Facts: Part 1

• Gruel is used to wean children off breastfeeding from 2-24 months
  • Cornmeal and bananas
• The gruel is not nutritionally valuable
• The mothers believe it is nutritionally valuable
• The mothers don’t believe in the efficacy of the new gruel
• The women would own the new formula through a co-op and make the new gruel
• 35% of children have stunted growth due to poor nutrition in a certain region of East Africa
• HIV/AIDS is prevalent in the region and is spread through breastfeeding
• Cultural Belief: Women tend to breastfeed until around 2 years of age 
• Has a solid funding base 
• Pesticides are used in the crops and could have adverse health effects on the children
• The prevalence of HIV/AIDS transmission is increased over time
• I received a grant to start the women’s co-op
• The goals of the co-op
  • Help the women make money
  • Have a stable product for the children/babies

Stakeholders/Motivations:

• Children
  • Personal Motivations: 
    • Want good tasting foods 
    • want to be breastfed
  • Professional Motivations:
    • n/a
• 1: Mothers
  • Personal Motivations:
    • Want healthy kids
    • Want to do what is socially acceptable 
    • Don’t want to pass on HIV
  • Professional Motivations:
    • Child-rearing
• Gruel makers/manufacturers
  • Professional Motivations: 
    • May think that their food is actually helping
    • Weaning babies off breastfeeding
    • Want to keep making money
    • Provide cheap food
• Women’s co-op = formula makers (are they a stakeholder yet??) They exist through shared social bonds currently) 
  • Professional
    • Making money
      • Support their family
    • Make porridge from local materials and sell the product as a product
  • Personal
    • Help raise their children and children of other mothers in the community
• Donor
  • Professional
    • Want the women’s co-op to be successful 
    • Expand the co-op
  • Personal
    • To create social impact 
• Grant recipient (myself)
  • Professional
    • Developing a women’s coop that can create a sustainable food product
  • Personal
    • Social impact
• Local farmers
  • Sell their locally grown crops

Ethical Questions:

How would you address the ethical health issues associated with prolonged breastfeeding in an area where there is

• a high prevalence of HIV/AIDS and few women are tested for the virus
• very early introduction of supplemental foods to the diets of infants
• possibility of pesticide residues in foods developed for infants and young children 

 

Drawing the line between education on HIV/AIDS education and running a business that makes nutritionally beneficial gruel. 

 

Drawing the line between what is in your court and what is not

 

Finding balance between using pesticides and educating on the prevalence of HIV/AIDS?

How invested should the co-op be in education ‘against’ HIV while still working on the sustainable food and recipe

 

Cultural implementation issues

• Standard introduction of supplemental food at 2 months
• Standard weaning period from 2 months until 24 months. 

 

Solution insight: the co-op can be designed to be whatever you want it to be

• Large
• Small 

Solution #1:

• Mass education program with the marketing of the porridge product
  • Workshops, fun women empowerment group days, mother support groups
  • Informative advertising
  • Educate mothers on the importance of feeding children the porridge and the importance of stopping breastfeeding at 6 months for mothers that are HIV+
    • Importance of peeling and washing fruits and vegetables
• Pros:
  • Can lead to positive behavioral change that can impact nutrition levels and lower HIV levels
  • Positive press for the women’s co-op
• Cons:
  • Lots of effort and money to implement these programs
  • Still have to compete with gruel makers 

Solution #2

• • Research what sociocultural norms are causing women to start breastfeeding at 2 months, and not want to stop after 6. Meet with the elder women to recruit them as sponsors to change that behavior by using our product. 
    • Bring gifts, use the local language, stay there for a small extended period of time → building rapport and trust. 
  • Pros:
    • Elders are respected
    • Are more in touch with the community
    • Change in behavior of the mothers
    • Nobody is intervening, we just plant the seeds and leverage an already existing cultural norm
  • Cons:
    • Actually convincing the older people to help and endorse the product
    • Recruiting will take lots of time and money
    • Network of impact is limited

 

• Which communities would we choose and how would we fund this education/scalability

 

 

Solution #3:

 

• Questionnaire to screen for HIV and target those women who are at high risk
  • Not practical – ethics questionable by itself
  • This would not solve the issue of needing to find a better food replacement and would also create a social divide between HIV+ and healthy people and only further contribute to discrimination

Implications:

• Need to be able to say who will educate and how many customers we will reach across the country — and at what cost

 

Seeking Additional Assistance

Work with local NGOs and the regional government to screen out solutions that would not work within the cultural context

The best course of action

I believe the best course of action is the second option. This would mean figuring out why women stop breastfeeding so early and working with various community elders to stop that behavior and implement our product with the support from the respected elders.

