''As researchers, we also get out there ourselves.''
Maarten Kok
Researcher
Giving Africans access to medical care and prevention programs: that is the goal of Research for Health Impact in Africa. The research, funded by the D.P. Hoijer Fund, a named fund within the Erasmus University Rotterdam Fund, consists of five major projects.
One of these is 'Healthy Entrepreneurs', coordinated by Maarten Kok, researcher at Erasmus School of Health Policy & Management. Of the approximately twelve countries where Kok works, the project is most advanced in Uganda.
Disastrous medical situation
Kok: "In rural Uganda, the medical situation is dire. First of all, there are far too few doctors, barely four percent of what the WHO standard prescribes. Patients have to travel long distances for a diagnosis and then go elsewhere to get medication. These medicines are often unaffordable and of poor quality. To improve this situation, we are developing interventions and monitoring their effect. Together with an expert in development work, I looked into the possibility of purchasing medicines on a large scale. This proved to be far too expensive, partly due to corruption in the medicine market. We had to come up with something else."
Healthy entrepreneurs
One of Kok's guiding principles is that his work should strengthen local capacity. In other words, the population should not only benefit from a project, but also be involved in it. After various experiments, a good formula was found. Kok: "To bring basic healthcare to the rural population, we focused on community health workers, volunteers who already had minimal knowledge of healthcare. We trained some of them—mainly women who already had children—to become independent health workers, or 'healthy entrepreneurs'. They took out a loan of forty dollars to buy a starter kit of health products. With this mini-pharmacy, they travel around the villages with reliable medicines for malaria and diarrhea, among other things, but also antibiotics, zinc, contraceptives, and toothpaste. In addition, these micro-entrepreneurs provide information via videos on a tablet and can refer people to clinics. So they make medicines available in remote villages, but also pass on their knowledge. Research shows that this is an effective strategy for improving healthcare.
There are now more than 7,500 healthy entrepreneurs, 3,500 of whom are in Uganda. These are small business owners with their own businesses. Kok: "This gives people a sense of dignity; they earn their own money. On average, around 25 products are sold each week. We also stay in touch every month. We discuss the health of the population and the medication that is needed. As researchers, we also go out into the field ourselves. We hire motorbikes and vans to administer questionnaires to thousands of villagers."