Healthcare at your doorsteps

Access to healthcare has been recognized as an essential contributor to health and wellbeing. Lack of access to healthcare results in unmet health care needs, delays in receiving appropriate care, inability to get preventive services, and hospitalizations that could have been prevented

However, in Ghana, about 30% of the population (mainly the rural population) are more likely to travel long distances to access healthcare services. As a result, many rural inhabitants resort to other healthcare alternatives such as the usage of traditional medicine and often seek proper healthcare when their condition has worsened, making it difficult to treat them.

The root cause of these problems is the government’s failure to invest in the general development of these communities and subsequently attract healthcare professionals to such rural regions. Yet, it remains imperative that people have access, at least, to routine health services in closer proximity than currently exists.

The difficulty in traveling to and receiving care at the hospital is not the only barrier preventing Ghanaians from seeking professional medical help: high costs and lack of established trust with medical personnel are also central problems. This leads to a significant number of Ghanaians suffering from diseases and conditions that could have been better managed if they had been diagnosed or treated early. One prominent example is hypertension, which accounts for 60% of all outpatient cases in Ghana. Timely healthcare is vital for diagnosed patients to make the necessary lifestyle modifications to improve their wellbeing.

Our Hope Health vans will bring holistic healthcare to the doorsteps of rural inhabitants. Our health vans will be equipped with multiple diagnostic machines, laboratory testing, two traveling doctors, one nurse, and a vast array of medications for immediate patient treatment. Additionally, members will have access to various specialists with our telehealth platform as required. When the needs of our members exceed the scope of our van services, we will refer them to specialists within our network for streamlined care and treatment. 

By providing holistic care to community members, we can provide them with an early diagnosis of conditions such as hypertension, diabetes, and peripheral neuropathy. This would allow our medical personnel to monitor closely and preemptively treat diagnosed members.

Lastly, our health van will serve as an avenue for health promotion and disease prevention activities through our different health communication methods.

Providing access to care for medically underserved populations has been the primary motivator of our pursuit in this project. Our goal is to provide care to marginalized populations, mainly rural settlers. Our target population is rural inhabitants located in Southern Ghana who live at least 15km from the nearest healthcare center and live on less than $2.50 per day. For instance, in the Mobia community, one of our target areas, more than 60% of its population are illiterate and farmers. The average person lives on less than $2.50 per day, and the nearest healthcare center is about 25km from the community. With our solution, these people do not have to travel long distances to receive desperately needed care or strain their finances.

I was born and raised in Ghana, living there until the age of 19 years. Access to healthcare was non-existent in my community. Many sick patients had to undertake a journey of several miles, traveling for days to receive care in hospitals located in major cities. These experiences became the driving force for starting OKB Hope Foundation. 

Starting with one health issue that affected most adults in my community, in 2017, while I was a junior in college, I authored and won a grant to provide free education and screening in rural communities. I partnered with several physicians and medical students in Ghana to embark on my first health outreach. Since then, I have been going back to similar communities to provide healthcare services. My experiences serving these communities drove me to pursue a master's in health administration to understand how to provide affordable care to rural and underserved populations. 

Beyond my own experiences, members of our administrative team and medical staff have been raised or have lived in Ghanaian communities and are aware of these communities' healthcare challenges. Their understanding of different local cultures and attitudes around healthcare is central in shaping our approach in each community.

Additionally, we listen to the needs of the communities that we serve at every step in the process. We achieve this via quarterly open-forum sessions during which community members can engage with our organization and give feedback on our service. We also train willing community members to engage in public health education and other administrative duties.

Financial and technical barriers are the two main barriers we are currently facing. We need financial support to expand our services, as we are still establishing partnerships and grant opportunities and are not yet financially independent. Additionally, we will need guidance on how to raise money effectively.

Regarding the technical aspect, we hope to use teleconference and telehealth software to reach more communities and also continuously check up on our patients. We do not have an IT personnel or software developer on our team. However, we hope that through the Solve program, we will be educated or obtain training on various software platforms that can help us accomplish our goal of providing telehealth options to our patients.

In 2007, Ghana established a Community-based Health Planning Services (CHPS) center as a national strategy to improve access and utilization of the healthcare system and reduce inequities. However, most rural Ghanaians still have to travel at least 7 km to get care at the CHPS center due to its immobility. Additionally, because of its location and distance from the urban areas, health personnel are less inclined to utilize the CHPS center to deliver healthcare. This often leaves the center understaffed. Mobile clinics have proven to be an effective and innovative approach to providing care in rural areas and low- and middle-income countries. For instance, mobile clinics were shown to provide healthcare for large numbers of adults and children routinely in studies conducted in rural areas of Malawi, where the shortage of district health personnel was a barrier to accessing primary health care. With our mobile clinic, we would be able to provide primary healthcare and education in various rural areas within the shortest possible time. Moreover, healthcare practitioners who are less likely to utilize the CHPS centers because of the reasons mentioned above would be brought on our van to deliver care to our members.

