SMALL BUSINESS
Low-paid, highly-motivated midwife starts own business
Thursday, October 24, 2002
http://www.manilatimes.net/national/2002/oct/24/business/20021024bus9.html

About a decade ago, Purita Dantes, then in her 20s, had to keep two jobs at a time - as an assistant to physicians at a maternity lying-in clinic and at another hospital - to earn a measly P2,000 at the end of each month.

Although her income was far from sufficient for her family's needs, Dantes still thought herself lucky. It wasn't common even for those who had passed the midwives board examinations - she was one herself - to be, well, doubly employed.

Now comfortable and secure financially, Dantes, who is now a mother of two, earns a minimum monthly gross income of P60,000 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 country.

Midwives are probably the least recognized in the hierarchy of the health care provider chain. Many end up working as assistants to physicians.

A common path many midwives take is to go abroad and work as caregivers. But Dantes had something else in mind - she knew that she did not have to leave her family just to provide for their basic needs. She continued working as a physician's assistant, while waiting for that big break.

The break came in the form of Well-Family Midwife Clinic (WFMC). She learned about WMFC through a friend who was a sister-in-law of a clinic manager of one of WFMC's centers.

This friend offered Dantes to become a clinic manager herself - even as she knew very little about the program, armed with guts and faith in her capabilities, Dantes grabbed the opportunity.

"I gave WFMC a try because it was my dream to have a clinic I could call my own. Before, that dream seemed impossible because I knew I had no-thing and no one to financially support me," Dantes said. "But during the WFMC seminar, I learned that we would be receiving support from NGOs (non-government organizations), so I was not afraid anymore."

The WFMC was conceived by the John Snow Research and Training Institute Inc. (JSI-RTI), a Boston-based NGO specializing in technical assistance to public health programs, and the United States Agency for International Development (USAID). Under Project TANGO (Technical Assistance for the Conduct of Integrated Family Planning and Maternal Health Services by Philippine NGOs), JSI-RTI and USAID launched a program to make health services more accessible and affordable to middle and lower-income groups.

In partnership with eight NGOs, Project TANGO (http://www.jsitango.com) started the establishment of a network of midwife-owned and operated clinics that provide quality and affordable health services in key areas in the country.

"TANGO 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," said Ester Dasmariñas, resident advisor of JSI-RTI. The WFMC is a result of numerous training and seminars on family planning and maternal and child health (FP/MCH). Like the standard WFMC, Dantes's WFMC provides FP/MCH services, counseling, pregnancy tests, minor gynecological services such as pap smear, basic health services within the competence of a midwife like normal spontaneous delivery, pre- and post-natal care and immunization.

With a monthly income of P25,000 to P250,000 depending on the location of the clinic, the WFMC seems a lucrative option for any midwife. However, not all midwives are qualified to go into this sort of business.

The midwife chosen to run a clinic undergoes rigid training in three areas: Quality assurance, business development, and marketing and promotions.

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

NGO support As part of JSI-RTI'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, WFMC signages and marketing promotional materials.

Each facility is monitored regularly to ensure quality service. The midwife is also required to have back-up physicians and a referral hospital in case of medical emergencies. "I shelled out P80,000, a part of which was a loan from my sister. It was used for the renovation of the clinic, for the purchase of tables and chairs, beds and other essential clinic facilities," said Dantes. "In November 2000, my own WFMC opened in Bagong Silang, Caloocan City."

Inevitably, the first months of Dantes' WFMC were difficult. Dantes did rounds of the vicinity, getting to know the people in the community and introducing to them her new clinic. For two weeks, she offered discounted services in order to promote the WFMC. Soon enough, Dantes' WFMC became known in the community. More importantly, her family's support erased all jitters she had as a neophyte businesswoman.

Dantes' WFMC is one of the fast-earning WFMCs in the country, generating an average income of P5,000 a day. Monthly, Dantes' clinic earns P60,000 to P80,000. The clinic, which is open from 8 a.m. to 5 p.m., accommodates some 15 to 20 patients a day.

The midwife-entrepreneur's efforts have been amply rewarded. "Patients say that my clinic offers the best health care service in the community. They say that they are very well taken care of by my staff, and they are very satisfied with our services," said Dantes.