Tibalabs

• Forbes reports that there are 8.6 million deaths every year in low- and middle-income countries that could have been saved with good-quality health systems. In a five-country sample in sub-Saharan Africa, only 50 percent of providers can accurately diagnose pneumonia or diabetes due to lack of technological equipment. The total number of deaths from poor-quality health care is five times higher than HIV/AIDS. This is why Tibalabs is using technology to provide access to quality diagnostics and affordable biotechnology equipment.
• A number of hospitals lack functional basic equipment e.g. adult weighing scales, otoscopes, ophthalmoscopes, ECG machines, cardiac monitors, defibrillators, ventilators and ambubags. Oxygen cylinders or functioning central oxygen supply are available at 57% of the Regional Health facilities, 41% of the General Hospitals, 33% of the specialty hospitals. Ultrasound services were available in only 46.9% of the health facilities surveyed. Schedules for maintenance of any medical equipment were observed in 13.4% of the facilities surveyed. (Draft Report Hospital and HC IV Census 2015)
• Due to high cost of medical equipment there are few health facilities providing specialized diagnostics, treatment and care (e.g. The Ocean Road Cancer Institute, Jakaya Kikwete Cardiac Institute for Heart diagnostics, MUHAS Genetics & Biochemistry laboratory) are overloaded and therefore incapable of meeting the growing demand for specialized health care and diagnostics. ii) Diagnostic equipment are lacking in most referral facilities. This leads to inappropriate diagnosis, treatment and wastage of medicines. Important diagnostic and treatment equipment that would be required include; Magnetic Resonance Imaging (MRI), Computerized Axial Tomography (CAT) scan, cardiology diagnostics, renal dialysis, cancer diagnostics and treatment including the cobalt 60 and linear accelerator radiotherapy equipment for cancer treatment
• Tibalabs Ltd analyzed information on patients referred for treatment abroad over the last five years through the Tanzania Medical Board and observed that the leading conditions for referral were Kidney Failure, Cancers, Heart Conditions, Orthopedic Conditions, Neurological Conditions and Eye Diseases. Over the five-year period, the total cost for treatment has been over US$ 5,610,029 ( Tanzania Medical Center, 2021 ). Tibalabs envisions to develop specialized diagnostics care services in the country to reduce on expenditures on referral abroad in view of the growing burden of Non communicable Diseases.

• In our journey to democratize access to healthcare, we have innovated an Oxygen Concentrator for Oxygen Support, It is an innovative continuous air-pressure machine that helps patients with breathing complications. Early trials of our Product to some local hospitals perform 60% better, and stay 40% longer than the current products in the market. A normal Oxygen concentrator is sold from $5400 - $10,000, We Supply our Oxygen Concentrators at $500 alone to help Hospitals, Healthcare centers and small dispensaries to afford procuring these devices for support to patients that are in need of them.
• Our Vision by year 2030 as Tibalabs is "To attain a good standard of quality healthcare and healthcare diagnostics provision for all people in Tanzania in order to promote healthy and productive lives". Our priority areas are: Strengthening health innovation in line with cost optimization; monitoring of laboratory's health systems in the country at all levels in order to innovate more in that area; establishing a functional integration of quality, values and services within our innovation in Tanzania.  
• Our Vision has the following objectives: i) To strengthen Tibalabs capacity in innovating around laboratory and healthcare systems ii) To improve access to quality diagnostics services at all levels in both the rural and urban areas. iii) To build a harmonized and coordinated Laboratory Health Information System in order to generate data for informing on the type of Innovations to consider. iv) To review and innovate relevant equipment/devices with regards to ongoing global changes. v) To ensure that essential, safe, good quality and affordable diagnostics services and health supplies are available and used rationally at all times in Tanzania. vi) To provide and maintain efficient, safe, environmentally friendly and sustainable diagnostics infrastructures in Tanzania.

• We generally target hospitals, specifically Intensive Care Units (ICU), The global healthcare technology market is projected to reach USD 829.2 billion by 2026 from USD 319.2 billion in 2021, there is over 67% growing demand for and use of Oxygen Concentrators
• We Already have Pre orders of 100,000 units of Oxygen Concentrators to Supply to government Hospitals and are looking to fundraising to be able to supply at such demand.
• On the other hand, there has been a steady improvement in the availability of health products, as measured by the tracer commodities. Improvements in the Medical Store Department (MSD) capacity to procure and supply required commodities is contributing to this. To-date, the pharmaceutical sector has made an improvement in availability of, and access to Essential Medicines and Health Supplies (EMHS) from 43% in 2009/2010 to 73.8% in 2020/2021 surpassing the 2020 target of 60%. There has been an increase in funding for medicines through both Government of Tanzania and donor streams from USD 92 million to USD 410 million (including USD 85 million for procurement of Long-Lasting Insecticide Nets-(LLIN)) over the same period, resulting into increased public confidence in the health system. However, the greater proportion (81%) of this funding was from Development Partners, and largely skewed to diagnostic equipment and devices. Despite increased funding for health commodities by government and Private Sector. There is over dependence on donor financing for procurement of diagnostics equipment and associated activities due to high cost of associated equipment and devices, Tibalabs cost reduction strategy is aimed at building capacity of government and private sector hospitals to procure such devices. 

