Azusa Healthcare Solutions (AHS)

Innovative solutions providing affordable and quality healthcare for all.

THE PROBLEM

Poverty puts people at risk of ill-health and also denies them from accessing healthcare(1;2). Over 70% of the Nigerian population live in poverty(3,4). The current trend of accessing healthcare in Nigeria include out of pocket payments by individuals, employer sponsored health insurance packages, private health insurance schemes and the National Health insurance scheme(NHIS). Out of pocket payments account, for over 70% of health expenditure. While the NHIS covers less than 5% of the population, more than 90% of the Nigerian population are uninsured while only 3% of people in the informal sector are covered by voluntary private health insurance(5).

The above challenges may be significant but are however not insurmountable. Furthermore they present a robust opportunity for private sector providers to improve access to quality healthcare since majority of the region’s poor people, both urban and rural, rely on private health care. "A poor woman with a sick child is more likely to go to a private hospital or clinic than to a public facility"(6).

MY SOLUTION: AZUSA HEALTHCARE SOLUTIONS(AHS) 

 Azusa Healthcare Solutions is designed to provide quality and affordable healthcare to low socio-economic communities in Nigeria.

 It is a value-based hybrid health system made up of  four components : a micro-credit scheme; a health maintenance organization(HMO); a network of health facilities (clinics and hospitals).These 3 components  are for profit.The last component which is a health promotion foundation is non-profit.    

The micro-credit scheme will provide credit(at very low interest rates) to community members to access health care in the system's health facilities (for any health event not covered by their health plan) and also open micro-scale businesses. Access to micro-finance has been linked to poverty alleviation and it also presents a useful opportunity to provide credit for the poor to access quality healthcare (7). 

The HMO will enroll patients into any of the health plans on the system and allocate a care counsellor (who may be a doctor, nurse, clinical psychologist or social worker) to guide patients and their families in making wise decisions in the event of any health challenge and provide psycho-social support (e.g. encouraging treatment compliance by patients) throughout the entire treatment pathway. 

The health facilities will provide affordable integrated( i.e. managing a disease, its associated complications, sequelae etc.) and  multidisciplinary (i.e. involving different healthcare professionals in patient management) healthcare delivery services in easily accessible locations and via information technology. 

The health promotion foundation will organize free health checks and medical information seminars in communities and also provide daily health information to enrolees via SMS and online on the health systems website. Members of the public can view free health information on the health system's website.  

“You have to make a deposit before we can treat the patient”(7). This is a popular statement that occurs frequently when patients are rushed to health facilities in Nigeria. Often the poor are denied access to healthcare when they can’t afford these deposits. The micro-credit fund which provides credit to indigent patients to access healthcare makes my solution innovative. Currently, in Nigeria, poor patients are not offered credit to access healthcare. This innovation will improve access to quality healthcare especially for the poor who often fail to receive healthcare due to insufficient funds.

Azusa Healthcare Solutions would be linked through an online platform which would include electronic medical records and telemedicine platforms. This would allow multidisciplinary teams in the systems hospitals and clinics to share and make value based decisions with patient's data. At enrolment, patients are issued a unique identification number which enables regular and easy payments of premiums (online or via mobile Short Message Services); gives them online or mobile access to their electronic medical records; allows them to book in- person consultations (or participate in telemedicine consultations)and have chats with their care counsellors or physicians on the health system’s platform.

1.To establish a hospital in one senatorial district in Lagos State, Nigeria and one out-patient clinic in each local government area in the senatorial district.

2.To set up the following:

a) the Health Maintenance Organization, 

b) the micro-credit fund, 

c)the Health Promotion Foundation, 

d) the telemedicine and electronic medical platforms

e) the website and affiliated mobile App.

3.To attain a customer base of 100,000 patients.

4. To form strategic alliances with:
a) Impact investors and Donor organizations ( for funding
b) Local and international medical training institutions to access continuing medical education. 
c) Local and international business schools to access mentoring and expertise

I plan to upscale Azusa Healthcare Solutions to every state in Nigeria. In addition I plan to (in partnership with donor organizations and government) establish a facility to rehabilitate the destitute (e.g. beggars, the homeless etc.) by giving them free access to quality healthcare and helping them return back into society's mainstream through skills acquisition, educational scholarships and grants to start businesses. I am also ready to work with governments and global agencies in other parts of the world to transfer my health system's methodology and technological framework to bring quality and affordable healthcare to other parts of the globe.

We will engage communities through community awareness programs(e.g public lectures, placing mobile electronic bill/advertisement boards in strategic areas in the community, conducting on the spot enrollent for new customers etc.) and adverts in print, electronic and social media. All adverts and all interactions with the community will be in english,pidgin and indigenous languages and will respect the socio-cultural values of the community. We will immediately allocate a care counsellor to each customer who will be charged with the frontline responsibility of maintaining excellent customer relationships and retention. 

I expect to achieve a subscriber base of about 100,000 people in 12 months and 500,000 by 3years. 
I plan to recruit well trained health professionals to provide quality integrated healthcare services via multidisciplinary teams of health experts. 
A highly skilled and well remunerated workforce is integral to the success of the health system or any organization. In addition “A happy worker translates to a happy customer.” Therefore all staff in the system (both medical and non-medical) will be excellently remunerated, provided career progression and opportunities for training and continuing education (both locally and internationally). 

I am a medical doctor with 18 years of experience. Please view my LinkedIn profile. I bring a wealth of clinical, laboratory, leadership and managerial skills to this assignment. In addition I am a team player and easily work with people from diverse backgrounds. I am very passionate about my profession as a medical doctor and the numerous opportunities it provides me to serve humanity, restore hope to the hopeless and health to the sick. I therefore believe that I have what it takes to attract the different resources (human, financial, material, etc.) needed to succeed and make an impact.

I intend to raise capital from impact investors (to provide seed or equity funding) and donor agencies( to provide grants). My revenue streams will come from the following:

1. Flexible (weekly,monthly etc) and low-priced premium payments for health insurance plans. 

2. Income from regular health education and continuing medical education seminars organised by the HMO for members of the public, corporate organizations and health professionals. These seminars are different from the free community health talks which are organised by the Health Promotion Foundation. 

3. Sponsorship of the Health Promotion Foundation will come from donations from the public, partner organizations and regular subventions from the HMO.

Long term sustainabilty and profitability are gauranteed because there is an immense demand by Nigeria's population (over 180 million people) for quality and affordable healthcare. The population is grossly underserved by available healthcare delivery services. Furthermore the uptake of information and communication technology(ICT) in Nigeria has been impressive in spite of challenges.The ICT sector is ranked as the single fastest-growing sector across Nigeria’s economy and currently acounts for11% of Nigeria's Gross Domestic Product.  Nigeria is therefore a viable market for   my solution.

A few years ago a young man told me about how his pregnant wife laboured at home for days (and eventually delivered a still birth i.e. dead baby) because he had no money to take her to the hospital. In many parts of the world the poor die not because their diseases are complex but because they lack funds to access timely and quality healthcare. There's always a "Why" for everything. Stories like the young man's above are my “why” for applying to solve to help me in making my vision of quality healthcare for the poor a reality.

Our services have been designed to ensure customer satisfaction at each touch point in the system. However , inadequate funding to take off and upscale the entire system will prove a barrier to success. I expect that solve will help in establishing partnerships with impact investors and donor agencies to provide adequate funds for my solution.