Sustainable Health Enterprise Foundation (SHEF): What Works

The Need for Health Services

Imagine that you needed urgent health care and the only way to get it was to walk to the nearest health facility more than an hour away. If that was not bad enough, what would happen if after you got there, the medication that you needed was not in stock? Imagine making the arduous walk hours back to your home in worse condition than you began.

Sounds impossible? Especially in the rural areas of Kenya, many people find themselves unable to access necessary health care, education and medication. Medical facilities are often hours away—the only way to get to them is on foot, and the facilities are often under-manned and under-stocked. Today, Kenya has a child mortality rate of 12.3 percent, many of them dying due to preventable and treatable causes. There is thus a dire need for a solution.

HealthStore Foundation

By making the infrastructure, manpower and medical supplies more accessible the Sustainable Health Enterprise Foundation (SHEF) (formerly called the Health Store Foundation) has made major strides to alleviate the existing health predicament in Kenya. HealthStore’s approach has now been assessed in detail through a “What Works” case study published by the US Agency for International Development and the World Resources Institute in November 2005. The approach offers valuable ideas and lessons for other countries in Africa suffering from similar health crisis.

The organization offers an opportunity for trained local health professionals (nurses and community health workers) to own and operate a SHEF Franchise in under-serviced communities. They operate like normal franchises with consistent branding, training, service and operating systems. They have meticulous quality control standards, sustained by regular inspections.

Apart from being strategically located within an hour’s walk of the communities that need them, they allow local doctors and nurses to sustain a steady income and contributes to stemming the tide of medical professionals leaving Kenya for more lucrative opportunities abroad.

The start-up cost is relatively low at USD$1,700 with 80 percent of that money being financed through the Sustainable Health Enterprise Foundation. SHEF supplies the franchise owners with all the supplies they need, allowing them to keep the cost of medication and other services down, while remaining competitive. The cost of medication is kept down due to the volume discounts that can be obtained by purchasing for the network as a whole as opposed to an individual outlet. Today, SHEF operates 64 outlets across Kenya, serving some 400,000 patients every year. The International Finance Corporation through the Grassroots Business Initiative, is supporting the further strengthening and scaling up of the microfranchise network to benefit a larger amount of the Kenyan population.

Read Full Case Study [pdf]

Learn more about how IFC works with the Sustainable Health Enterprise Foundation [pdf]