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Table 3 Strategies for reducing cost, generating income, and increasing volume

From: Business models for primary health care delivery in low- and middle-income countries: a scoping study of nine social entrepreneurs

Financial sustainability strategies Mechanism
Costs Bulk purchase of generic medicines Purchasing generic medicines directly from suppliers allow organizations to negotiate lower prices as well as eliminating the cost incurred by intermediaries
Paramedical staff Training paramedical staff to treat simple cases lowers the cost of salaries
Laboratory service Running laboratory tests in own centralized laboratory saves the transportation and service cost of referring to outside laboratories.
Income Flat-rate pricing Charging a low flat-rate price to all patients save the direct and opportunity cost of measuring each patient’s socio-economic status
Alternative revenue streams Having alternative streams of revenue to support health services lowers cost to patients by subsidizing the cost of treatment
Subscription packages Subscription packages allows financial pooling that lowers the cost to patients by distributing the cost of treatment among all subscribers
Scaling strategies Mechanism
Scaling physically Chains, franchises and mobile units increase volume of patients by widening geographical access
Scaling virtually Telemedicine increases volume of patients by increasing access to hard-to-reach areas and saving the cost of transportation