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Shahid Yusaf describes his project as “the McDonald’s for health care service – but without the supersize.” Yusaf is president of FINCON services, an organization in Pakistan dedicated to improving the country’s health care system. FINCON, which received a grant from the Saving Lives at Birth partnership, hopes to borrow the successful franchise business model used by companies like McDonald’s and apply it to the field of health care.

FINCON’s bold idea was catalyzed by the recognition of two critical barriers preventing pregnant women in Pakistan from receiving adequate care at the time of birth. First, health care facilities in remote areas of the country are few and far between. The costs (often over 500 USD) incurred traveling to a main hospital and receiving treatment are too high for many women to afford. While this problem could potentially be mitigated by the presence of midwives in rural areas, a second critical barrier remains: trained midwives lack the financial capital and business-management support to set up practices in these areas, despite the demand for their skills. FINCON’s project seeks to tackle both of these issues.

Mujtaba Hussain, the project manager at FINCON, believes a franchise business model, supported by a microcredit loans program, can encourage community midwives to set up practices in remote regions of Pakistan. FINCON’s business management experts will guide the midwives to become entrepreneurs and set up local health centers in rural areas where there is a demand for community health workers. An associated microcredit program will lend the midwives 1000 USD to cover initial start-up costs for these facilities. Hussain hopes this franchise model will eventually become self-sustaining, reducing the need to rely on continuous donor funding.

Recognizing that simply setting up a practice is not enough to ensure that pregnant women receive adequate health services, FINCON is developing an additional tool to help midwives provide a higher quality of care and reduce the need for women to travel to city hospitals. “We will provide the midwives with a mobile application through which they can enter patient data,” explains Hussain, “and a clinical decision support system will in return give them a response as to whether this case is normal, serious, or an emergency” (green, yellow, or red). If the screen is green, the midwife can proceed normally. Conversely, a red screen will alert the midwife to an emergency situation and a GPS system incorporated into the application will direct an ambulance to the patient; this is crucial as it is often difficult to locate a physical address in remote communities. Finally, a yellow screen connects the midwife to a medical expert at a referral center. Specialists at these centers can view the patient data through a web interface and make a diagnosis remotely, advising the midwife on what procedures to follow. This system reduces diagnostic time and often removes the need for the woman to travel to a city hospital. Moreover, in the rare cases where a woman does need to visit a hospital, the midwife can electronically transfer the woman’s medical history and profile, reducing the need for lengthy and costly preliminary tests.

According to Hussain, one of the greatest advantages of FINCON’s mobile application is its interoperability. “Funding a separate system like this for every developing country would be far too expensive, but this product can be deployed anywhere in the world.” The system can be adapted for any situation in which there is a lack of physical presence of doctors.

FINCON aims to have the product software developed by July, 2012. At that time, a team of fifteen community midwives will test the functioning of the application. Based on feedback from these midwives, FINCON will then refine the software before distributing the technology on a wider scale.

“Technology can play a vital role in global health,” says Hussain, “especially in areas where people are not able to pay much for their health care services.” By reducing diagnostic time, facilitating immediate access to medical specialists, and encouraging midwives to set up practices in remote areas, FINCON’s project will undoubtedly save and improve the lives of pregnant woman around Pakistan, and eventually across the developing world.

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− Kaitlyn Shannon (@KaitShannon)