• Our team members are the mix of doctors, Biomedical Engineers, Electrical Engineers and management specialists, We have known each other even before we co-founded Tibalabs Ltd, we both met in a National Innovation Competition hosted yearly by the Ministry of Science and Technology in Tanzania, that is when we developed an interest to work together to establish a social venture and innovate to democratize access to Healthcare in Tanzania and eventually in Africa.  

We conducted a five months survey to 200 dispensaries, 60 diagnostic centers and 20 Hospitals located in both rural and urban areas, Given the results we found, there are a number of issues that Tibalabs will strategically focus on; Firstly, a comprehensive package of essential diagnosis health services,  as we observed,

i) many new/re-emerging health threats are constantly coming up such as pandemic outbreaks such as COVID -19. A focus only on a minimum package primarily providing communicable disease diagnostics will mean the sector focus is not aligned with the changing needs on the ground. The essential package of services needs to address conditions of public health importance (either due to their burden, cost, and / or perceived importance) covering prevention, promotion, curative, rehabilitative and palliative services. We observed that, majority of healthcare facilities already have an essential health care package of services, It will require revision to suit the parameters agreed following stakeholder consultations, and as appropriate reviewed periodically to ensure it is adapted to the changing country context and aspirations of Tanzanians. 

ii) Constant analysis of the district diagnostics performance trends and provide more support to poorly performing districts using corrective measures which may range from increasing the number of resources (financial resources, human resources, infrastructure) to more frequent and regular support supervision.

 iii) More emphasis on neglected age cohorts, particularly the new-born, adolescents and elderly. As we found out, there are still many conditions affecting these age cohorts that don‘t have effective diagnostics in place.

 iv) Holistic investment in health infrastructure with a focus on reducing existing inequities. This should focus on reducing disparities in medical equipment including diagnostics and ICT across districts, and ensuring availability, functionality and readiness of infrastructure in facilities of the same level. 

v) Prioritization of definition, and operationalization of a more comprehensive health information system. Tibalabs has developed a comprehensive strategy for data generation, validation, analysis, dissemination and use, disease surveillance, research, and health surveys, we are looking forward to create a software that will cut across these areas for deployment and use in healthcare facilities. At present, we observed there are still many gaps in these present various systems. Coordination therefore should be strengthened at national and sub national levels for routine reviews, disease surveillance including processes for data collection and validation and Civil Registration and Vital Statistics.

 vi) coordination mechanism to ensure that better harmonization and alignment is being practiced, As part of the plan implementation, Tibalabs has developed a monitoring and evaluation Plan with key indicators and targets to monitor overall performance.

Guidance on coordination and management is provided through three oversight structures; Firstly, The management structure: This guides internal company’s coordination, to guide implementation of defined interventions and activities at different levels of decision making. Secondly, The Directorate structure: This looks at defining the guiding strategic direction and following up on the operation of Tibalabs. Lastly, The partnership structure: This guides external coordination of service delivery by all stakeholders at the respective levels of healthcare. All partners and stakeholders providing services to Tibalabs at a given level of care engage with Tibalabs through this structure.

We believe Solve is a platform and an opportunity for us to learn and connect with fellow like-minded solvers, and connect with potential partners to support us advance our solutions through monetary and/or non-monetary support, Partners that can support us to contribute to the attainment of the highest standard of health diagnostics for the population of Tanzania by ensuring the availability, accessibility, affordability and appropriate use of essential diagnostics of appropriate quality, safety and efficacy at all times.

We believe partnership for the Goals is essentially in advancing any successful solution, hence, SOLVE will help us accelerate movement towards Universal Health Coverage with essential health diagnostics and related services needed for promotion of a healthy and productive life, making it possible to ensure that all people receive essential and good quality health services they need without suffering financial hardship.

Our majority of competitors are in the delivery of healthcare services mostly in terms of cost and quality. At a local national level scale we are the only locally available manufacturer of CPAPs but we compete with local re-sellers/agents of international suppliers. Still we are able to offer over 50% less price and at a 40% more improved quality. Early trials of our first Product to some local hospitals perform 60% better, and stay 40% longer than the current products in the market and we aim to sell at 50% less than what is offered in the market, while maintaining a good profit margin to help us innovate other products for the goodness of the community we serve.

