Uchembere Wabwino Maternity Clinic

The burden of maternal and infant mortality is increasingly high with 439 maternal deaths per 100,000 live births and 35.3 deaths per 1000 live births respectively due to lack of proper health care services and infrastructure. Uchembere Wabwino Maternity clinic therefore, came in to offer quality maternal and child care services in order to significantly reduce the burden in Mzuzu City. If the solution is scaled globally a lot of people will have good health as it is a known fact that a healthy population is key to socio-economic development of any country.

Globally maternal mortality is unacceptably high. In 2017, 295 000 women died during child birth. The Malawi demographic health survey 2015-16 indicated that there are 439 maternal deaths per 100,000 live births. Between 4 and 5 women aged 15-49 died during pregnancy. Northern region of Malawi registered 74 maternal deaths in 2019-2020 from a population of 1,063,388 females in fiscal year and Mzuzu city registered 26 maternal deaths from a population of 112,424 females, accounting 35.1% of maternal deaths which occurred in Northern region. With that reason Uchembere Wabwino Maternity clinic is significantly reducing complications that occur following pregnancy and during child birth to people surrounding Mzuzu city and beyond. The factors contributing to maternal and neonatal mortality rate are due to long distances to travel to the health facility and lack of specialized services which can be offered to clients. The problem affects the, individual families, communities and county as a whole since each maternal and neonatal death is accounted for.

The clinic offers affordable maternal and neonatal health care services that include but not limited to; Antenatal care, labour and delivery, postnatal care and under-five clinic services including Growth Monitoring and immunizations. The clinic provides holistic services targeting early detection of complications and healthy timing and spacing for couples. The business solution offers services at an affordable price, that most individuals can afford than other service providers, whose services are considerably higher. We use essential equipment for example ultrasound scanning during 1st trimester to check fetal wellbeing and rule out any abnormalities and during 3rd Trimester to check estimated fetal weight. In addition to that we also have well trained staff with the much needed expertise and experience than most public institutions would have. 

Our target population are clients who come for maternal related services (18 to 49years); Under five children (0 to 5years) who come for Expanded Program on Immunizations and their mothers including youths seeking family planning methods and counselling. These are the clients who have got small and medium enterprise and some who are working in various industries who seek antenatal care, labour and delivery even postnatal care and family planning services. Uchembere Wabwino provides quality health care services with commitment to physical and psychological care in order to address their needs. In order to engage the customers, we offer free Blood pressure checkups, free pre conception counselling, nutrition counselling and free health education concerning birth preparedness and readiness. The solution addresses their needs in the sense that, the services are offered within their reach and they do not need to travel long distance to access the services when in need.

Globally maternal mortality is unacceptably high (297,000 deaths; 2017) and the Malawi demographic health survey 2015-16 indicated that there are 439 maternal deaths per 100,000 live births. Uchembere Wabwino maternity clinic is significantly reducing complications that occur following pregnancy and during child birth to people surrounding Mzuzu city and beyond so I feel that the problem, solution and dimension are well aligned to the challenge because our vision is to make sure all women and their babies have access to safe and appropriate childbirth services. 

Our solution is innovative because our approach is different from our competitors in the sense that while we have well trained, committed and experienced staff; our services are considerably affordable that most individuals can afford than other service providers, whose services are considerably higher. 

We are also convenient in terms of access: the clinic is located right where the people are in the community and we provide specialized care unlike our competitors whose focus is also on other conditions.

The following is a list of our competitors:

Mumbwe Medical Center:  this clinic provides general medical services and partly maternity services at higher prices.

St Johns Private hospital: this is a Christian hospital which offers general medical care and surgical care to people surrounding Mzuzu city and they also offer maternity services.

Wezzie Medical Center: this is a new entrant. The clinic has just been opened.

Mzuzu Central Hospital: this is a government institution of which all the 6 district hospital depend on in terms of referral system.

The core technology that powers our solution is through the use of imaging and sensor technology for example we use ultrasound scanning machine which was placed to be used for assessment of fetal well-being and to determine gestation age before 24 weeks and during third trimester to every pregnant woman.

We also use Audiovisual media through Tigabane Radio station to empower young girls and women on issues concerning sexual reproductive health and safe motherhood programs every Mondays and Tuesdays of the week.

Big data study analytical surveys which are conducted are being used as a reference when managing our clients. As we believe in using evidenced based information. 

