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Almost 90% of South Africa’s population relies on the country’s stretched and underresourced public healthcare system. Imperial Health Sciences managing director Dr Iain Barton contends that this system is further burdened by many patients who have insufficient knowledge to self-medicate and, as a consequence, are seeking healthcare from the incorrect levels within the system. It’s this thinking that has prompted the Imperial Logistics group company to invest R7 million in the Unjani Clinic franchise network, and become the first private sector organisation in South Africa to start a nurse owned and operated primary healthcare network.
Outlining some of the issues in South Africa’s state health sector, Barton notes that the country suffers from a triple affliction: the pandemic of HIV/AIDS/TB, preventable conditions arising from socio-economic determinants and the poverty cycle and a growing amount of noncommunicable disease affected by lifestyle. ”Around 88% of the population is dependent on the overburdened public health sector. This is aggravated by the fact that the provision of care is focused on hospitals – or curative care – rather than on health prevention and promotion in communities. The cost implications for the wider health system are huge – with a cost of R105 at a primary healthcare facility compared with a hospital cost of R320. Healthcare is better organised and supported in suburban areas compared to informal settlements and rural areas, where the majority of the population faces challenges to access primary healthcare due to time, cost and distances. There is an urgent need for transformation in the South Africa’s health system,”he stresses.
Imperial Health Sciences is contributing to this transformation with the setup of its network of franchised “Unjani Clinics”, which aim to meet the need for primary healthcare in poor communities by providing essential medicines and education at the point of need. In addition, the initiative empowers black women by creating entrepreneurial opportunities for professional nurses to own and operate commercially viable primary healthcare clinics, supported by a franchise network and structure. Unjani Clinics are in line with UN mandate of empowering women fighting diseases like AIDS and TB, improving maternal health. Barton explains: “The project is based on the premise that only a small percentage of people seeking treatment at primary healthcare facilities actually need the attention of a medical doctor. In addition to providing an affordable and accessible service for the poor who would otherwise spend vast amounts of time and incur travel costs to receive attention at a state healthcare facility, it also creates an entrepreneurial opportunity for professional nurses. The Unjani Clinic business model is a financially sound business opportunity that is empowering women and creating jobs. The ownership model sees the professional nurse increasing her ownership share annually based on a franchise agreement with Imperial Health Sciences. Further employment opportunities are created due to the need for administration support staff at the clinic, as well as cleaners and other service providers. Each clinic creates between three and five sustainable jobs, and produces real, localised enterprise development that empowers women.”
Unjani Clinic has been in operation for 4 years, with the pilot project taking place in Etwatwa for 2 years. During this time, 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 from Imperial Health Sciences.
Imperial Health Sciences now has seven fully franchised Unjani Clinic units – at Orange Farm, Nellmapius, Bram Fischerville, Villa Lisa and Etwatwa in Gauteng; at Kwaggafontein in Mpumalanga; and Delft in the Western Cape. Each Unjani Clinic operates from a customised 12m shipping container.
Patients pay between R100-R150 for a consultation with a qualified nurse, and receive medicines to treat a range of common primary healthcare conditions. “All of the clinics are equipped to deal with primary healthcare illnesses,”Barton states. “In addition to this core service offering, other services include curative, preventative, promotive and chronic care. Curative care covers the treatment of minor ailments, STIs and wound care,” he explains. “On the preventative side, the clinics offer familyplanning, pregnancy testing, antenatal care, immunisation, HIV testing, TB screening and wellness screening that encompasses blood pressure, blood glucose, cholesterol and vision screening. Chronic illnesses like diabetes and hypertension are treated, and, in terms of promotive care, the clinics offer health education and counseling.”
“Unjani Clinic engages the underserved and lower income population as customers, offering them community access to quality primary healthcare at prices they can afford. Thisis an affordable, accessible and quality healthcare offering that provides the lower end of the market with an attractive treatment alternative and real potential to improve healthcare outcomes in South Africa.”
The qualified nurse running the Unjani Clinic is authorised to prescribe and dispense schedule 1 to 4 drugs. The clinics also sell over-the-counter drugs such as aspirin and various cough and flu medication, should a patient not require a consultation.
Based on the success of the project to date – each of the seven clinics sees between 150 and 500 patients per month – Imperial Health Sciences plans to establish a national network of 400 Unjani Clinics in the next five years.“We used population estimates, national primary healthcare infrastructure, primary healthcare national expenditure, non-hospital public health expenditure per capita by district, GDP contribution per province and primary healthcare process indicators to determine the number and geographic distribution of the 400 clinics,” says Barton.“We will focus on those areas where the greatest need for accessible and affordable primary healthcare exists.”
While Imperial Health Sciences’ overriding motivation for this project is to contribute to the dire need for transformation in South Africa’s health system, while driving empowerment and job creation, the business logic behind the initiative lies in the opportunity to grow new markets for clients. “Through servicing a segment of the population which is currently not being served, Unjani Clinic has huge potential to grow our pharmaceutical and consumer clients’ sales volumes and provide an opportunity for innovation around repackaging traditional offerings for affordability in this market. This is another way in which Imperial Logistics is improving our clients’ competiveness by customising our experience in outsourced value chain management,” Barton concludes.
