Our mission is to improve access to Effective-Quality Care (EQC) and prevention services for children and their families in the developing world, using franchise healthcare models that maintain standards, scale by replication, and achieve economies of scale.
Throughout the developing world, millions of children suffer and die because they do not have access to affordable, effective primary healthcare.
A 2018 Lancet analysis of deaths from treatable conditions across 137 countries found that “poor quality of health care [is] a major driver of excess mortality across conditions, from cardiovascular disease and injuries to neonatal and communicable disorders.”
The problem is not that people lack money to pay for care; the problem is that the care they receive is ineffective and substandard. Faulty diagnoses, negligence, inappropriate care, and fake medicines are widespread. Perverse incentives pervade the healthcare industry in most countries where quality regulations are not enforced. For example, care providers often purchase cheap, counterfeit drugs for resale at higher profits than selling real drugs can yield. There is little to gain by going to the extra effort and expense required to deliver effective care.
For healthcare to be effective, each step in the process must be done correctly. And that requires a business system that makes all the required resources available when and where they are needed. Healthstore’s franchise system, branded as Child and Family Wellness Clinics (CFW Clinics) throughout Kenya, equips nurse practitioners to get primary healthcare right, creating opportunities to own and operate their own franchise medical practices and providing all the support they need to deliver Effective-Quality Care (EQC). Because the benefits of business ownership depend on the provider’s compliance with our rigorously enforced EQC standards, franchisees are consistently motivated to deliver EQC to each of their clients.
Children and their families don’t have to suffer and die from substandard care when we can give them Effective-Quality Care (EQC) for for an average price of $4.50—about the same price as a Starbucks latte in the United States.
How Franchising Got Healthcare to Over 10 Million People
The Healthstore Foundation’s mission is to establish and operate social business entities that use the franchise business model to enable independent franchisees to deliver EQC. Our work has so far resulted in the launch of about 160 clinics in three countries serving hundreds of thousands of people per year; about 12 million since 2000. Two networks initiated by HSF have been transferred to independent local management teams with access to resources to support them: in Ghana, resources from the World Clinics program at Sanford Health (the largest rural healthcare provider in the U.S.); and in Rwanda, from the global pharmaceutical company GlaxoSmithKline. Healthstore continues to operate Child and Family Wellness Clinics (CFW Clinics), its flagship network in Kenya.
Since 2000, the CFW network has served over 10 million people in dozens of primary care franchise clinics owned and operated by nurse-practitioner franchisees who provide diagnoses, treatment, hygiene products, and high-quality essential drugs. (Approximately half of the visits occurred in clinics and half in community health education and prevention programs run by franchisees.) It is funded by The Healthstore Foundation, a U.S. tax-exempt organization that develops systems to incentivize the delivery of EQC primary care in the developing world.
CFW Clinics offer a short list of services and drugs that meet 80-90 percent of clients’ needs, like treatment for malaria, diarrhea, and respiratory infections, while those with more severe conditions are referred to higher-level providers. This minimizes the complexity and cost of opening a clinic, making the model easily scalable so that more people—in more hard-to-access areas—can receive EQC for the most common ailments.
Kenyan franchisees own and operate their own clinics under our CFW Clinics brand and in compliance with our franchisor’s standards. Each clinic is owned by a nurse-practitioner and regulated by our franchise operating system. Standards are set by the franchisor to safeguard the brand’s EQC promise of quality (for example, the franchisor manages a standardized drug supply chain for the entire network); clinic networks are scaled to broaden access; and economies of scale are developed to make health care widely affordable. These are the three pillars of Universal Health Coverage (UHC), a UN development goal.
In order to continue operating their business under our franchise brand, franchisees adhere to diagnostic, treatment, and prescription guidelines, accounting and record-keeping practices, supply chain compliance, and other EQC standards. Each one is designed to ensure that every time a parent brings their child to a clinic, the treatment will be effective.
We rigorously streamline and coordinate the clinics’ practices to guarantee a quality experience. People in communities where we operate know that when they come to a CFW Clinic, they can expect affordable care that will actually work. This is highly valuable to health workers interested in opening their own businesses.
Our franchisees—almost all of whom are women—earn incomes that reflect their effort and expertise; they reinvest in their businesses, families, and communities; and become respected community leaders in places where ineffective, substandard health care was long the norm. Since their whole business rests on compliance with EQC standards established and enforced by the franchisor, each franchisee is heavily incentivized to maintain those standards and deliver EQC. Failing to do so means losing the ability to operate their business under our brand. Our franchise model provides business, technical, and financial support that franchisees require to operate their businesses in compliance with EQC standards.
Franchisees enjoy the benefits of owning a valuable, profit-making business, but may retain it only by compliance with CFW’s regulations. It is in everyone’s interest for franchisees to follow the regulations.
Healthstore’s CFW-branded franchise system produces extraordinary performance results.
In 2019, the most recent data available before Covid showed:
- Franchisees served 457,606 people
- The 158,514 served in clinics paid an average price of $4.50
- The 286,211 served in community health education and prevention activities were free of charge
- Our non-profit franchisor spent only $165,460 – $0.36 per person served – to provide support to franchisees
- The average clinic served 8,800 clients per year, or 733 clients per month
- When the total franchisee support cost of $165,460 is divided between the 54 franchisees the cost to support each franchisee is about $3,000 per year; or $250 per month, per franchisee