MARKET DOCTOR HEALTH ON WHEELS

More than 70% of Nigerians are the informal sector. The informal sector do not have any form of health insurance. The coverage of health insurance in Nigeria is less than 5%.Most of those in the informal sector earn income daily and are unable to access healthcare when they need it because it brings catastrophic financial problems. Most of them also pay out of pocket for healthcare.

Their major source of healthcare is the traditional herbalists who do no consultation and give herbs which usually does not solve the problem.

If they have to go to the hospital they go to the government hospitals which are too far to walk, no medical personnel due to brain drain, drug stock outs and long waiting time before medical attention is got. This prevents them from making an income that day further pushing them into poverty.

They also live in urban slums and hard to reach areas making the journey time long and waiting time makes an economic loss for the day.

We are solving the problem of accessing healthcare without disturbing the economic activity of the patient.

This is the  "unseen cost" of healthcare access by way of journey time. Waiting time to go to the hospital.

Healthcare access for the informal sector is a huge problem. It is not affordable because they earn daily income and cannot afford huge
healthcare costs. It is not accessible because primary healthcare centers are far from where they live or work. It is not available because there is
scarcity of healthcare workers and most healthcare workers are migrating so we deliver care in person .They  spend out of pocket for healthcare and they do not even have disposable income.

Our solution is 2 pronged approach.

We use mobile clinics and we use community health agents

We have a team of community health workers which are kitted with point of care medical devices and go to markets ,since everyone comes to
the market. They deliver care from stall to stall and if communities from house to house. They can measure blood pressure, blood
sugar,cholesterol,urine assessment and other tests depending on the complaint.They are also equipped with mobile devices where they can
connect and do voice or video calls to medical doctors to confirm diagnosis and prescriptions. They have drugs with them which they can
dispense. This way without leaving the comfort of their homes or at a work place  which can be the market they can have access to healthcare.

We have mobile clinics which we take to communities to deliver healthcare at scheduled intervals. The mobile clinics are a one stop center which can provide medical consultation physically and via telemedicine. They can offer point of care tests, can get remo9te specialist consultations for stuff like dermatology and some tests can be interpreted by specialists remotely. We use simple technology like phone calls, video calls and emails. A lot of them do not have phones talk less of smart phones so we serve as the link between them and health system. In our years of existence we have reached over 1000 communities with 7 mobile clinics and delivered care to more than 400 000 people across the communities. Right now we have introduced a  call center where  we do telemedicine and can give referral to pharmacies for drug pick up. WE partnered with a pharmaceutical giant for the distribution network.

We serve the informal sector which are 70% of Nigerian population and the bottom of the pyramid who live\on less than a dollar a day which is 40% of the 200 million population.

World bank report March 2022:According to the report, which brings together the latest evidence on the profile and drivers of poverty in Nigeria, as many as 4 in 10 Nigerians live below the national poverty line. Many Nigerians – especially in the country’s north – also lack education and access to basic infrastructure, such as electricity, safe drinking water, and improved sanitation. The report further notes that jobs do not translate Nigerians’ hard work into an exit from poverty, as most workers are engaged in small-scale household farm and non-farm enterprises; just 17 percent of Nigerian workers hold the wage jobs best able to lift people out of poverty.

Most of them can not afford the regular health insurance, cannot go to private hospitals because of cost and must work daily to earn income any disruption to this means they will loose the income for the day and affect feeding their family.

Most of them live in far areas from town centers as well as live in urban slums because they cant afford decent accommodation so are prone to disease outbreaks and have poor outcomes to treatments. Where they live do not have health centers which are far between in location, they lack good drinking water and sanitary facilities.

A major problem is also their level of education, they ae usually semi literate and the women grossly uneducated and this has a correlation with their health seeking behavior.

We work with them by taking healthcare to their work place thereby removing the cost of transportation and white coat barrier.

We partner with their associations and take healthcare to them during their local monthly meetings thereby creating avenue of killing one bird with 2 stones, they meet and they access healthcare.

We partner with their microfinance banks to invest their interests into health tokens and created a micro health insurance scheme for them.

We are culturally sensitive so women healthcare providers care for their women who sometimes are not allowed to leave home.

Taking the healthcare services to the communities afford them opportunity to be reached, Hey can call the health worker for advice and care if they so need and taking it to the markets afford them the opportunity to access basic healthcare when they shop for food ,groceries and other household items. One place-two purposes.

My name is Yetunde meaning someone who lost her grandma jus before she was born. I was designed as my grandma incarnate.

My father was the only educated person in his community. When my grandma fell ill it was difficult to reach him...no phones. By the time he heard ,he rushed to the village only to find her vey ill. There was no health center around and not even a health worker. He rushed her to the closed hospital which was 30 minutes drive away ,by the time she got there she got a diagnosis of simple diarrheal with complications. She already had electrolyte imbalances. They tried to give intravenous solutions but it was too late, she died. My dad was not a doctor, though he tried to become one. I was born 3 months after her death. I was given her exact names but my dad told me the story. He wanted me to become a medical doctor. Today I am one.