According to the WHO 2018, recommends one ultrasound scan before 24 weeks of gestation (early ultrasound) for pregnant women to estimate gestational age, improve detection of fetal anomalies and multiple pregnancies, reduce induction of labour for post-term pregnancy and improve a woman’s pregnancy experience.  The introduction of ultrasound scanning was made in order to detect early pregnancy complications and confirm fetal viability in low resource setting which could increase antenatal service utilization and reduce morbidity and mortality.

There are also numerous applications and indications for ultrasound in low and middle income countries like Malawi, where by the ultrasound has been used to diagnose obstructed labour, non-cephalic presentation, single or multiple pregnancy, incomplete miscarriage, molar pregnancy, ectopic pregnancy, fetal abnormality, intrauterine growth restriction and placenta Previa. It has also been used to measure pelvic outlet and estimate gestation age. Although the degree of diagnostic accuracy may vary depending on when pregnant women present themselves for an ultrasound exam, its utility has been highlighted in many studies nonetheless. In addition to this, gynecological conditions have also been evaluated using the ultrasound scanning particularly in emergency medicine.

Our purpose

We exist to help reduce the number of women and their new born from dying or injured during child birth.

Activity 

Early initiation to antenatal care clinic

Early detection of complications through the use of technology

conducting delivery using skilled birth attendants

essential intrapartum newborn care

provision of essential new born care

help mother survive bleeding

helping babies breathe

expanded programs on immunizations

Output 

Improved health and well-being for the women and children

A healthy generation

Outcome 

Reduced maternal and neonatal mortality rate 

Increased quality of life (QALYS) of mothers and children 

Mzuzu city has a population of 271,400 and the majority of the population are youths who are still in the childbearing age of 18 to 35 years’ old.  Currently we are serving a population of 10,000 people in the catchment area where we are located in. In one year we believe the solution will serve 120, 000 people and in five years we will serve 1,440,000 people.

Goals within next year: we want to make sure that we have purchased essential equipment for theatre so that it can enhance the service delivery to our clients and thereby bringing in more revenue

Goals within next five years: we plan to lease a piece of land and start developing it into a fully fletched medical Centre. This will help us to do away with monthly rentals and also will help us design a medical facility that fits our set without compromising certain features that limit our service delivery. 

We also plan to have an Ambulance for easy evacuation of patients in case they need specialized care at a major referral center (i. e Mzuzu Central Hospital.)

The barriers that exist to accomplish the goals in next year and next five years are as follows: firstly, is due to lack of essential equipment for example theatre bed, fetal monitors anesthesia machine and rescussitaire to mention a few. These are essential equipment that are necessary for a clinic to function properly and this limits procedures and amount of revenue collected. Secondly, it’s difficult to access loans to improve the business. Thirdly we have high tax rates which make life hard for startups like me

To overcome this, I have strategized to save some money each month and set a target that by the end of 12 months I should be able to buy some of the essential equipment. I have opted for saving because to get a loan to buy equipment it is not easy and loans you pay with a lot of interest. Secondly ask from family members on how they can help the clinic to grow. Lastly, write up any challenging competitions that can help with funding.

Currently, 11 people are working on this solution full time but we have got also hospital advisory committee, disciplinary committee and procurement committee. We have five registered nurse midwives’ technicians who work on day and night shift. Two clinical officer, two Health surveillance assistants and one patient attendant and one receptionist. 

Uchembere Wabwino maternity Clinic is managed by Ms. Lucy Msukwa who is also the founder of the clinic. She has 7years of working experience under obstetrics and gynaecology department in a busy central Hospital. Last year in September 2019 she decided to open a maternity clinic in her community since the government health centre was closed and is under renovation for a period of 24 months.

she uses her experience from previous job to effectively run the clinic.

This year she was selected to attend cohort 3 for African Women Entrepreneurship cooperative. 

 To effectively run the affairs of the clinic, she assembled a team that cohesively work together to achieve a common goal for the clinic.

The following are the positions existing and filled in the organisation: We have 5 Nurse midwife Technicians who have got good working experience in midwifery

We have 2 clinicians who specialized in obstetrics and gynecology for over 14 years. Therefore, we are well positioned to deliver this solution because we have well trained and well experienced staff who help our customers holistically. In addition to that, we provide individualized and specialized care to the people in the community each at their desired time.

 We provide physical and psychological care to our clients and the clinic offers a therapeutic conducive environment. People in the community do not travel long distance to access the services as the clinic is located right in the community with ease access to the road, markets and even banks.

Ministry of health: provides free vaccines for expanded programs on immunization for under-fives hence bringing in more customers.

Pharmaceutical companies: we buy medicine and supplies at an affordable price. 

