May 1

Luke Filose

Global Social Venture Competition: Weighing the Health of Children in Mali

Editor’s Note: The following article profiles one of the finalists at the 2009 edition of the Global Social Venture Competition, held last week at the Haas Schol of Business at UC Berkeley.

Around one in five children in Mali dies before his or her fifth birthday. Imagine preventing half of these 117,000 annual deaths with a few cell phones and scales. I interviewed the founders of Pesinet – a new non-profit organization and 2009 GSVC finalist – and I’m excited about the ability of their new micro-insurance program to accomplish just that.

“Around 70% of child mortality is caused by easily treatable illnesses such as diarrhea, malnutrition and malaria,” Pesinet CEO Anne Roos-Weil told me. “We are trying to create a culture of preventative care.”

To make this culture shift possible, Pesinet harnesses the tailwind of high mobile phone coverage (85% worldwide by 2010 according to the GSMA) and exploding mHealth services with a simple business model. Families subscribe to the service for about $1 per month. Health workers make regular house calls and transmit basic health information via SMS to a doctor who reviews the data, and brings children in if any warning signs are detected.

This sounds like the right approach. While living in Mauritania, I accompanied health workers on a door-to-door polio vaccination campaign. I was struck by two things: first, the ability of the workers to visit an incredibly large number of houses per day, and second, the willingness of households to receive health workers in their homes.

Pesinet should be able to take advantage of this dynamic across most of West Africa, and it already has 500 paying customers in its pilot program after one year of operations. The biggest challenge will be making ends meet at such a low price. Anne estimates the break-even point for a single site at around 600 clients. With four health workers ($70/month each), one doctor ($140/month), and one administrative staffer ($100/month, my estimate), that’s already $520 per month in costs, which leaves a thin $80 per month to cover other costs including cell phone airtime and transportation.

Charging for pharmaceuticals or increasing the monthly fee could improve the balance sheet, and data on Mali’s private health care spending indicates that the average Malian is already spending around $2 per month on health care. Another idea is to reduce the frequency of visits through a hotline approach, but Pesinet’s goal of creating a culture of prevention may require a more hands-on approach.

It’s not an easy problem to solve, but Pesinet has one other trick up its sleeve: tapping into the millions of Malian migrant workers who send an average of 160 Euros back home each month. The organization is seeking $50,000 in support, which it plans to use to expand its program from Bamako to some of the 50 high potential sites it has identified in Mali.