ Drive Prompt Treatment Living Goods CHPs encourage their clients to call or text their CHP at the first sign of disease illness symptoms. This ‘on-call’ health worker system speeds treatment and improves outcomes. Analytics Dashboards Improve Performance and Monitoring Automated dashboards show field staff how CHPs are performing in real time. Staff call or text customer to check service quality. Managers see real time performance data on every CHW on any devise.
Real time data drives impact, quality and efficiency
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A J-PAL randomized control trial
revealed Living Goods is achieving a
25% REDUCTION IN UNDER-FIVE
MORTALITY
The study was independently sponsored by the Children’s
Investment Fund Foundation. IPA surveyed 8,000
households over 3 years across 214 villages. Mortality rates
improved across income groups at similar rates. The study
also found a 7% reduction in under 5 stunting.
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Vision: Improve health of over 50 million people in the next 10
years through highly effective, well-managed CHWs.
Where we currently work:
Uganda – 3500 CHWs; 6500 CHWs by 2018
Kenya - 250 CHWs; 1800 CHWs by 2018
Partnership w/CARE in Zambia and PSI in Myanmar
Future:
• Grow networks of CHWs in close partnership w/government
including PPP arrangements.
• Technical Assistance to other NGOs and governments to build
and manage CHW networks
• Advocate with bi/multilateral funders and governments to
effectively finance and plan community health
• Leverage bi/multilateral aid and performance based financing
deals to drive more domestic financing of community health
“A lot of programs
give lip service to
‘sustainability’ —
this is the real deal.
Living Goods is one of
few models with the
potential for game-
changing scale.”
HOLLY WISE Former Secretariat Director, USAID Global Development Alliance Thank you!
Made Possible by Extraordinary Partners
“Living Goods is a pioneering initiative—effectively reducing childhood mortality while
structured from the outset to endure fiscally. Their approach of training community members
to be ‘Avon-like’ entrepreneurs creates a level of sustainability that is hard to match.”
JAMIE COOPER-HOHN, Co-founder of The Children’s Investment Fund Foundation
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