Unjani clinic pilot

Within the public health sector in South Africa we are overburdened with patients who have insufficient knowledge to self-medicate and as a consequence are seeking healthcare from the incorrect levels within the system. The public health system is congested, with the cost to serve completely disproportionate to the requirement.

Unjani Community Clinic is a sustainable full-service Primary Healthcare (PHC) facility which empowers an entrepreneur to transition from salaried health care workers to a full business ownership model. Unjani Community Clinic provides PHC to the community at point of need staffed with a dispensing nurse (who is able to dispense drugs up to schedule 4) and a nurse assistant.  

Unjani Community Clinic is located in Ward 26, Extension 34, Etwatwa (Johannesburg). The total population of Etwatwa is approximately 30 000 people. The unemployment rate is +/- 60% with those who are employed working in the surrounding areas of Springs, Benoni, Boksburg and Kempton Park. There are five state funded public health clinics in Etwatwa.

To understand how to scale the concept we do the following: 1.Test the drug formulary and treatment protocols. 2. Understand demand and patient volume. 3. Test operating procedures. 4. Determine suppliers. 5. Check the pricing model. 6. Test sustainability.

IMPERIAL Health Sciences piloted the Unjani Community Clinic in Etwatwa for a period of 22 months. During this period processes and controls were established and refined. Community engagement was strengthened through working with the local Councillor’s and the community for marketing. Throughout the pilot stage the staff in the unit underwent extensive coaching and mentoring on a weekly basis.

ACHIEVEMENTS

1. Affordability: Price point established at R80 per patient (including medication). 2. Accessibility: The Etwatatwa community are the main supporters of the clinic. 3. Quality: Quality perceptions of patients (based on interviews and surveys) show that quality is the overriding factor in choosing Unjani Community Clinic. 4. BoP focus: Forward incentivisation, rapidly scalable and cheap back-end. 5. Staff “buy-in” to franchise model: Staff ready and committed to transition of full ownership model.

LESSONS LEARNT

1. Site: location! 2. Infrastructure: the quality of the clinic is critical to define quality standards. 3. Community: understand community value of time and convenience. Understand the status of the nurse within the community. 4. Staff: staff to have business acumen for growth. 5. Incentivisation: create incentives for the community (loyalty cards) and the staff. 6. Sustainability: Share product channels. Mentoring and consistent support to staff is critical to the success of the model. 7. Business model: low cost of managing supply chain support.