Almost 90% of South Africa’s population relies on the country’s stretched and underresourced public healthcare system. Imperial Health Sciences managing director Dr Iain Barton contends that this system is further burdened by many patients who have insufficient knowledge to self-medicate and, as a consequence, are seeking healthcare from the incorrect levels within the system. It’s this thinking that has prompted the Imperial Logistics group company to invest R7 million in the Unjani Clinic franchise network, and become the first private sector organisation in South Africa to start a nurse owned and operated primary healthcare network.
Outlining some of the issues in South Africa’s state health sector, Barton notes that the country suffers from a triple affliction: the pandemic of HIV/AIDS/TB, preventable conditions arising from socio-economic determinants and the poverty cycle and a growing amount of noncommunicable disease affected by lifestyle. ”Around 88% of the population is dependent on the overburdened public health sector. This is aggravated by the fact that the provision of care is focused on hospitals – or curative care – rather than on health prevention and promotion in communities. The cost implications for the wider health system are huge – with a cost of R105 at a primary healthcare facility compared with a hospital cost of R320. Healthcare is better organised and supported in suburban areas compared to informal settlements and rural areas, where the majority of the population faces challenges to access primary healthcare due to time, cost and distances. There is an urgent need for transformation in the South Africa’s health system,”he stresses.
Imperial Health Sciences is contributing to this transformation with the setup of its network of franchised “Unjani Clinics”, which aim to meet the need for primary healthcare in poor communities by providing essential medicines and education at the point of need. In addition, the initiative empowers black women by creating entrepreneurial opportunities for professional nurses to own and operate commercially viable primary healthcare clinics, supported by a franchise network and structure. Unjani Clinics are in line with UN mandate of empowering women fighting diseases like AIDS and TB, improving maternal health. Barton explains: “The project is based on the premise that only a small percentage of people seeking treatment at primary healthcare facilities actually need the attention of a medical doctor. In addition to providing an affordable and accessible service for the poor who would otherwise spend vast amounts of time and incur travel costs to receive attention at a state healthcare facility, it also creates an entrepreneurial opportunity for professional nurses. The Unjani Clinic business model is a financially sound business opportunity that is empowering women and creating jobs. The ownership model sees the professional nurse increasing her ownership share annually based on a franchise agreement with Imperial Health Sciences. Further employment opportunities are created due to the need for administration support staff at the clinic, as well as cleaners and other service providers. Each clinic creates between three and five sustainable jobs, and produces real, localised enterprise development that empowers women.”
Unjani Clinic has been in operation for 4 years, with the pilot project taking place in Etwatwa for 2 years. During this time, 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 from Imperial Health Sciences.
Imperial Health Sciences now has seven fully franchised Unjani Clinic units – at Orange Farm, Nellmapius, Bram Fischerville, Villa Lisa and Etwatwa in Gauteng; at Kwaggafontein in Mpumalanga; and Delft in the Western Cape. Each Unjani Clinic operates from a customised 12m shipping container.
Patients pay between R100-R150 for a consultation with a qualified nurse, and receive medicines to treat a range of common primary healthcare conditions. “All of the clinics are equipped to deal with primary healthcare illnesses,”Barton states. “In addition to this core service offering, other services include curative, preventative, promotive and chronic care. Curative care covers the treatment of minor ailments, STIs and wound care,” he explains. “On the preventative side, the clinics offer familyplanning, pregnancy testing, antenatal care, immunisation, HIV testing, TB screening and wellness screening that encompasses blood pressure, blood glucose, cholesterol and vision screening. Chronic illnesses like diabetes and hypertension are treated, and, in terms of promotive care, the clinics offer health education and counseling.”
“Unjani Clinic engages the underserved and lower income population as customers, offering them community access to quality primary healthcare at prices they can afford. Thisis an affordable, accessible and quality healthcare offering that provides the lower end of the market with an attractive treatment alternative and real potential to improve healthcare outcomes in South Africa.”
The qualified nurse running the Unjani Clinic is authorised to prescribe and dispense schedule 1 to 4 drugs. The clinics also sell over-the-counter drugs such as aspirin and various cough and flu medication, should a patient not require a consultation.
Based on the success of the project to date – each of the seven clinics sees between 150 and 500 patients per month – Imperial Health Sciences plans to establish a national network of 400 Unjani Clinics in the next five years.“We used population estimates, national primary healthcare infrastructure, primary healthcare national expenditure, non-hospital public health expenditure per capita by district, GDP contribution per province and primary healthcare process indicators to determine the number and geographic distribution of the 400 clinics,” says Barton.“We will focus on those areas where the greatest need for accessible and affordable primary healthcare exists.”
While Imperial Health Sciences’ overriding motivation for this project is to contribute to the dire need for transformation in South Africa’s health system, while driving empowerment and job creation, the business logic behind the initiative lies in the opportunity to grow new markets for clients. “Through servicing a segment of the population which is currently not being served, Unjani Clinic has huge potential to grow our pharmaceutical and consumer clients’ sales volumes and provide an opportunity for innovation around repackaging traditional offerings for affordability in this market. This is another way in which Imperial Logistics is improving our clients’ competiveness by customising our experience in outsourced value chain management,” Barton concludes.
