Hamidou Jawara is a lecturer at the University of The Gambia and a research associate of the Center for Policy Research and Strategic Studies in The Gambia. His research interest is in the area of financial inclusion, development economics, and impact assessment and evaluation. In the past few years, he has worked as a consultant for several organizations including the World Bank, International Trade Center, International Organization for Migration, as well as ministries in the Gambia. Hamidou is a Research Fellow at the EIB-GDN program in Applied Development Finance, during which he studied the medical network, NEST.
Q. Why is the health of mothers and babies in Senegal receiving more importance?
In Senegal, the rate of maternal and neonatal mortality is still above the SDG targets. In order to improve such health outcomes, the government of Senegal launched a new National Health and Social Development Plan in 2018. The new plan put particular emphasis on the need to improve the quality of healthcare for women and children.
Q. Which particular gap or gaps is NEST addressing?
NEST is a medical network that was set up in 2012 to offer private sector solutions for quality MCH care access in Senegal. Realizing that the middle class finds the costs of the private health care services too high (e.g., delivery care in private hospitals costs about USD800) and the quality of the public health care services too low, the company initially chose to target the middle-class population. In so doing, NEST aims to fill the gap between private clinics and hospitals. The company has since been working to replicate the Lifespring Hospital model from Hyderabad, India in Senegal, by creating a chain of small-size clinics with the aim of providing standard maternal and paediatric childcare services at a low cost. NEST mainly targets middle-class and poor families.
Q. What were the main findings of your study, and what are their implications?
In our study, we focus on the midwife package offered by NEST, which is a maternal care service that is led by a midwife rather than a gynecologist. The adoption of this package is hampered by the negative perception about midwives in Senegal. In this study, we used an experiment to evaluate whether the provision of information via innovative means, such as the use of short stories, can change willingness to pay (WTP) and willingness to use (WTU) the package more than just the provision of basic information. Based on the interest of the company, we also studied the profile of the existing clients of the company.
Our key finding from the study of the profile of the client is that NEST is reaching out to mainly middle-class with four percent of their clients below the extreme poverty line. Furthermore, NEST services are accessible to women without health insurance coverage (42% of respondents), including women working in the informal sector. From the experiment, we find that providing information via short stories raises WTP and WTU more effectively than providing basic information. Hence, using short stories to disseminate information about the package could be a cost-effective way for NEST to promote midwife-led care services.
Q. Can you describe the support you received from GDN in completing this study – what was most usable?
This study was financed by the EIB as part of the EIB-GDN fellowship program. The design of the fellowship program is well done: the fellowship is such that it provides young researchers, like me, access to much needed career development tools, such as in-depth technical training, mentorship, and networking. In fact, I was able to meet eminent scholars in my field, as well very young and promising scholars from the African continent and beyond, and share my ideas with them.This experience from the program is just amazing.
Q. Would you recommend that small businesses conduct impact assessments on a regular basis? Why?
I think it is important for small businesses to conduct rigorous assessments of their inventions regularly. Small businesses, especially those investing in social services such as education, health and sanitation, have the potential for great social impact. Hence, understanding to what extent their inventions can yield desirable outcomes is crucial. They can also test various ways in which to design their products, expand their business, and experiment with different ideas, while at the same time learning what works best in their context. Together, this will enable them to maximize their impact on society.
Find out more
In correspondence with Madhuri Dass Woudenberg, Head of Communications at the Global Development Network in November 2020.