The Problem We Solve
International healthcare accreditation currently serves the 20% of the world’s hospitals that can afford it, and excludes the other 80% by design.
The Evidence Base
A 2026 peer-reviewed study in the Georgian Medical Journal analysed 13 major international accreditation bodies examining their governance, fee structures, and accessibility for health systems in transitional economies. The minimum four-year cost of ISQua External Evaluation was €40,513 for a non-profit organisation, applied against a 5.7:1 income gap where the fee ratio is only 1.3:1. No body published a complete three-layer cost. None offered a non-profit fee tier. None conducted assessment in local languages as standard practice. None published their complete standards free of charge.
Peer-reviewed, open-access: doi:10.66636/gmj.v1.i3.a205
The Structural Problem
Existing international accreditation bodies were designed for large hospitals in wealthy health systems. They were not designed for a 50-bed regional hospital in Georgia, a primary health clinic in Nigeria, or a home care provider in Bolivia. For these facilities, the choice is not ‘JCI or ASF.’ It is ‘ASF or nothing.’ And nothing costs lives.
What ASF Addresses
- Price: Income-tier fees from €40 to €800 per year. Non-profit tier at €50. Full three-layer cost published.
- Language: Constitutional commitment to assessment in the national language.
- Regulatory context: Local Regulation Modules putting national healthcare law first.
- Administrative burden: 96 criteria (hospital), quarterly updates that carry forward, one supervision day per year.
- Entry barrier: Certification pathway via local partners — meaningful recognition in weeks to months.
- Transparency: Standards always free. Fee schedule always public. Read the full model →