Tigabane radio station: we provide health tips about safe motherhood programs hence attracting more customers to the clinic

Currently, the clinic has break even, the clinic is able to make money and sustain itself. Currently we see 124 patients per month and we make $800 per month. By the time we reach 250 patients per month we shall be making significant profits. These profits will be re invested in business by adding essential equipment’s and instruments, hire more staff and increase the building space and purchase an ambulance for emergency transfers for patients who will need specialized care at central hospital. We then plan to get contracts with different companies and health insurance companies to increase revenue which will help the company to survive on its cash flow.

I am applying to solve because I see great opportunities coming to our organization if the organization will be selected to benefit from the solves challenge. The following are some of the reasons for applying to solve:  

Working capital: Every company needs funds to succeed, and we are applying for solve challenge because sufficient working capital is a key aspect to the company’s financial health. We want to create enough working capital to enable us to fulfil our growth ambitions. We want to take advantages of the new opportunities that may arise, investing in new product or services to enable us to expand.

Asset purchase:  we want to purchase new equipment to enable us scale up our services. People are looking for advanced technology even in health system.

Growth funding:  the funding is needed to execute the business plans that we have, for example hiring more staff, moving into a bigger premise.

Mentorship programs: to get advice from well experienced business entrepreneurs who are already into business.

Product service distribution: we need help in making decisions about distribution in line with company’s overall strategic vision and mission.

Funding and revenue model: we need help in identifying which revenue source should we pursue, what value to offer to clients and identify who will pay for the value.

Monitoring and evaluation: we need help identifying the most valuable and efficient use of resources which provide necessary data to guide strategic planning, implementation e.t.c

Marketing media and exposure: help us to increase media and exposure and coverage within our target industry as this creates more business opportunities.

Our vision is to make sure all women and their babies have access to safe and appropriate childbirth services. We will go in partnership with organization whose focus is in line with our vision for example:

Partnership for Maternal, Newborn and Child Health: the organization focuses on sustainable development goal number 3 good health and well-being targeting reducing child mortality and improve maternal health, with women and children enable to realize their rights to the highest attainable standard of health in the years to 2015 to beyond.

Fund for Maternal Health and Happiness: the organizations mission is rooted in evidence that a healthy and happy mom improves the health of her entire family and community. The organization partners with individuals and other organizations to improve the well-being of mothers through a variety of data driven initiatives the FFMHH’s efforts increase maternal confidence, self-respect, joy and knowledge.

Our organization is qualified because we exist to help reduce the number of women and their new born from dying or injured during child birth. 

Malawi has the highest mortality ratios globally, currently estimated at 439/100,000 live births with adolescent pregnancies comprising 29% of all births and 15% of maternal deaths. We provide free menstrual cups as a method of menstrual hygiene as research done by UNFPA 2019 has shown that many girls in Malawi stay home from school or drop out due to lack of proper menstrual hygiene methods. 

We provide safe abortion to girls and women who did not plan to have pregnancy. Research has shown that majority of induced abortions in Malawi are performed under unsafe conditions and complications from these unsafe abortions have been estimated to account for between 6%and 18% of maternal death in Malawi. 

So our organization provides safe abortion in order to save the lives of women and girls who may need these services.

We  provide free cervical cancer screening to girls and women. Data has clearly shown that Malawi has a highest incidence and mortality in the world with age standardized rate of 75.9 and 49.8 per 100,000 populations respectively.

Therefore, the innovation will help boost the services which we are currently providing through the use of advanced technology for example buying cryotherapy machine to treat the pre-cancerous cells at an early stage; Manual Vacuum Aspirators and buy more menstrual cups to distribute to women and girls in the community and beyond.

Malawi’s current neonatal mortality rate is at 22.8 per 1000 live births. Currently our organization is already expanding and supporting the health workforce for newborns, pregnant women and new mothers where the newborn mortality rates are high. Our vision is to make sure all women and their babies have access to safe and appropriate childbirth services. We provide preventive and curative services to pregnant women and new born in our community. Currently the government health center which was providing services to the people in Mzuzu city with a population of 241,000 is under renovation and other activities are not being done. Hence our organization came in to close the gap by providing these services to pregnant women with ease access and reduced the burden of long distance to travel to access these services to a central hospital which is a referral facility for all the six districts in the Northern region of Malawi.

 The health innovation prize will help us to improve on our solution as we will be able to employ more health workforce team with good skills; buy essential equipment for example phototherapy machines, resuscitaires, radiant warmers, oxygen concentrators, bCPAP machines, non-pneumatic anti shock garments and more delivery beds of which will be used in managing our clients as modern technology in health sector has proven to be effective in promoting and improving quality of life.