For the next year and the next five years are incorporated in our ten years plan (2022/2023 - 2032/2033)  In our next year to five years we are aimed at accelerating Tibalabs' movement towards Quality Universal Health Coverage for everyone, everywhere with essential health and related services needed for promotion of a healthy and productive life. Tibalabs aims to make it possible to ensure that all people receive essential and good quality health services they need without suffering financial hardship due to high cost of treatment. The Plan builds on the achievements registered under the Health Sector Strategic and Investment Plan of Tanzania and takes into consideration the challenges encountered and lessons learnt during its implementation. HIV, malaria, lower respiratory infections, meningitis and tuberculosis still are estimated to cause the highest numbers of years of life lost in Tanzania. In five years we seek to leverage opportunities and honor obligations presented by emerging developments at the national, regional (East African Community (EAC), and the Common African Position of the African Union), and global levels.

Our five year Plan provides overall strategic direction with outlining expected roles and responsibilities in attaining this goal, in addition it lays down the implementation and collaboration/partnership frameworks within which Tibalabs will collaborate with the development stakeholders to  contribute towards improving the health of the Tanzanian population. Our main 5 years goal is to accelerate movement towards essential health and related services needed for promotion of a healthy and productive life. Thus, Tibalabs' Plan sets two key objectives to be attained during the 5-year period.

These include:

• contributing towards provision of affordable, safe and sustainable health services
• Increasing financial risk protection of households against impoverishment due to health expenditures;

Towards our Impact Goals, Tibalabs will focus on attaining the following results: reducing the Infant Mortality Rate per 1,000 live births from 54 to 44 and the Maternal Mortality Ratio per 100,000 live births from 438 to 320/100,000; increasing TB case detection rate from 70% to 95%; increasing deliveries in health facilities from 44% to 64%; To attain the above outcome targets, Tibalabs will focus on three thematic areas namely: health diagnostics across the life course (Reproductive Maternal, Neonatal Child, and Adolescent Health & addressing social determinants); non communicable and communicable diseases diagnostics.

Tibalabs intends to strengthen the management and use of health information from all sources, to better guide decision making. Data generation will focus on ensuring all the different data elements needed for the indicators are being collected, from the different sources. The different sources of the data are the routine operations, administrative data, diagnostics registration and statistics, surveys, census and research. Data verification will be based on a comprehensive system to review the collected data for completeness and accuracy. The actual method used will depend on the data source. Data Quality Audits and Data Quality Surveys will be regularly carried out to provide a picture of the level of accuracy of the data collected. Appropriate correction of the data will be applied, based on its expected accuracy to provide more realistic pictures of the state of the different indicators. Appropriate analytical approaches will be applied, with the level of automation of the data analysis will be increased for operations. The focus of analysis will be on comparing planned with actual results, understanding reasons for divergence and comparison of performance by peer lab units. Information dissemination will focus on the packaging and sharing of the information. This will range from facility chalk boards, up to the quarterly and annual performance review reports for our organization. All monitoring and evaluation and research results shall be translated and use the data/information analytics for decision making, planning, review and development. Tibalabs intends to achieve this by focusing on the following components; Monitoring and Evaluation Organization Structure, Monitoring and Evaluation capacity building, Data management, Data quality and performance review.  

The monitoring and review process will measure the extent to which the objectives and goals of the plan (key output indicators and their targets) have been attained. This will be complemented by a stepwise analysis to assess which objectives and programmes were successful; from inputs such as finances to service access and quality, utilization, coverage of services, and health outcomes, financial risk protection and responsiveness. The progress in terms of distribution of health system interventions will involve analyses of differences within and between population groups, among districts, etc. using a series of stratifies and summary measures. The Plan monitoring and review process will be interlinked across the different planning entities, based on continuous monitoring of different levels of indicators; gathers additional data before, during, and after the period to be assessed by multiple methods; uses several analytical techniques to deal with various data gaps and biases; and includes interim and summative evaluation analyses. This implies that information at each level will be provided from the planning entities below it. Management support, on the other hand, as well as partnership information will be analyzed at the same level it is to be provided. Evaluations shall be separately scheduled activities performed at specific intervals (for example baseline, midterm or at the end of a year). All activities will be subjected to rigorous evaluation during the preparatory design phase, mid-term and end term

Tibalabs intends to attain improvements in access to services, quality of care, demand for services, efficiency and equity in delivery of services as the key outputs from investments it is making. These outputs will define the effects of any investments made, and therefore their capacity to influence the attainment of the desired health outcomes as elaborated in the previous sub section. Each of these output areas has clear domain areas and targets the sector is intending to attain. ▪ Improvement in access looks at the improvements in availability, affordability and acceptability of the services provided. As such, it is monitored from the perspective of improvements attained in physical, financial and socio-cultural access to services.

