Live Well, a CARE Social Business
As Managing Director of Live Well, a health social enterprise in Zambia, Alexandra Burrough is filling a critical need for a visionary leader with business acumen to carry and further ignite the torch of harnessing the market economy in last mile villages. A British national, Alex has lived and worked in Zambia for 10 years having come as a volunteer. Her experience includes serving as Operations Manager for SunnyMoney, a social enterprise focused on lighting up homes across Zambia selling over 300,000 lights. Working for Article 25 (London) helping to secure funding for disaster hit areas around the world to build better. As a VSO in Zambia, Alex experienced the immense barriers to accessing basic goods and services faced by Zambians and committed her life to breaking those barriers. At Zambia Open Community Schools (ZOCS), she fundraised $2.5 million, to support community schools throughout Zambia.
Community Health Workers (CHW) are one of the only options that communities have at the last mile to be able to access help, advice and support. However these CHWs are all volunteers, by training to be a Community Health Entrepreneur not only are they improving there economic status but giving communities access to much needed basic health products. There are over 60,000 CHWs working within last mile communities across Zambia. Through Live Well’s model training methodologies we can enhance and stabilize the access to health products in rural Zambia by incentivizing CHE, increasing their retention rates and accountability and systematizing the support for the expanding network of CHEs in a cost-effective way. By giving access to health products we are elevating humanity.
Access to quality healthcare is a fundamental human right and a critical development issue. In Zambia the average life expectancy is 59 years and many Zambians suffer from easily treatable or preventable health conditions. The country is well below global averages for health and income. Around 75% of the population lives on less than USD $1.25 per day and almost 50% of children under the age of 5 are stunted due to malnutrition, poor maternal health, and infections. Many Zambians are inadequately served or outside a health system that grapples with a physician to patient ratio of 0.2 per 1,000, limited infrastructure, and a vast landmass.
Although the Government (GRZ) provides free health services and products, stock-outs and long distances from rural areas—where over half (64.1%) of the population lives—mean that the most vulnerable households still lack access to basic healthcare. Getting to clinics is difficult and costly for families who must sacrifice a day’s income to make the trip. People therefore rely heavily on the 60,000 volunteer CHWs who provide much needed health products to rural households and last mile.
However, these CHWs are not paid for there vital work. This is where Live Well is able to help.
Live Well is a health social enterprise in Zambia which strengthens access to health products by developing and training a network of Community Health Entrepreneurs (CHEs) who purchase consumer health products from Live Well and resell to their communities. Live Well works with public and private partners to strengthen the healthcare system by providing ongoing training, close supervision, and income generating opportunities. Through Live Well CHEs remain motivated, active and high performing. This increases access to affordable health products and improves healthcare awareness amongst rural areas and last mile communities.
CHEs are trained in business skills, financial management, entrepreneurship, and basic health care and product knowledge so that they can sell health products including soap, toothpaste, painkillers and condoms. They also provide health information in their communities to help support behavioral change. CHEs are generating at least 10% of their household income through Live Well activities which is significant for households where diversified income is the norm. The CHE can spend this income on school fees, hospital fees and/or nutrition options to improve the quality of life for family. Live Well believes in empowerment as opposed to handouts as being the best way to lift people out of poverty.
Live Well targets rural areas where the proportion of persons who report illness is nearly twice that of urban areas. While Live Well specifically targets women and children, the entire family and community benefit from products sold by the CHEs that are not normally available. For example, access to fortified porridge is critical in Zambia where thousands of men, women, and children suffer from one of more forms of malnutrition and only 11% of children 6 – 23 months are fed appropriately. Through the sale of chlorine water purification solution and baby delivery kits, Live Well has been able to improve sanitation, avert malnutrition and stunted growth, and improve hygiene for birthing mothers. Poor sanitation is a major source of public health problems and epidemics in Zambia. Live Well is able to help contribute to a reduction in people having to visit clinics by giving them access to health products. Which in turn leads to a saving for the MoH.
Live Well benefits the CHWs by changing the status quo (training them to become CHEs) and providing them a sustainable income for providing these health services.
