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Tackling the Access Gap: Nonprofessional Workforces Expand the Reach of Basic Services  

June 30, 2016

By Joony Moon - Skoll Foundation

Comparing the recently-launched 2016 Social Progress Index to prior years, we can see what many already know—social progress takes time. As developing countries struggle to provide equitable access to important services like basic healthcare and education, they are faced with the reality that building proper infrastructure and developing the human capital to support it can take years, if not generations. And available resources are often reserved for urban and wealthier areas, leaving rural and poor communities to fend for themselves.

In the absence of adequate infrastructure and resources, nonprofessional workers are often used to extend the reach of services to rural and poor communities. Given that the most basic services—like distribution of medicine, for example—can be delivered by almost anyone with a little bit of training, using nonprofessional workers is an efficient way to address some of the gaps in the formal system.

These workers typically come from the communities they serve, and can help an organization broaden its reach at modest cost by shifting frontline service functions away from professionals. Social entrepreneurs know the importance of partnering with communities to expand the reach of important services and use this model well.

Living Goods

In rural areas of Africa and Southeast Asia where doctors and clinics are scarce, Living Goods supports networks of village health entrepreneurs who go door-to-door teaching families about better health practices while selling basic health products, including simple treatments for malaria and pneumonia, fortified foods, healthy pregnancy kits, and solar lights. This basic, timely information and counseling from community health promoters help children and their families to thrive even when they cannot easily access the formal healthcare system.

 

 

Namati

All over the world, millions of people in impoverished communities live without the protection of law, with the formal legal system either out of reach or unreliable. Namati trains and deploys community paralegals as grassroots legal advocates, helping disenfranchised communities access fundamental rights like citizenship recognition, land tenure, and access to quality healthcare. Drawing on data from thousands of cases, Namati then advocates for broader administrative improvements and policy changes.

 

 

Pratham

Pratham focuses on developing and deploying high-quality, low-cost, replicable interventions that address gaps in the Indian education system. They recruit volunteers—regardless of education level, so long as they are good with children—to teach basic literacy to youth in their communities. Pratham’s main innovation is called Teaching at the Right Level, which helps children lacking basic reading and arithmetic skills to learn based on their true level of learning rather than by age or grade.

 

 

The nonprofessional workforce model has allowed Living Goods, Namati, and Pratham to reach communities that the formal system was otherwise not equipped to support.

Using such an approach effectively requires thoughtful consideration of several factors:

Compensating staff. While some nonprofessional workers may be volunteers, compensation can be an important motivator and can help make an intervention more sustainable. Sales-based models often include commissions and sales targets as parts of the compensation structure. In those cases, earned revenue from the sale of products and services can also help pay for a significant portion of staff compensation.

Living Goods uses monthly impact and sales targets to track agent performance, which helps to advance their goals while also supporting each agent’s livelihood. “Why in so many poor countries are the poorest people in the health system, village health workers, expected to volunteer without pay? Is that right? Is it sustainable?” asks Chuck Slaughter, Founder and President of Living Goods. Living Goods community health promoters make approximately $150 per year, enough to send two or three children to school.

Connecting clients to additional services. While nonprofessional workers can help expand the reach of basic services and serve as frontline resources for communities, more complicated cases may require consultation with professional practitioners. It is thus essential that nonprofessional workers be able to refer clients to a professional network for cases that require more expertise.

In Namati’s case, its country operations employ a cadre of community paralegals supported by a central home office where administrative staff and trained lawyers provide additional assistance and guidance. Professional and nonprofessional workers complement each other. “A lot of lawyers are not necessarily good at client care, they’re not able to spend that time in a prison supporting someone, or explaining a legal process, or make sure that a pregnant woman who’s in prison gets to go to hospital for medical treatment. That’s really the kind of work that paralegals do,” says Sabrina Mahtani, Co-Founder and Executive Director of AdvocAid, a legal aid NGO in Sierra Leone that is part of the Namati network.

Sharing learnings across the network. A core element of the nonprofessional worker model is that staff are trusted members of their communities and understand the clients they serve. This allows each worker to develop his or her own approach to servicing the community. Since nonprofessional workers often work independently, it is important for them to learn from and share with each other.

To this end, Namati has formed the Global Legal Empowerment Network, bringing together over 700 organizations and 3,200 individuals to learn from each other and share a growing library of legal empowerment resources through both online and in-person engagement.

Ensuring model fidelity. As an intervention scales up and is adopted by the government and partner organizations, core elements of the original model can be compromised. Social entrepreneurs need to think about how their models will be accurately replicated without direct oversight. What level of model fidelity is important, and how much data should partners be expected to feed back?

When collaborating with state and local governments, Pratham helps ensure effective implementation of its model by remaining involved from the program design phase through implementation, providing training, monitoring, and technical assistance. For example, over a period of two years, Pratham trained 89 percent of the government teachers in Punjab.

The concept of nonprofessional workers is not new. Nonprofessionals have worked to improve the lives of poor and rural communities for many decades, but the majority of such programs have operated in isolation and at small scale. For nonprofessional workforce models to scale up, social entrepreneurs must work closely with peer organizations and actors in the formal system to ensure effective adoption of their interventions.

By leveraging the potential of community members, social entrepreneurs and their partners can transform systems so that even the poorest and most remote communities can access basic health, legal, and educational services.

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