1. Concept  Begin with a medical office staffed by a physician that acts as a “hub” for a networked ring of health services.  The hub supports and is surrounded by a series of “microclinics” operated by nurse- entrepreneurs, who refer more difficult cases to the physician and receive inventory from the hub.  Each nurse-run health clinic is in turn encircled by mobile salespeople who offer over-the-counter products that promote health and hygiene, such as insecticide-treated bed nets, oral rehydration salts, and sanitary pads.  At each level, franchising principles are employed to ensure quality, consistency, benefits of scale, and drive profits to every member of the value chain, from the doctor to the village seller.  Market-driven approach relies on two forms of payment: out-of-pocket from individuals and reimbursement from govt insurance plan.  Extend credit to nurses to join franchise and build MicroClinic, to be repaid over time.  “Avon Lady” village sellers, men on motorbikes. Leadership  Kojo (Ben) Taylor is a Ghanaian who moved to Minneapolis and started a franchise business offering online training. He sold the successful company and launched MicroClinic, funding the nonprofit with part of the sale’s proceeds. Mission  To dramatically improve the quality and access to healthcare for the poor in Africa. MicroClinic Analysis  This is one of our 4 key investments in the field of health franchising. Very similar to HealthStore, but the key difference is that MicroClinic combines the physical health clinic with the mobile salesperson on the street and on the motorbike. As such, it is seeking to tackle the entire health pyramid below the urban hospital -- an ambitious and more perilous undertaking that could open affordable healthcare to the poor.  Taylor is taking a two-track path to growth, launching simultaneously in Ghana and soon in Uganda. He has partners who have connections and a passion for establishing a parallel organization in Uganda.  The weakness in Taylor’s plan is the high capital cost ($22k+) to build new structures for the MicroClinics, which may increase the debt burden beyond the capacity and risk appetite of potential franchisees.  Average yearly sales of $11,245 per MicroClinic store, with a franchisee gross margin of 45% and 6,500 patient visits per year.  Nurse-entrepreneurs operating MicroClinic outlets would earn an annual income of $5,138 before debt and interest for capital costs. Progress  MicroClinic opened its first hub in Ghana in summer ‘08. DWFF contact: Josh Kwan, Director of International Giving. joshkwan.dwff@gmail.comjoshkwan.dwff@gmail.com Updated: 9/08. Site visit: n/a. www.microclinics.comwww.microclinics.com 1 World Health Organization, 2 USAID Plan for Scale 200820092010201120122013 New MicroClinics32075100150200 Total MicroClinics32398198348548 Revenue at MicroClinic stores (franchisees) $16.9k$146k$680k$1.66M$3.07M$5.04M Revenue to MicroClinic (franchisor organization) $13k$98k$401k$734k$1.25M$1.92M Operating costs($214k)($373k)($500k)($654k)($762k)($1.0M) Capital spending, inventory($37k)($506k)($1.9M)($2.6M)($3.9M)($5.2M) US costs($77k)($82k)($109k)($130k)($140k)($158k) Profit / Loss (funding need) ($315k)($746k)($2.0M)($2.4M)($3.3M)($4.2M) Problem  Many of the diseases of the world’s poor are easily treatable. But partly due to a lack of knowledge and access to basic health products, each year 1 million people die of malaria 1 and 2 million from diarrhea-related causes 2. Status: Approved May 2008 Since: new MicroClinic: (nurse) mobile sellers (villagers) Model Hub (doctor) MicroClinic (nurse) mobile sellers (villagers) mobile sellers (villagers) mobile sellers (villagers) MicroClinic: (nurse) MicroClinic: (nurse)