Norman Macrae -The Economist pro-youth economist -bravo sir fazle abed & jack ma
It was critical for brac to choose which goal area (2 end hunger, 3 health, 4 youth education, 5 gender equality, 6 water/sanitation) to scale first across the rural nation from the bank of solutions it had developed during 7 years of living and learning in around one rural lab. Infant health was chosen because what could be better than saving a quarter of infants lives with a solution requiring maternal learning but no more cost than oral rehydration's mixing of boiled water, sugar and salts. There were also huge cultural impacts by choosing OR as brac's first nationwide donor solution and para health netwiokers as its first 200000 microlan-microfranchise
Nationwide oral rehdration training of iliteratye vilage motehrs would nebver have hapened sucessfully without btrac's ability to test and test concept before rilling it out. The first test failed because it tirnjed out that trainers did not believe in the soluition of water sugar and salts as much as a medicine when it came to their own chikdren
The sceiond concveot tyest failed because village mothers didnt want to risk applying somethin gh new in such a critical area as their inafnant life withlout the approval of their husbands. Magically this same concern became a huge forward in gender eqaility once oral rehydration was saving lives everywhere thanks to the mothers applying it.
In thise days UNICEF was run bt=y an entrepreneurial type James Grant. ONce he saw oral rehydration workingh he wanted to fund tgeh training everywhere- indeed he became a global ambassadoir for oral rehydation. When he had dinner with leaders of developing nations he would pull out a scahet of OR mix from his poclkect and demonstarte mixing this and drinking it. Oral rehydration chnaged life expectancies and the number of babies vilage men demanded their wives greed- increasing the motgers health and quality time to work. If you think any single viral learning has changed women empowerment as much as oiral rehydration then we would love to hear of it. On the bavck of the demand that volage mothers know how to be the fkirst responders to their infants brac built the para-health franchise whereby 200000 women served vilages with 10 simplest solution for maternal and infant health. It has been estimated it took 100 doalrs to train these vilage worklers and get them sgtarted with an income b=generationg franchise in the village. You could say that a 20 million dolar loan started the building of the whole rural nation's health secroive as well as establioehed microfinace and microfrachises as the integral dynamics of social busiens economics replacing conventioan aid and charities.
Over time BRAC has become a cebtre iof gravity for other last mile health solutions. I=With some infectious disaes (eg tiubeculosis) the most efficient helath servent is omeone who has had the dissease and survived. Ith other solutuons- eg ending unnnescarily blindness with caract surgery, the aravind model works by bussing inj rural patients. In oter words the parahelth networker can arracnge for the viklager to join the next tour to end blindness. Aravind is a supernly exceuited social vfranchise.
It has brough down the cost by an oder of magnitude. It maximises how many ioperations a syrgeon can do by making sure that vikage girls gtrained only in ebore and after patuent habnndling if eyecare serve every element iof teh custimer expoerience aoprat from the direct operation
You can look through economisthealth.com for many of her favorite chnage the worlkd ehalth servants kincluding paul farmer and for a quarter of a centiry Jim Kim of parrtebrs in health. While pih ofeer a brilaint stident exchnage model from harvrad to places in desperate need of ehalth seruve like hsiti and peru, it has never scaled a micrifranchiose like brac's . This means it has to spend a huge amount of leadership time fundraising. Now it is true that poih mission involeves building a show case tarining hospital in each contient - so far out of haiti and out of rwanda. IUts offereing some levels of services to tose within the hospitals catchment area that brca never can. And it is trying to get national keaders to decide they need tgeoir own training hospoi=ital with focuse on serving poorest rural . But without the brac tyope of microface model its unlcelr how poorest natiosn can ever build their ehalth sercices to ensure the pooorest are incluided.