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Innovative practice

Live Well social enterprise model builds and supports local distributor networks in Zambia

Aim:

Improve affordability and supply, by addressing constraints in local supply chains linked to the high cost of borrowing.

Model:

Network of local outlets for health products run by community members; financial assistance (lower interest rates on bank loans) for these and their upstream wholesalers, provided savings are shared with purchasers.

Partners:

Barclays, a UK-based multinational investment bank and financial services company.

Scale-up:

To 20 communities in Zambia, from four in 2016.

In 2015, GSK and Barclays, together with other partners, began to pilot their Live Well initiative across four sites in Zambia. Run by GSK and local partners, Live Well raises awareness of health issues, increases access to products that benefit health, and provides local people with opportunities to earn income and gain skills. Now scaled up, it aims to reach a million people in Zambia.

The initiative acknowledges that, in Zambia, the health system depends on thousands of community volunteers to plug the gaps. Live Well recruits and trains “community health entrepreneurs” (CHEs) who become last-mile distribution agents, promoting healthcare and selling products in underserved rural and semi-rural communities. They sell oral health, pain control, contraceptive and other health-related products, together with goods such as cooking stoves.

In Zambia, GSK's Live Well equips community health entrepreneurs to provide last-mile access. ©Marshall Foster

How does Live Well work?
Each CHE receives training in business, financial management, basic healthcare and product knowledge, equipping them to educate and inform communities they visit. Each one earns a small profit margin on sales. Overall, the initiative aims to strengthen Zambia’s health system. In places where unemployment is often high, it offers workers a way to generate income, and aims to motivate them to help improve the health of others. 

Live Well also tackles constraints in the supply chain that stem from high borrowing costs. Previously, wholesalers and distributors took out bank loans and passed on costs to customers and patients. With Barclays and other stakeholders, GSK set up affordable financing arrangements for wholesalers and distributors who share savings with patients. This led to the creation of a private supply chain, incorporating a network of social enterprise health outlets run by individuals from communities to provide access to healthcare. Such outlets also provide jobs, helping to increase economic prosperity.

The Live Well partnership was designed to align with the Zambian government’s national health plan. With a business model based on “shared value”, it involves: contributing to local economic prosperity, creating new sources of revenue for companies, and selling health products. GSK, in turn, benefits from selling products through health outlets and reaching new markets and customers.

How has this business model been scaled up?
By the end of 2016, GSK and Barclays have invested GBP 7 million in providing Live Well with financial support and on-the-ground resources over a 3-year period. Live Well now reaches 45,000 people each month. Since 2016, the initiative has trained a further 385 CHEs, bringing the total number to 432. It is reported that the initiative has helped distribute more than 200,000 health products to around 660,000 people since its inception. The number of communities served has also grown from the initial 4 pilot sites to 20 in the last two years.

The consulting firm Accenture conducted an impact assessment for Live Well. Preliminary analysis shows that, overall, CHEs generate at least 10% of their household income through Live Well activities. In a survey undertaken by Live Well in March 2018, 24% of 70 CHEs interviewed said they generated more than USD 70 per month through Live Well activities.


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