South Sudan :: Social Enterprise

Emergency aid is essential in conflict zones, but so too are long-term solutions like social enterprise which offer powerful opportunities to improve health while promoting local ownership and economic development Read on

Social Enterprise Models

Through our research, we look forward to advising policy makers and practitioners on how to design social enterprises that are cost-effective and suited to their local contexts. This table highlights three innovative models that can help finance and support community health workers (CHWs). These new models exist outside of the mainstream that typically relies on national health ministries, foundations, and corporate social responsibly programs, or community health insurance programs for funding.

Innovative models for financing healthcare

Sales Basket of Health Products	Outreach from Mission-Driven Private Clinics	Cross-Subsidization from Other Enterprise Activities
Generating revenue through CHW sales of medicine, personal care products and other household goods that promote family health and well-being (such as clean-burning cook stoves or solar lamps)	Using a portion of the revenues from private clinics and hospitals to pay for the free door-to-door outreach of CHWs to low-income neighbourhoods	Linking CHW funding to non-healthcare related enterprises and utilities that can provide stable, year-round funding by offering a share of user-fees, levies or supplemental income
Who Pays?
Patients directly	Wealthier fee-paying patients	Customers of non-healthcare businesses and users of various community services
Most Suitable For:
Lower-middle-income communities with sufficient disposable income to support product and service purchases Communities with sufficient density to support door-to-door sales	Communities with large disparities between the rich and poor Regions where a significant share of the population has formal education, mobility and sufficient disposable income to enable access to private healthcare	Smaller insular communities that are economically homogenous Regions that prioritize investment in non-health related sectors
Key Success Factors
A "balanced" basket of goods where high-margin products such as cook stoves subsidize low-margin products and door openers such as antimalarials CHW training encompasses sales and health promotion	Clinic with a strong social mission to reach out to underserved populations Affluent customers cross-subsidize poorer ones Efficiencies and economies of scale	Strong customer insights and validated learning into what people will pay for, if they are reticent to pay for healthcare
Examples:
Living Goods leverages micro-entrepreneurship to empower CHWs to earn supplemental incomes through door-to-door sale of health products in Uganda and Kenya	The South Sudan Physicians Organization is developing a social enterprise clinic which will deploy CHWs to low-income neighborhoods and camps for people displaced by national conflict	eHealth Point is an Indian social enterprise that uses drinking water provision as a gateway to providing eHealth services to rural villages
The HealthKeepers Network in Ghana leverages traditional and non-traditional networks of community based agents, especially women, to serve hard to reach communities	Narayana Hrudayalaya cardiac hospitals and Aravind eye hospitals in India both provide subsidized or free care to low-income patients, supported through scale efficiencies and fees from wealthier paying patients	In Kenya, CHWs are encouraged to open their own enterprises, such as hair salons, to generate additional income In Mozambique, VillageReach cross-subsidizes and piggy-backs the distribution of vaccines with the distribution of natural gas to health clinics