It resonates with me that people in remote areas and the poor find it hard to access healthcare. My background in health insurance further proved that only white collar job staff had access to health insurance in Nigeria. I wanted to profer a solution and that is why I founded Market Doctor.

Culture and language is very critical to develop solutions in the informal sector. Our dressing is culturally sensitive, we take note of gender sensitivity and we speak local language. We are also aware of payment strategies so we retail such that they can buy what they need daily because of  financial limitation.

My team is made up of similar minded individuals who also share this vision. We recruit from within the community for acceptance  and sense of belonging.

Our community entry skills involve getting the traditional rulers involved and aware of our presence. They handle the publicity and we park our mobile clinics at the palace or community head place. If there are things we need to do our work like sometimes canopies and extra chairs we get it from the community.

We constantly ask questions and try to create linkages within he community. Our health agents are trained by us for 8 weeks and they are from the communities so they in turn can work within the community. We support the local drug sellers and advise on potent brand  medications that can be stocked. After a phone or teleconsultation buying the medication within their community feels good because no added transport cost and they can also get credit facility.

We organize free medical outreaches for them when we have support from partners

400 000 people

I am looking for networking and expansion of ideas from solve. I want to sharpen my go to market skills at solve using proven strategies by similar organizations.

I also think solve will bring the organization to limelight and attract the kind of partnerships we are looking for.

I am hoping solve will help deepen my tech ability and partnerships especially to using AI to do more at the community level.

Our solution is unique because we turned status quo upside down. Normally patients go to doctors but now doctor goes to patient both at work or at home.

Nrmally care to informal sector is fragmented but now we have put together a one stop solution to address health needs.

We are the first solution to take healthcare to the market.

We have a team of community health agents which are kitted with point of care medical devices and go to markets ,since everyone comes to
the market. They deliver care from stall to stall and if communities from house to house. They can measure blood pressure, blood  
sugar, cholesterol, urine assessment and other tests depending on the complaints. They are also equipped with mobile devices where they can
connect and do voice or video calls to medical doctors to confirm diagnosis and prescriptions. They have drugs with them which they can dispense 

Our is to achieve a sustainable, accessible and affordable preventive and curative primary healthcare services within the community. We hope to have a chain of  community health agents from the community to community. and be able to franchise our mobile clinics creating more entrepreneurs. We hope to get to a point when we will have community health agents in all
communities in Nigeria-Africa .That is increased prosperity along inprooved healthcare.

Human Resource for health

We want to have  a chain of health agents of across 100 communities who are mini entrepreneurs themselves. We can only achieve this if we have an academy to train them. Health workers are fast migrating leaving the country devoid of health workers, if we can task shift and use technology to consult we will make significant gain.

We hope to achieve this by digitalizing our existing training project so they dont have to come physically for training. And this will also reduce the cost of training significantly.

Affordable medicine

Despite the fact that we put a low margin on our drugs for sale we know we can still get a better deal if we procure more directly from pharmaceuticals. This will bring more affordability to our services more can buy.

We want to have partnerships with manufacturing pharmaceuticals who can produce essential drugs for us and distribute to our agents to sell at last mile. This will drop the cost significantly. We hope to get funding to do this.

This will have great impact in  chronic non communicable diseases like hypertension and diabetes because of monthly drug purchase.

Mobile Clinic franchise

Despite the success with mobile clinics its a huge investment and we cant possibly be everywhere are looking to franchise our mobile clinic services to those who have vehicles that can be converted, give them the SOP to operate and make profits. This will increase our impact. It will also create employment.

We measure using this metrics

Number of people reached in total by our health messages, health interventions like blood pressure measurements, blood tests etc:350 000.

Number of people with first time medical consultation [face to face or virtual] leading to a new diagnosis: 140000

Number of communities :1011 communities

Markets visited: 125 markets.

Number of new discoveries of chronic diseases like hypertension, diabetes: 35 000

Number of malaria cases tested and treated :133 000.

Number of referrals to higher care facilities which may have resulted in morbidity or death if not discovered: 6 360

Number of outreaches executed:1500

Number of mobile clinics managed:8

Number of staff employed-permanent : 58

Temporary staff:35

Ad hoc /volunteers:>250

The average Nigerian has poor attitude to health, and this has resulted in a lot of avoidable deaths.

Time and cost to access health facilities often constitute a major obstacle to seeking care, particularly for those in the informal sector. It is not uncommon for a patient to be obliged to allow one full day of travel and waiting time in order to access a health facility. These indirect costs can be so high as to be catastrophic for the financial stability of a household.

This is why Market Doctors has adopted the use of mobile clinics, medical outreaches and health agents to bridge the gap between the poor and quality health care in Nigeria.

