health is primary sector to develop country and create jobs -NB opportunties to expands productive working lives from under 20 years (eg modal life expectancy 30) to 45 years eg modal life expectancy 65 or over
in fact one way to define transition beyond an undeveloped country is one in which such health services are delivered to reach modal life expectancy of 60+
As John Mackey clarifies: one charscteristic of world record jobs creators is they celebrate highly meaningful purpose in the markets their skills relate most to.
bangladesh is benchmark example of 100+ million person country which as newly independent nation in 1971 was so poor that average life expectancy for over 80% living in rural areas was in low 30s; in part this average was due to over a quarter of infants dying of diarrhea before age of 5 and another 15+% being so malnourished that brain did not develop fully during first 1000 days. Health and then education were services that BRAC helped village women to build from next to no resources. For Keynsians, who had identified ending village poverty as the greatest problem , the ;life work and knowledge that sir fazle abed has shared makes him the deeper living innovator of human development.
Sir Fazle Abed innovated the greatest systems challenge of entrepreneurial revolution -namely blending the west's 4 main organisational constitutions so as to p[revent compound risks [reventining sustainabiloity of a networked world:
companies
charities
governments
professions
Instead of the worst of each model, he designed the best . So like a company he demanded organisational design with ;positive cashflows, but unlike a stockmarketed company the (contunuus improvement) goal was not profit extraction but investing in accelerating service of an unique purpose such as raising life expectancy through infant and maternal health care services empowered out of each village, Instead of top down government, his boltom-up networks innovated (technolgy etc) Preferential Option Poorest (POP!). And instead of believing the smartest professionals could sit in a cosy office, he valued professions who action learnt with the poorest in the field (the paulo freire ideology).
Sir Fazle innovation model involved microfranchises. Experiment small until you have a model that is effective, efficient and expandable - then scale big. BRAC's first massive scaling was oral rehydration - an infant health service solution which is all about a mothers knowhow - serve boiled water, sugar and salt solution in right proportions to save a baby from death by diarrhea. Seeing that BRAC could do this it became the preferred bottom-up partner for over a hundred microfranchises in the pre-digital age to 1996. Bangladeshi villages were also first in the world to experiment with partners in mobile leapfrogging. BRAC is one of the extremely few world leading microfranchisers to transform through age of pre-digital grassroots networking to the blended networks that have become universally mobilised digitally (Industrial Revolution 3 and 4)
When you are building a helth service from nothing, it becomes natural to segment health services around clusters of microfrabchsie solutions that can be served by a para-health professional who is prepared to live in a village (without electricity etc) instead of requiring fully qualified profesisonals for every sort of eg nursing service. Moreover the type of top class nurse used to eg electricity and clean running water isnt necessarily capable of functioning in a village environment. It turned out that hundreds of thousands of livelihoods could be franchises out to para village health workers as women started to develop rural Bangladesh.
Segmenting health services so that they reach the poorest is an opposite process top building a singl-centre city based health service. Aravind from India provides one of tghe clearest examples of why a microfranchsie needs every bit as much trail and error in developing a complete service routine as a McDinalds. The difference is the purpose is not to extract more and more money out of the community Aravind Eye Hospital
Unfortunately top--down aid really doesnt have the local design access needed to develop microfranchises. It thus fails to relentlessly build communities lout of [poverty and misses all sorts of valid local livelihhod and learning opportunities. No wonder Sir Fazle was celebrated as the wporld's first education laureate by WISE and that research published in his honor was called Learning for a Living.
Over 46 years BRAC has become the largest NGO and world favourite partner in any purposeful microfranchsie anchored to ending poverty and maximising female empwerment round life shaping services. Those who insist on seaparting development of finacial services from health and learning-connected-to markets designed round inclusiion of livelihoods for the poorest are not likely to have a passion for joib creation and certainly are not going to be able to end the most broken systems that trap people in extreme poverty.
In 2013, Ebola provided another chilling reminder of how basic health service is as a driver of economic growth. A lot had been spent on growing the economy of liberia but not enough on basic last mile health services. So not only did thousands of people die of Ebola but the economy was retarded many years because it had been grown with out sufficient health service foundations. And whilst most neighbouring countries spent heavily to prevent contagion reaching them it became clear that they were missing grassroots capacity which would have made protecting theirepopes from ebola much more economical.
In the 1990s solutions to combating Tubercoluosis developed by both BRAC and Parners in Health turned out to have many lessons. First the front line health servants for preventing infectious diseases are best recruited from those who survived the disease. Secoind it really deosnt make logical let alone moral sense to say that some infectious disease are poor peoples ones that cant afford to be served whereas others are diseases that impact the rich and are therefore medically economical to treat. Without the grounded networks of BRAC , Partners in Health, Medicines sans Frontieres, plagues might be the greatest risk to the hyperconnected net generation. This is not to say that we have anywhere near enough health service jobs distributed out of every community to be secure. The failure to date of extending basic health service knowhow to schools and teenage adolescent health curricula is still a big risk. But lets follow George Paton and the Lancets advise and quickly turn it into a peer to peer curriculum offering teenagers a lot more skills in health than 20th C schoolingt deemed necessary.
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