The Problem We Solve
International healthcare accreditation currently serves the 20% of the world’s hospitals that can afford it, and never reaches the other 80%.
The Evidence Base
A 2026 peer-reviewed study in the Georgian Medical Journal (whose editor-in-chief is ASF’s founder, disclosed here for transparency) analysed 13 major international accreditation bodies. The findings:
- Minimum published accreditation costs for a non-profit organisation were not proportionate to the income gap between high-income and upper-middle-income countries
- No body published a complete three-layer cost
- None offered a non-profit fee tier
- None conducted assessment in local languages as standard practice
- 12 of 13 did not publish their fee schedule at all
Peer-reviewed, open-access: GMJ 2026;1(3):a205
The photograph above was taken by Prof. Pkhakadze in a Georgian hospital in 2014. It shows the medical archive — thousands of patient records in an unmanaged room with no classification, no retention policy, and no access controls. This facility had never been accredited by anyone. No international body had assessed it, because no international body was affordable. This is what being out of reach of the global accreditation system looks like.
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.
The exclusion is not deliberate malice — it is the natural consequence of a business model. When accreditation depends on multi-day survey team visits, international travel, English-language documentation, and fees calibrated to high-income budgets, the 80% are excluded automatically. No one decided to exclude them. The model did.
What ASF Addresses
| Barrier | ASF’s answer | Where to read more |
|---|---|---|
| Price | Two packages, billed monthly. Full three-layer cost published. | Fees → |
| Language | Permanent commitment to assessment in the national language. ASF funds translation for ADC review. | Local adaptation → |
| Regulatory context | Local Regulation Modules putting national healthcare law first. Higher of local law or ASF governs. | NAP model → |
| Administrative burden | 95 criteria (hospital). Quarterly updates that carry forward. One supervision day per year. | Quarterly cycle → |
| Entry barrier | Certification pathway via local partners — meaningful recognition in weeks to months. | Certification → |
| Transparency | Standards always free. Fee schedule always public. Theory of change published. | Transparency → |