LifeNet International is a US based non-profit organization that has developed a primary care franchise for East Africa. LifeNet works with existing medical clinics owned by entrepreneurs and churches, providing its staff of nurses additional medical and business training, growth financing, and access to a dependable supply of quality pharmaceuticals. By collaborating with these clinics and converting them to franchisees, LN will significantly increase both the clinics’ daily patient count and the quality of patient care. The goal of the organization is to create a sustainable healthcare platform that significantly increases the quality of and access to care for underserved populations.
In this first part of a two-part series, Jonathan O’Connor, LifeNet’s Vice President & Country Director, shares with CHMI the impetus behind the LifeNet model and the key underpinnings of the franchise network.
Jonathan has lived in Burundi for a year and a half. He is responsible for overseeing LN’s Burundi operations and fundraising efforts. Prior to joining LN, Jonathan was an investment analyst with CNL Real Estate Advisors.
What need did you see in Burundi that LifeNet International is trying to address?
JO: Burundi ranks as the third poorest country in the world. In 2005, it emerged from a 12-year ethnic-based civil war that destroyed over 30% of national GDP. The vestiges of its war-torn past are most palpable in the health sector today.
The latest data record infant mortality at 101.3 per 1,000 live births; in the United States, the estimated infant mortality rate was 100 per 1,000 births in the year 1900. That data is difficult to even conceive. It’s likely I’ll live nearly 30 years longer than my Burundian friends who’s life expectancy is 50.43 years. Yet we can’t get lost in these stats, but must continually see the friends, family, and communities behind them.
The country’s roughly 200 doctors work mostly in the capital, Bujumbura, where about 10% of the 8.5 million population lives. Most Burundians receive primary care by a nurse with secondary school education plus two years of training. Often these nurses diagnose and prescribe without the supervision of a doctor. We sought to work within the realities of healthcare here by seeking out existing clinics and offering to bring education to them, to their clinic, through our franchise systems and in-clinic trainings.
How did you select the participating clinics? What were some of the specific things you looked for in a perspective franchise?
JO: Prior to joining as a franchisee, clinics undergo a 4-6 week assessment period. It gives us time to know each other and determine whether partnership makes sense. Through a series of interviews, site visits, and basic data collection we seek to understand the clinic’s operational and functional challenges and also learn what they’re doing really well. It’s a co-learning process.
We focus a lot on the clinic operator or entrepreneur; they play a key role. We look for operators who are running sustainable clinics prior to LN’s involvement but who face a challenge they can’t solve alone. By running a sustainable clinic, they’ve already self-selected as a competent leader, which reduces a lot of risk on our end. Secondly, we’ve had particular success with church-owned clinics. They serve a vital role in the private health sector here and have good management depth. Church clinics generally prioritize social good first but also aim to run a sustainable organization. Most churches use clinic profits to subsidize care for the poorest patients or fund other social programs for the community. That’s a real win for us.
What are some of the benefits of franchise membership?
JO: Each clinic benefits differently from our franchise. We’ve designed our franchise around core components of clinic operations: nurse training, business coaching, pharmaceutical supply, and growth financing. During the assessment period we try to understand each clinic’s biggest challenges and start there. For some, it may be business coaching and receiving one-to-one advice with our staff. For others, it may be a loan to expand their facilities. Over time, each partner will implement the full franchise of on-going nurse education, business tools, marketing, and pharmaceutical supply (the loans are optional). We’ve tried to create a franchise that addresses the unique challenges of each clinic, while using a standardized format that can serve the needs of a great many clinics at once.
In the long run, the LN brand will be particularly valuable to all our partners. As the LN brand becomes associated with affordable and quality care the clinics will benefit from patient recognition. The brand also gives us positive leverage as the franchisor to uphold the highest standards of care in a way that benefits the network as a whole.
Stay tuned for part 2 of this blog series for a look into LifeNet’s supply chain enhancements, growth financing strategy, and early successes.