Implications of solution

• Advice from the elders would be much more respected
• We would be working on the community level and could change strategy for each area if something didn’t work in a particular context
• Would allow the people to feel empowered since the directive comes from their own people

Grassroots

Our role: achieve both outcomes of improving nutritional status of children and the livelihoods of rural households

• Convince other board members and constituents of what needs to be done

Facts: Part 2

 

• Co-op is very successful and the women are overwhelmingly satisfied
  • Livelihood improvement was not attained
    • It’s going to the husbands instead of the women or children 
  • Empowerment was attained by the co-op
  • Men take all the money from the women 
  • The money goes to alcohol and “frivolous things” instead of supporting their children
• We are still a board member for 6 months and we are loved and respected by the community 
• Other 6 board members are local women who also want things to change but they are not necessarily for or against taking away the money from the men
• Not achieving strategic social outcomes of improving the nutritional status of children and the livelihoods of rural households

Stakeholders and Motivations

 

1. 1: The original entrepreneur
   1. Personal 
      1. Leave with an impact that is aligned with your personal ethics and morals and reasons for engaging
   2. Professional
      1. Align women with the advantage of their opportunity
2. 1: Board members
   1. Personal 
      1. Avoid stirring up too much of a dilemma for something they don’t massively care about
   2. Professional
      1. Have a fully functioning co-op
3. 1: Women involved in the co-op
   1. Personal 
      1. Feed their children good food
      2. Make their husbands happy
   2. Professional
      1. Make money that goes towards the family
4. 3: Children and families in the cities who have improved nutrition
   1. Personal 
      1. Continue purchasing this decent product
      2. Health of the children
   2. Professional
      1. none
5. 2: Children and families with unimproved nutrition (co-op worker families)
   1. Personal
      1. Health
   2. Professional
6. 2: Husbands taking the money
   1. Personal 
      1. Drink more
   2. Professional
      1. Not look embarrassed

 

Ethical problem: 

The husbands are taking the money from the women and it doesn’t go to improving the conditions of the family.

 What is your strategy to get the cooperative back on track to meet the twin social outcomes for the cooperative on a sustainable basis? 

Do we have any say in how a family spends their money?

Make coop work in the long term to enhance your own credibility

Solutions

• Do nothing

  • Pros
    • Lol none
  • Cons
  • How does it save face of those involved?
  • Implications on relationships (short and long term)
  • Implication on venture (short and long term)

 

• Paying them in nutritious food or with free porridge to feed and benefit their children with their salary

  • Pros
    • Goes back to twin social outcomes for benefitting family and providing nutrient to foods
    • Give food that will go bad/porridge that is already made so that it cannot be sold on a black market
      • Tumbler can be refilled each day 
  • Cons
    • Men can still waste the rest of the money
    • Potential of a black market
  • How does it save face of those involved?
  • Implications on relationships (short and long term)
  • Implication on venture (short and long term)

 

• Having medical programs, food banks, and other benefits for mothers and children that work at the co-op

  • Pros
    • Program you can opt into
  • Cons
  • How does it save face of those involved?
  • Implications on relationships (short and long term)
  • Implication on venture (short and long term)

 

• Embarrass the men for depending on their wives’ money to have fun by stamping pacifiers onto the bills

  • Pros
    • Easy to implement
    • Easy to a/b test
    • Easy to get approved by the board
  • Cons
    • Potentially patronizing the men → they could hurt the women

 

• Not liquidate cash- women get shares in country and build equity

  • When you have small amounts of money you tend to spend it
  • Requires no corruption and strong book-keeping
    • Women must be ensured that there would be a return on investment

 

• If women have children, set up daycare at facility and make porridge and food available to children

  • Pros
    • Women would love to see their children at work

 

The best course of action

I believe the best course of action would be to not pay women in  liquidate cash but pay women in shares of the company and allow them to build equity.

Implications of solution

• Could liquidate the equity in a relatively short time if a sudden expense came up
• Money would not be on-hand for the husbands to waste
• The equity could grow and become more valuable over time
• Women get a sense of ownership in the venture

Next steps: focus on how to get other 6 women on board and make this happen

• • Informally talk to women individually
  • Or hold a meeting
  • If you can get 6 women on board, they can get more (20 workers) on board 
  • Self interest
  • Common interest and goals
  • Trust
  • Desire to be around a group of people
  • How do you help people build trust and build the social capital to work together
  • Play local politics