Wednesday, December 07, 2005

CFWshops : "Health Store - Kenya" and Superheroes Of Healthcare

I hope that you do not get tired of reading about superheroes, because I do not get tired of writing about them. Two more superheroes to add to the list are Scott Hillstrom and Eva Ombaka, Ph.D. In 1997 these two wonderful people founded The Child and Family Wellness Shops network (CFWshops) to address the growing healthcare gap between the wealthiest nations and the poorest. By adapting a traditional franchising model to the problem of distributing essential medicines in remote communities, Mr. Hillstrom and Dr. Ombaka attacked the problem head-on.

The CFWshops web site states that its 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." These micro pharmacies and clinics target the most common killer diseases including malaria, respiratory infections, and dysentery among others. In addition to providing essential medicines they also provide health education and prevention services. This is carried out in an effort to accomplish CFWshops' mission, which is "to improve access to basic health services and essential drugs for children and their families in the developing world."

It may seem a little unusual that CFWshops uses a franchise model. But the reason for this is because in the 20 poorest developing countries public health funding is less than $33 for each person annually. In the 20 most developed nations over $2,500 is spent on each person. And in the US the figure is $4,500. CFWshops states that 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. SHEF seeks to improve access to these essential drugs using its micro-franchise business model.

Because of the lack of revenues there needs to be a supplement to public health funding in developing countries. And CFWshops believes that the solution to the distribution of medicines must incorporate a sustainable market-based model with effective incentives.

CFWshops states that its 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.

Taking advantage of "economy of scale, CFWshops uses the combined buying power of the full network to obtain quality medicines at the lowest possible cost. And this is a very important factor in trying to reduce the cost of health care.

By operating two types of outlets CFWshops makes it possible for the community health workers who own and operate the CFWshops make a modest living selling the competitively priced drugs. There are basic drug shops operated by community health workers, and clinics operated by nurses who provide a more comprehensive availability of essential medicines as well as basic primary care. If the franchisee fails to comply with the franchise rules and standards CFWshops can revoke a franchisee's right to operate an outlet; thus helping to ensure quality control.

The market for CFWshops is comprised primarily of lower or middle-income women and children subsisting on agriculture. However the shops are open to people of all ages and incomes. And as the location of these shops is important, they are usually located at market centers in agricultural areas of approximately 5,000 people.

The essential that the shops be operated in accordance with an acceptable standard, and in order to do this the CFWshops franchise operating model include:

- A system of franchise rules and strict treatment standards that govern how the outlets are run and what drugs can be sold.

- A thorough training program that ensures every operator knows how to diagnose the target conditions and accurately prescribe the correct medicines. Base training is backed up with continuing education on clinical skills and management practices.

- A centralized procurement operation that drives down drug costs and ensures drug quality by qualifying all the medicines, buying only from reputable suppliers, and maintaining quality standards throughout the supply chain.

- A record keeping regime that compiles patient records and vital health statistics, as well as financial performance statistics for each CFWshop.

- A consistent monitoring program that makes sure every outlet is operating to standard.

The CFWshops got under way in 2000 when Scott and Eva lead the creation of the first 11 basic drug shops in Central Kenya by, using his own funds. A year later, Management Sciences for Health (MSH) and CFWshops formed an alliance under which MSH supplies technical advisory services to CFWshops. MSH, with significant backing from the Gates Foundation, is one of the world's leading health development organizations.

Since its beginning the CFWshops network has increased to 61 locations comprised of 41 drug outlets and 20 medical clinics and has the capacity to treat up to 25,000 patients per month. Those locations have treated over 350,000 patients in central Kenya. It is anticipated that CFWshops will increase its network to over 100 outlets in 2005. And as a sign of the respect that CFWshops has earned in Kenya, the Ministry of Health for Kenya has incorporated the CFWshops network into its National Malaria Strategy. Also, CFWshops is supported by Global Giving .

The organization's major goals for its project are:

To create a reliable supply of high quality, low cost essential drugs and to make them available to the people who need them when and where they are needed.

To treat childhood infectious diseases in the communities where children live, thus reducing congestion in the healthcare system so that scarce resources can be applied to others not so easily treated;

To reduce under age 5 mortality rates thus encouraging family planning and lower population growth rates;

To discourage the development of drug resistant microbes by the provision and appropriate use of adequate supplies of effective drugs; and

To improve community health through educational and prevention activities.

CFWshops has a lot planned for the future and you can read about it at their web site; which is maintained under their corporate entity - Sustainable Healthcare Enterprise Foundation; and is often known by its popular name "Health Store - Kenya"

But whatever you call it, Scott Hillstrom and Dr. Eva Ombaka have started something Great!


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