Trevor Lewis

Healthcare Highlights: CHMI lists dynamic markets from the past year

Ringing bells traditionally announce itinerant sales agents in rural Ghana. The bells rang more frequently in the past year as more and more villages saw agents with carrying baskets stocked with oral rehydration salts, contraceptives, water purification tablets and other preventative health products.

Thousands of people gained easier access to these and other key health products thanks to HealthKeepers, which follows an “Avon lady” sales model for health and more than doubled its reach to serve 646,000 Ghanaians from 2012 to 2013.

HealthKeepers and 80 other programs that are working to improve health care around the world are profiled in “Highlights: 2013,” the Center for Health Market Innovations’ annual look at promising trends in health markets in low- and middle-income countries.

More than 240 programs reported results across 10 performance dimensions tracked by CHMI. Eighty-three organizations reported health outputs (such as the number of health services provided), 67 reported changes in the health status of a given population and 57 reported improvements in the affordability of health services or products. Altogether, the CHMI database profiles more than 1,200 programs in 100 countries.

HealthKeepers is one of more than 40 health programs that reported having scaled up significantly over the past year.

Most organizations have enormous hurdles to scale, including sourcing effective personnel, mastering quality standards, accessing funding and achieving an effective business model. As such, the momentum reported to CHMI is worth celebrating; we do so in “Highlights: 2013.”

Here are a few more top-line messages from “Highlights”:

• One of the fastest-growing innovations in the CHMI database is the use of vouchers allowing the poor to access quality health services. According to data in the CHMI database, the use of vouchers has grown by 18 percent per year since 2000. Other rapidly growing approaches include health-provider training and the use of information communication technology.

• Many low- and middle-income countries are home to diverse and vibrant health markets. India has seen a boom of private health care development, and many health programs identified by CHMI are clustered in southern India.

• Even in fragile states – home to a third of the world’s poor – promising health care solutions are surfacing. For example, Healthy Entrepreneurs’ Pharmacy-In-A-Box is stocked with 25 essential generic medicines tailored to the specific health needs and infrastructure realities of rural communities. Healthy Entrepreneurs operates in five countries, including the fragile states of Burundi, the Democratic Republic of the Congo and Haiti.

• Innovators are finding effective solutions to tackle diseases that are top contributors to the developing world’s mortality and morbidity rates. In South Africa, On Cue Compliance has used a custom-designed pill bottle to help 90 percent of patients comply with their TB drug regimen, a huge improvement compared to the 22-60 percent who normally comply.

• Organizations are also employing supply chain innovations to ensure that patients have access to life-saving preventative and curative medicines. These innovations occur at various points along the supply chain, from production to delivery, and range from “buyer of last resort” models to using motorcycles to get medicines to hard-to-reach areas.

CHMI uses data describing organizational impact to identify promising approaches. With a better understanding of which health organizations are having an impact in these extremely dynamic health markets, we can better track and support the scaling up of care to measurably improve the lives of the poor.

Trevor Lewis focuses on health care financing and delivery innovations at the Center for Health Market Innovations (CHMI).

Editor’s note: This blog originally appeared on CHMI’s website and is reprinted here with permission.

Health Care, Impact Assessment
public health, scale