The framework for Our Theory of Change covers the leadership factors, internal and external factors, routine performance monitoring, quarterly reviews, annual review and evaluation of all the indicator domains. Our goal is to increase the access to quality healthcare in Tanzania to everyone, everywhere. The goal is premised on two key strategies:

• Institutional Capacity Building
• Evidence Generation and Dissemination

Under the Capacity building, Tibalabs will work with dispensaries, hospitals, and healthcare diagnostic centers under our innovation partnership policy to build their capacities in using quality healthcare equipment, utilisation of data generated and evidence, knowledge of using data to inform innovation in health care and decision making. With capacities strengthened, health care facilities will be more knowledgeable on the sector, able to accurately articulate healthcare issues and engage more widely in the sector, and develop strategic collaborations as a result of improved diagnostics development With increased collaborations and alliances with sector players, health care facilities influence on health care policies and issues will increase, drawing government attention and political will to support health care diagnostics development, to engage constructively in addressing health care diagnostic policies, Structured collaboration with stakeholders will enhance accountability in the sector.

Under the Evidence Generation Strategy, Tibalabs will address gaps identified in the context analysis. Separate research will be conducted to understand the role and significance of health care data generated and effectiveness of models such as co-management of data in a single system in addressing diseases outbreak resilience and preparedness in Tanzania. Research will also cover the other knowledge gaps highlighted in the context analysis including climate change and gender with specific focus on health care in Tanzania. Specifically the research target will focus on how gender and intergenerational aspects can be mainstreamed in health care resilience in rural and urban.

Information generated from the research will be packaged for Health care centres, Government Agencies, International Organisations, Private Sector, Media, Community Based Organisations, Research Institutions and policymakers at regional and National levels. Information shared will increase awareness and knowledge on health care diagnostic issues, allowing to collaborate and participate articulately in meetings, multi-stakeholder platforms and alliances with governments and the private sector, increasing political goodwill eventually leading to enactment and implementation of policies in support of health care diagnostics in Tanzania.

We use biotechnology to manufacture devices and medical equipment, we also leverage using Machine language (ML) to train data for informing decision making.  

In order to respond adequately to future health service needs and demands, Tibalabs prioritizes issues of gender, inclusion, diversity and equity. Tibalabs intends to achieve this by focusing on the following service areas: Enhance effectiveness and efficiency in Tibalabs Workforce development without segregation based on gender, Tibalabs has zero tolerance against gender based violence, Improve equity in distribution and utilization of Tibalabs workers, Improve Tibalabs workforce performance at all levels, Strengthen Public Private Partnership in development and utilization of the Tibalabs workforce, Establish supportive Human resources policy and work environment for everyone • Strengthen capacity for Tibalabs recruitment. 

We provide our services to organizations (B2B) and to the government (B2G), We conducted a 2 months survey to 230 potential customers and found out that 96%  would prefer using the equipment financing model compared to one-time payment. We offer flexible contract terms based on the length of the contract, we offer monthly instalments, maintenance services, servicing and upgrade frequency. In emerging markets such as Tanzania, where most hospitals do not have the adequate budget to acquire a good quantity of thousand-dollar medical devices, they prefer a flexible financing model.  Buying one Oxygen concentrator machine costs from $5000 – $7000. This cost is too much for developing economies of Africa, Tibalabs bridges and eradicate this gap by making CPAP available for as less as $500 only

Tibalabs Financing strategy 2020/2021 - 2021/2022 has a detailed Tibalabs financing model that best fits Tanzania’s target market. The overall goal of Tibalabs financing strategy is to facilitate attainment of this plan through making available the required resources for delivery of the essential package of diagnostics services and biomedical innovations in an efficient and equitable manner. Tibalabs is expected to address the current health diagnostics challenges by ensuring a strong financial management system that; 1) Guarantees efficient use of available resources 2) Ensures universal access to a quality diagnostics health care package The primary motivation of the financing strategy is to transform the financing mechanism from an input focus to a results oriented thus improving decision making and accountability. 4.1 Tibalabs Financing Mechanisms Funds for Tibalabs are expected to be derived from:  1) Equity financing; 2) direct payment by hospitals, healthcare centers, and patients; and, 4) Global Health financing Grants. 

We have been able to raise $150,000 which is helping us scale to more hospitals in Dar Es Salaam region,  we are now on the due diligence stage to raise $5,000,000 from MAVEC company which will mature by may, 2022 and will help us reach more hospitals in the whole country of Tanzania.