Bringing the Avon Lady Philosophy to Rural Ghana

One of the HealthKeepers sales ladies heading out on her rounds.

In many rural areas of Ghana, a ringing bell is the traditional way that itinerant sales agents announce their arrival in a village. More and more, those bells are announcing the arrival of the entrepreneurial women from the HealthKeepers Network who are promoting health while also making a living, with the motto “prevention is better than cure.” And they are forging a new way of using the private sector to deliver health and hygiene to rural areas often overlooked by traditional global health programs.

Daniel Mensah, head of HealthKeepers

Although different private sector strategies have been tried to promote contraceptive use in Ghana (where the 2008 Demographic and Health Survey  indicated a contraceptive prevalence rate for modern methods was 16.6%), the impact of these strategies has been limited due to the long distances to be traveled to reach relatively small numbers of people with limited purchasing power.

In October 2009, I visited HealthKeepers with two colleagues and Executive Director Daniel Mensah in a village about an hour outside of Accra. We were the first visitors just after HealthKeepers had been registered to continue the work begun by Freedom from Hunger. I immediately thought of Avon, a U.S. company I remember from my youth, and its Avon ladies who have sold cosmetics door-to-door since the 1930s. The HealthKeeper difference is that these sales ladies travel by foot, with their products in a basket perched on the top of their heads.

The merchandise includes a mix of health products — such as contraceptives, insecticide-treated mosquito nets, oral rehydration salts and home water treatment tablets —and other carefully selected personal care products which help ensure that the ladies turn enough of a profit to keep them motivated. In 2009, they were also selling low-cost eyeglasses; they gave one of my colleagues an impromptu eye exam under the mango tree.