In the past 5years, we have visited over 14 states in Nigeria, with our team of medical professionals, providing primary healthcare interventions. We have carried out over 935 medical outreaches, with a minimum of 150 people attended to per outreach.

In the year 2022, we managed 6 mobile clinics for one of our partners, MTN Foundation, across 6 states in Nigeria; Lagos, Kwara, Kano, Gombe, Anambra and Rivers. Over 47,000 beneficiaries were reached across the 6 states.

This year 2023, we are prepared to do much more to impact the lives of Nigerians through the mobile clinic initiative.

Also, selected women and youths will be trained on some health-related topics, to enable them become health agents, who can serve as intermediaries between people, within the community, and doctors back-end. They will be trained and kitted to carry out basic health checks like temperature, blood pressure, blood sugar and malaria, using self-care medical devices, and then contacting the doctor via telemedicine. The doctor will consult with the patient and prescribe

We believe that if our mobile clinic can be equipped with digital devices and point of care test kits with essential medicines we can task shift some of the medical services to health workers and reduce cost of delivering care to hard to reach communities driving them around, this also fuels affordability. If we can train and produce digitally   enabled, supervised and compensated health agents will cause increased access to primary healthcare services at the bottom of the pyramid especially in the community doing door to door delivery of healthcare in their own communities bringing about affordability and cultural sensitive care will provide enhanced health service delivery for infections, communicable diseases, chronic diseases and health information leading to improved health outcomes and financial sustainability for the informal sector and poor.

Eventually increasing and improving access to healthcare to millions of people at scale across communities in Nigeria and Africa.

The core technology driving our solution is mobile phones and internet connectivity. And its basically for medical consultation and interpretation of test results.

We are able to do video calls via apps like WhatsApp and Electronic medical records solution.

We are able to communicate using phone calls and  sms.

We may need a better platform when we scale our impact.

Its simple technology because that is what the lower pyramid can understand.

but we need  to incorporate GIS to be able to locate  patients and connect them to closest pharmacies in our network for prescription when we are not there.

We are diverse and inclusive. We employ both men and women though we have more women on the team due to nature of work women tend to work more in healthcare.

We employ from different backgrounds especially from communities we work in.

We provide support for those who come from poorer backgrounds by provision of accommodation to reduce burden of transportation. We provide creche facilities for nursing mother.

We offer flexible work hours.

KEY PARTNERS-Pharmaceuticals. Diagnostic companies, Medical Device We buy products we use from them.

KEY ACTIVITIES-Marketing partnerships and sponsorships, delivering
care to subscribers, health program execution ,medical outreaches. We provide services for them.

KEY RESOURCES-Medical personnel, support staff. Logistics support for movement, medical devices and point of care tests, technology for teleconsulting value. We employ this group of people creating employment.

PREPOSITION: health at one stop shop, affordability, availability on
request, continuous care, payment flexibility, quality service. Our preposition is one stop shop for the man on the street. The common man.

CHANNELS-community health workers, telemedicine, mobile clinics
,outreaches. We use the above as channels to do this.

 CUSTOMER SEGMENTS-Users, corporate entities, NGOs
program management. 

REVENUE STREAMS-Sponsorships from corporate organization's social responsibility budget , execution of health projects for International NGOs, payment for services by patients.

 COST STRUCTURE-profit margin of > 35% from each segment
drugs, user fees, administration  B2C =15% profit margin.More profit from B2B than B2C

We are looking to partner with donor agencies interested in working with the informal sector on healthcare access e.g USAID this way we will be able to work at scale and be sustainable especially if we have 3yr-4yr partnerships.

We already work with some big corporation on their yearly sustainably budgets for health to deliver to poor communities.

We plan to partner with pharmaceuticals to deliver health commodities at last mile. We have a partner now but want to engage more. This way  we sell products and become more profitable and expand our impact.

We want to be able to partner with government for big scale projects like vaccination, Vit A administration and deworming.

We do not have any B2G partnerships.

We are improving our B2C model by designing a micro health insurance scheme to cater for them and reduce out of pocket spending and catastrophic spendings on health.

We execute projects for more than 40 organizations since inception with varying pay checks from as low as $500 to hundreds of thousands of dollars.

We executed a mobile clinic management across 6 states for MTN FOUNDATION YHELLO DOCTOR PROJECT

They owned the mobile  clinic.It lasted one year .2021-2022.We equipped the clinic with personnel, rapid diagnostic tests and drugs.

Each clinic visited  a minimum of12 communities every month travelling across all zones in the states. Attended to  at least 1200 per month and delivered medications to at least 1500 people every month.

Total of 72000 beneficiaries accross 700 communities.

The worth of the business was $300 000.00

Profit was $80 000.00

Logistics and truck repairs were major areas of concern.

Below was our thank you note to MTN