Easing birth of midwives as entrepreneurs
Sunday, Nov. 03, 2002
http://www.inq7money.net/features/view_features.php?yyyy=2002&mon=11&dd=03&file=3

ABOUT a decade ago, Purita Dantes, now 34 years old, had to keep two jobs at the same time -- as an assistant to physicians at a maternity lying-in clinic and at a Novaliches hospital -- only to earn a measly 2,000 pesos at the end of the month.

Although her income was not enough to take care of the daily needs of her family, Purita, or Rita to close friends and patients, thought that she was still lucky. After all, it is a rare feat for somebody like her who had just finished her Midwifery course at Lantin College in Sangandaan, Quezon City, and passed the midwives board examinations to be, at least, doubly employed.

Now comfortable and secure in life, Rita, a young mother of two, earns a minimum monthly gross income of 60,000 pesos as one of the midwife-entrepreneurs of the Well-Family Midwife Clinics.

Her story is just one of the many success stories of the birth of midwives as entrepreneurs in the Philippines.

"All I wanted was to have a decent salary and to practice what I've learned in school. I also aspired to do community work, so when the Quezon City Hall accepted midwives to do rural help, I applied," Rita says.

Fact is midwives are probably the least recognized in the hierarchy of the health care provider chain. Nowadays, they don't get the chance to practice what they have learned in school because more often than not, they end up as mere assistants to physicians, or if they are fortunate enough, they get to volunteer or be accepted as contractual employees.

Seeking greener pastures elsewhere, usually as caregivers abroad, is a common path some of them usually take.

But Rita had something more important in mind. She knew she did not have to leave her family just to provide their basic needs. She believed her time will soon come, and all she had to do was practice her profession with a passion while praying and waiting for that big break.

Rita's big break came in the form of Well-Family Midwife Clinic (WFMC).

"I gave it (WFMC) a try because it was my dream to have a clinic I could call my own. Before that dream was really impossible because I knew I had nothing and no one to financially support me. But then during the WFMC seminar, I've learned we would be receiving backup support from NGOs, so I was not afraid anymore," adds Rita.

The WFMC is the product of the creative concept conceived in 1997 by JSI Research and Training Institute Inc., a Boston-based nongovernment organization specializing in technical assistance to public health programs, and the United States Agency for International Development (USAID).

Project Tango
Under Project Tango (Technical Assistance for the Conduct of Integrated Family Planning and Maternal Health Services by Philippine Nongovernment Organizations), JSI and USAID launched a program that will make health services more accessible and affordable to middle and lower-income groups. In partnership with eight NGOs, Project TANGO started the establishment of a network of midwife-owned and operated clinics that provide quality and affordable FP/MCH services in key urban areas and selected municipalities of the country.

"Tango project aims to build a network of franchise-type service delivery facilities consistent with the theme of entrepreneurship, ownership and empowerment combining business and social development concepts. This objective is realized through the WFMC," says Easter Dasmarinas, resident advisor of JSI.

The WFMC is the concrete end product of numerous trainings and seminars on FP/MCH services and business development a midwife like Rita went through.

Like the standard WFMC all over the country, Rita's own WFMC provides FP/MCH services, checkups, counseling on contraceptives, pregnancy tests, minor gynecological services such as pap smears and basic health services within the competence of the midwife like normal spontaneous delivery, pre- and post-natal care and immunization.

The clinic also provides blood pressure and weight taking as well as wound dressing and first aid.

With a monthly income ranging from 25,000 pesos to 250,000 pesos, depending on the location of the clinic, the WFMC seems a lucrative option for any midwife. However, not all of them are qualified to just go into business.

"As the saying goes, 'Many are called, but few are chosen.' We adhere to some strict standards in choosing our midwives to run the WFMCs as clinic managers. We believe these standards set the brand of our network of midwife-run clinics that has only the best in quality and safe FP/MCH services for the public," Dasmarinas says.

The chosen midwife then undergoes rigid training in these three areas: quality assurance, business development, and marketing and promotions.

"Like the previous midwives who are now clinic managers of WFMCs, I also went through trainings in basic and comprehensive family planning services and business planning which are crucial for would-be entrepreneurs," states Rita.

Just like any business franchise, the midwives-entrepreneurs have to shell out investment money when putting up their own WFMC. The reasonable amount mainly depends on the costs for construction or renovation of the clinic to be opened.

"If it all comes for free, the tendency is not to work hard for it, and it is not the concept we provide in order to produce hardworking, responsible and world-class midwives," Dasmarinas says.

Support services
As part of JSI's support services to the would-be midwife-entrepreneur, it conducts feasibility and marketing appraisals to determine a prospective clinic's strategic location, as well as providing her clinic with the necessary equipment and instruments including a delivery table, the WFMC signages and marketing promotional materials.

Each facility is monitored regularly to ensure quality service and the midwife is also required to have backup physicians and a referral hospital in case of medical emergencies.

"I shelled out 80,000 pesos, a part of which was a loan from my sister and my own savings. It was used for the renovation of the clinic, for the purchase of tables and chairs, beds and other essential clinic facilities. So in November 2000, my own WFMC opened in Bagong Silang, Caloocan City," recalls Rita.

She said the first months of operations were difficult but everything paid off, and soon enough, Rita's WFMC became known in the community.

"Of course, I also had my fears about my business, like what if it won't work or what if I wouldn't get the return of investment (ROI). But I just told myself that everything depends on me, on how I would push my full potential to make my business a success," recounts Rita.

Rita is a picture of a hardworking businesswoman who constantly thinks of ways to improve her clinic's services and income. As a result, Rita's WFMC is one of the fast-earning WFMCs in the country, generating an income of 5,000 pesos a day, or 60,000 pesos to 80,000 pesos a month.

Rita's WFMC usually has 15 to 20 patients a day. It is open from 8 a.m. to 5 p.m., but she is also on call round the clock depending on patients who still seek her services especially deliveries. She has two assistant midwives as her staff, who are also trained by JSI. So far, she can say that she has earned the fruits of her labor based on the favorable response she gets from patients.

Currently, there are over 200 WFMCs all over the country and nine NGOs to back them up. JSI is now working toward sustainability of the current network of WFMCs and the future clinics to come. It aims to continually improve the quality of service of the WFMCs and the training it provides to the selected midwives in order to give the best health care service within the reach of its target market.

Through the WFMCs, JSI encourages community work by working hand in hand with the government in providing an affordable option for the middle and lower-income groups. This is working within its tagline of "Affordable Quality Health Care At Your Convenience."