Today was the day. The day we turned a project into a profitable enterprise. The day we turned models into managed business. The day we may have finally cured our pilotitis.
Yesterday, we went on a day trip to Nairobi to collect last minute things for today’s meeting, so that we would be completely ready for the changes that we were to make. We found a wholesaler for BP machines, bought ourselves some weighing scales from Nakkumatt, and by chance found a place with affordable backpacks and white coats. We had decided that our final business model change should come with a fresh start, both financially and with the physical devices. We were probably the most efficient we have been thus far, waking up at 7:30 am and then getting into and out of Nairobi within 3 hours (including a lunch stop!).
We had set up a noon-time meeting with all 6 of our MKOs – now called Mashavu Health Workers (MHWs). We also included Bernard, a manager at the CYEC who has worked with Mashavu before in various ways. He had agreed to provide the on-the-ground supply chain management necessary for our new plan, and was the first contact that the MHWs should have for questions and concerns.
Steve and I were terrified to have this meeting announcing the changes. We love the women that work for us. We know their families, have been to their houses, had countless cups of chai, and have watched them develop into tech-savvy Community Health Workers over the past two years. However, business is business. We had to tell them we were no longer able to provide them with free stuff, and they had to pay us more money. With Feb 1 looming, we knew we couldn’t procrastinate any longer. The first of a month is the perfect day to start so that due dates of monthly payments are not confusing.
One big change is that we switched to wrist blood pressure cuffs. This will allow the women to save money on batteries (they require 2 AAAs as compared to 4 AAs) and also will allow them to measure overweight patients. Before the meeting, we were still horrified. Turns out the women were also nervous. Steve had sent a text to them to confirm the meeting time that was mildly cryptic as it said to meet at the Center at noon and bring all Mashavu items with them. When the ladies came in and saw Steve wearing a suit (they had never even seen him in closed toe shoes) they knew something was up.
The MHWs receive all new backpacks, wrist BP machines, weighing scales, and receipt books. The MHWs will work largely in Nyeri town, but also in Karatina, the villages, and anywhere else they find themselves able to. They currently charge customers for BMI and BP. At the 1st of each month (starting with the 1st of March), they will deposit a set amount of money (more than they had previously been depositing) into the Mashavu bank account. They keep all remaining profits. When their receipt booklets are filled out (each receipt book holds 150 patients), they will go to Gatitu Dispensary to drop off their filled out booklet and pick up an empty one. Each month, Bernard will check the bank account to make sure that each MHW has paid. He will also withdraw money in order to purchase new receipt books, then take those books to the Gatitu dispensary for pickup by the MHWs.
After waiting for all MHWs to arrive, we nervously began the meeting. We discussed the importance of making Mashavu permanent, and how changes needed to be made to ensure its sustainability. We proposed our plan, then let them discuss as we waited outside the meeting room. The minutes past as we nervously waited. We knew that this change was necessary, and was the actualization of the ‘economic sustainability’, ‘local-driven’, theory that we frequently discuss as vital for the success of any venture. We could no longer subsidize devices, piece-meal our purchasing, or provide freebies for the sake of personal relationships. We needed to establish a business that could be pitched, sold, and scaled in other parts of the country, region, and world.
We returned to an understanding, although slightly unhappy group. We were happy to see that they too were treating this seriously, as rather than complain or protest, they provided a counter-offer. After further discussion and addressing some of their concerns, we came to an agreement that everyone seemed to find appropriate.
Wow. It had just happened. The negotiating was over. Smooth rolling from there on out. The only thing left to do was Oprah-style give out OUR FAVORITE THINGS!!! It just so happens our favorite things are wrist-BP machines, weighing scales, and backpacks. How incredibly convenient for Mashavu.
I went through teaching them how to use the wrist BP machines, we took pictures, and everyone seemed good to go. We then sent them on their way with their new things, new outlook, and new Mashavu sustainable business plan.
We as Mashavu have several things to do on our end, including gaining permissions in new towns, planning marketing schemes etc, but we are extremely excited about this new model. Big things to come soon!