- Elevating opportunities for all people, especially those who are traditionally left behind
Live Well elevates opportunities for all people by supporting marginalized Community Health Workers/Volunteers to become Community Health Entrepreneurs and earn income and return for the investment of their time and effort. With half of Zambia’s population in rural locations they are effectively left behind by the traditional health system. A cadre of motivated CHEs are reaching that population and in turn elevating the health of a previously undeserved population.
Live Well was born out of a project under CARE International where health products where being give out for free to Community Health Workers (CHW) who, at the time, had very limited training on the products. It was realized that with a bit of training these CHWs could become entrepreneurs buying and selling the products which would give them a livelihood and supply critical health products to the last mile. Live Well was formerly registered in Aug 2016.
Since joining Live Well I have been able carry on the vision and the mission and been able to train over 800 CHEs, cut the costs not only to train the CHEs but also the running costs to make sure that Live Well is a viable business through creating a solid business plan which will mean that Live Well is financially independent in the next 5 years. I have also made sure that the product basket is relevant and what the CHEs need in order to be able to make a living out of selling basic health goods through maintaining good relationships with supplier.
I got a taste for living and working in the Southern Africa region when I was 18 living in a small thatched 1 room house for year and it’s there that I realized that women and children can be an afterthought when it comes to education and health. Having realize this I went on to learn how to fundraise and manage projects. I soon realized I had to be back on the ground in Southern Africa and that is what lead me back to the region 10 years ago with all the skills needed to be able to manage projects and social business.
Live Well is close to my heart as an organization, we don’t only empower CHEs but because I am a mother, it’s about being able to get basic health needs to mothers in communities. Clean baby delivery kits is one of our best selling products and I am inspired everyday knowing that we are able support the reduction in infections when women are giving birth. Raising my daughter in Zambia its important to be able to make sure that every woman and child is able to access health products like my daughter and I are able to.
I have over 10 years of experience of living and working in Zambia with 8 years of that running social enterprises. I thoroughly enjoy being able to run an innovative and sustainable program which allows me to give back even more. I like knowing that every dollar we spend and invest into it generates the ability capacity to train more CHEs and deliver more health products to the last mile. My career to date has enable me to learn and acquire different skills that you need to run a social business which include a business mind with a calm approach to any situation. Working for 10 years in Zambia has also allowed me to be able to connect with people at all levels from community members, refugees, CEOs of big businesses and government officials this is key to being able to run a successful social business.
MORE
The greatest challenge that comes with running Live Well is managing the demand for our services and the lack of budget to be able to train CHEs. Having to let staff go because Live Well had to make cuts earlier this year was one of the hardest things I have faced as a CEO, especially because it was simply due to a lack of funds, not because the staff members had done a bad job.
The challenge of becoming financially sustainable and to break even is something that I battle with every day. To find the balance of making sure that Live Well becomes a successful social business with a very limited cash flow is hard. Its important to make key decisions and not have regrets about them and acknowledge and apologize when your wrong. I have also learnt that I am only as good as my team around me so its key to listen and learn from what my colleagues have experienced not only in the field at a sales level but in the office. I have also learnt to appreciate and accept my Board of directors who all have there own ideas on the direction of Live Well.
At Live Well I am not only the CEO but also sales person, procurement and even driver. I make sure that I am able to do all of the roles that I need in my team as if I cannot do the roles then how can i expect anyone in my team to. I have learnt in Zambia that is important to 'get your hands dirty' and work as a team. This was best shown when I drove over 14 hours to a particular area in Zambia where we are working in a refugee settlement. Live Well had been tasked by UNHCR to make sure that training was completed and stock was in place for the newly trained CHEs to be able to start distributing in the settlement, due to lack of staff at the time, it fell to me to make sure that the team got there and we did not face disappointing UNHCR. Once there I helped to organize the training in make shift areas, liaise with the staff on the ground and use my basic french to even help with the training.
- Other, including part of a larger organization (please explain below)
Live Well is owned by CARE International US but is fully registered as a business in Zambia.