In addition to providing healthcare to underserved Ghanaians, we also want to revolutionize how rural Ghanaians think about healthcare. Currently, many Ghanaians are hesitant to seek medical help - whether it be because they are not aware of the importance of early diagnosis and treatment or mistrust of the system. By forming partnerships with local faith-based groups and community leaders, we can enter communities with trust, allowing us to reach more individuals in need of our help: specifically, more people who have the most hesitance pertaining to seeking medical treatment, check-ups, or other services.

Our goal is to provide 250,000 people with primary health care over the next five years. Additionally, we will expand our services to other 5,000 rural communities and provide specialized care such as mental health and eye and dental treatments in the communities we serve. Furthermore, we plan to train potential healthcare providers by offering medical professionals internships with our organization. We plan to achieve this goal by securing 16 health vans that would be equally distributed among all regions in Ghana. Our vision is to ensure equitable, and quality healthcare is accessible to all Ghanaians.

We are currently tracking the number of patients who use our services each month through our Electronic Medical Record system. This data assists us in making informed decisions on the design of our educational materials and determining inventory for medications as each community we visit has different health needs. For instance, from March 1st to March 10th, we served 310 patients. Ninety-six were male, and 214 were female; as females are the more vulnerable group in receiving healthcare in Ghana, we want to continue ensuring our services remain accessible. 

Inspired by the UN Sustainable Development Goals 3 and 10, we are working hard to reduce the mortality rate attributed to malaria, hypertension, diabetes, and chronic respiratory disease. Our goal is to mitigate the rate of malaria and chronic diseases by 60% in year 3 of operation. We plan to achieve this through a test and treat program that the Hope Health Van offers. Additionally, through our public health program, we plan to educate, train, and empower local community champions to serve as an advocate for healthy living in their respective communities. 

Theory of Change: Health Knowledge and Services for the Mobia community

1. Activities: Screening services diagnose conditions such as hypertension; Hope Health Van team consults and educates patients

2. Outputs: Community members in rural communities receive health education, health screening, referrals, and care 

3. Short Term Outcomes:  Individuals make lifestyle changes (e.g., more regular exercise) that allow them to deal with the condition better 

4. Long Term Outcomes: Increased productivity to work by eliminating illness, and the economic status of community members increases as well. 

We plan to improve the health of rural inhabitants in Ghana through education and clinical care. Research has shown that 63% of women and 86% of men that are hypertensive reported being unaware of their condition (GDHS, 2014). This situation is even worse in the rural areas, where there is an increased rate of knowledge gaps and misconceptions surrounding chronic diseases (Boateng et al.) due to the low literacy rate and inaccessibility of primary healthcare. With our health van, we will bring transformative healthcare to the doorsteps of rural inhabitants, which will consequently eliminate the need for the long journeys they make to seek healthcare. Additionally, through our public health programs, members will be well-educated about their current health status and help them make an informed decisions about their lifestyle choices. We believe that providing quality healthcare to the members will also improve their economic situation in the long term.

The Hope Health Van is equipped with an online-offline Electronic Medical Record system that allows us to store patient data even in areas with limited internet connection. This data does not only assist us in monitoring and preemptively treating our patients closely, but it also helps us in making strategic and informed decisions on the design of our educational materials and medications to secure for our different health outreaches in the various rural communities.

Our leadership team consists of a diverse and experienced group passionate about serving marginalized communities. OKB’s core team consists of 5 medical doctors, two nurses, and a lab technician, with an average of 10 years of experience in the medical field. Additionally, we have eight dedicated board of directors with a plethora of skills in management, strategy, and community engagement. 

Our goal is to even increase the diversity among the OKB’s core team in the next three years. To achieve this goal, we will be working closely with various medical and health alliances, universities, and colleges to recruit female healthcare providers. Additionally, we plan to develop an internship program focused on training, educating, and empowering young girls to explore various health fields.

We have two main categories of our key customers and beneficiaries: 1) communities and 2)  corporations. 

We provide rural communities with subsidized screening services, medication, and education (for communities with the direst need, we will provide our services cost-free). These communities need our services as it is not feasible for community members to travel many kilometers to the nearest hospital, and many people cannot afford their care.

Our Health Van initiative also serves corporations that can purchase regular screening services for their employees. For the substantial proportion of employers in Ghana that provide health insurance, we may also decrease their premiums due to thorough screenings.

Our Health Van initiative overcomes the three main barriers individuals have in healthcare: convenience, lack of education, and financial constraints.

We will sustain our long-term expenses through the revenue we collect from agreements with corporations to provide their employees with health screenings. By having a slight margin between prices and costs, we will use the revenue to both pay for the van’s operational costs (e.g., gasoline) as well as purchase additional equipment and materials needed to serve rural communities for free or at a significantly discounted price (e.g., blood pressure strips). We have already established partnerships with the Ministry of Forestry and a few radio stations and are creating more.

In the near future, we plan to secure a supportive revenue stream in the form of collecting advertising revenue. We will offer local corporations an opportunity to leave fliers, brochures, or posters near the area where patients will wait in line to receive their care. They may also pay for videos to be shown.

Our team will also continue seeking and applying for grants, which will allow us to expand operations and offer affordable services to more communities.

In 2021, I raised $20,000 from my network (i.e., friends, family, colleagues, etc.) to secure a van, and I invested $12,000 to secure medical supplies and equipment to retrofit the van.