Entrepreneurial Community Health Promoter Model
RCTReview
Standard volunteer community health workers frequently experience limited incentives and high turnover, leading to low service delivery coverage in low-income regions with high under-five child mortality.
Picture this
Instead of relying strictly on unpaid volunteers to deliver medical advice, health workers operate like door-to-door micro-entrepreneurs. They generate personal revenue by selling essential health commodities at discounted rates while earning small financial bonuses for key health checkups, turning health promotion into a sustainable small business.
What the evidence says
Under-five child mortality decreased by 27% (48.5 vs. 68.4 deaths per 1,000 births), infant mortality decreased by 33% (32.4 vs. 49.7 per 1,000), and neonatal mortality fell by 28% (24.1 vs. 33.4 per 1,000) at an average cost of $65 per year of life saved.
- Who was studied
- 214 rural villages (115 treatment, 99 comparison) involving ~7,000 households and >11,000 children in Uganda.
- How
- Randomized Controlled Trial (RCT) evaluated three years post-implementation using household surveys and Poisson rate ratio empirical models.
What to do
Recruit local health promoters through competitive selection, provide two weeks of combined medical education and micro-business training, and supply health products wholesale at 30% below market rates.
From the source
"Child mortality dropped by 27 percent in CHP villages relative to the comparison group. Similarly, infant mortality fell by 33 percent and neonatal mortality decreased by 28 percent."
in-the-business-of-saving-lives.pdf