Caregiver training & education: a global & local opportunity

We are focused on professionalizing the vocation of caregiving based on the principles of person-centered care.  We work with current caregivers, or those seeking to enter the field, to provide the comprehensive knowledge needed to help older adults age with dignity.  Through our structured learning programs, students can become certified as a caregiver and learn how and when to integrated into the broader care team including healthcare professionals.  Successfully matriculating students can then seek employment within Bangladesh or look for opportunities elsewhere.  We also provide training and education to family members seeking to provide better care for their loved ones.

Our curriculum democratizes advancements made in the world’s leading medical institutions and universities and provides it to those people who need it the most – caregivers – to perform their daily work with the greatest impact.  By doing so, we are able to improve care while lowering overall cost to the healthcare system.

In today’s world of unprecedented longevity, living better as we live longer has become a dominant theme.  With one billion people projected to be 60 years or older by 2020, and two billion by 2050, no government or healthcare system will be able to afford to growing costs of caring for an even older population unless we change the paradigm.  In Bangladesh, 7.5% of the population is considered elderly (12.5 million), this number is expected to reach 20% by 2050 (40 million).  

In many countries, the older generation cares for the young children, allowing both parents to work and raise the economic viability of the extended family unit.  When the health of the elderly is compromised, the negative impact can extend to the broader family.

In Bangladesh, policymakers have cited the need to take effective steps for ensuring various necessary services for the poor, middle-class and urban affluent ageing population.  The World Health Organization highlights the need to empower a new vocation of caregivers to help address the issues of successful ageing.  However, no structured, accessible learning program exists today in the world capable of engaging people who desire to join one of the fastest growing areas in healthcare in the 21st century.

There are more than 4500 medical clinics in private and public sector in rural Bangladesh that provide health service locally.  However, these clinics are sufferings from inefficiencies, planning constraints and resource limitations.  Among these challenges, the shortage of trained health workers is severe. The proposed project aims to help address this problem.

This proposal meets the needs of the population of Bangladesh in not only building up a supply of credentialled caregivers but also it promotes a new career opportunity capable of addressing national, regional and international workforce shortages. We serve the broader community seeking to provide improved care to older adults seeking to age with dignity.   

We partner with government organizations, vocational training institutions and non-profit and for-profit entities that provide in-home person-centered care.  For all of these groups we seek to upskill people who are already working as caregivers or who are seeking to enter the vocation of caregiving.  We also serve families seeking to gain the competencies and education needed to provide more informed care to their ageing family members.

We also work with government finance ministries, insurers and payers who are seeking to provide extended care that results in improved quality of life and well-being at a lower cost.

We have worked with nursing and care experts around the world to develop structured on-line education through which students who enroll, complete the course work and successfully pass the tests gain the education and insights needed to become caregivers.  Each vocational education program is comprised of courses in specific areas which each consists of modules which focus on key domains and are themselves devolved into lessons.  The lessons focus on individual topics and last five-15 minutes each.  

In addition to an introductory course, we have four different programs that results in certification levels (I-IV) of increasing complexity and sophistication.  Level I teaches the fundamentals of caregiving for older adults based on the principle of person-centered care.   Levels II & III provide in-depth insights into activities for daily life (ADL) and age-related conditions (ARC).  Level IV covers the information needed for the most challenging cases including diminished mental capacity and early dementia.  The information contained in the learning modules is presented at a level that can engage people with little formal education and do not require that a university degree is first obtained.  All of our courses will be available on-line and accredited by eduQua, the Swiss quality body for continuing education and training programs.

We will partner locally with the highly regarded  Japan Bangladesh Friendship Nursing Institute (JBFNI) to establish a center-of-excellence in Dhaka where hands-on training will be provided as a complement to our on-line curriculum to facilitate competency development as well as train other trainers who would then take the programs into other areas in Bangladesh to extend knowledge and create a new workforce capable of improving care for the elderly country-wide.   

JBNTI works with Dhaka-based Japan Bangladesh Hospital to meet the need for supplying trained nurses. Japan Bangladesh Hospital helps trained health workers to get employment with different health service providers in Bangladesh and overseas.  While this program is very successful and active, there is still a significant unmet demand for health care workers.

We are also partnering with Anandapur AA Saleh Ahmed Community Hospital This hospital is located in rural area, Feni district, which will provide an opportunity for trainees to have work experience in rural environment.

The skill of caregiving has received very little investment in training and education despite being identified by the World Health Organization and the World Economic Forum as being one of the fastest growing vocation in the 21st century.  While there are many advancements and insights being made in academic institutions, these are seldom translated into practical educational content for people with lower levels of educational achievement

Care Campus has focused on partnering with experts around the world to create best-in-class online accredited educational content and then building a platform to support vocation training.  We constantly survey the field and find topics of interest that can be develop at a high standard and made available to platform members to continuously acquire new knowledge and insights aligned with global standards to improve care delivery at the local level.

We are engaging at the local level to partner with recognized institutions to deploy hands-on training as a complement to our on-line curriculum to facilitate competency development as well as train other trainers who would then take the programs into other areas to extend knowledge and create a new workforce capable of improving care for the elderly.

We also are seeking to partner with government finance ministries, insurers and payers who want to document how our coursework creates a workforce that provides enhanced care results not only in improved quality of life and well-being, but also does so at a lower cost and burden to the healthcare system. 

Like most of the world, Bangladesh is facing a crisis in caring for an increasing older population while at the same time lacking trained caregivers capable of meeting that need. Our online educational education platform will be translated into Bengali allowing people across Bangladesh to access the world’s leading advancement in care delivery.  

Economic opportunity in today’s changing world requires new skills and education.  Our platform will help create a new pool of workers by professionalizing the vocation of caregiving.  These newly certified caregivers will be capable of engaging within Bangladesh to elevate elder care and also to travel to meet economic opportunities in other countries. .  This proposal will provide a solution that is twofold, that of increasing the education level by way of gaining an internationally recognized qualification and through providing a solution for increasing primary health care services so that older people in Bangladesh can continue to make a contribution to society.

By helping assure successful ageing, caregivers can help family units to thrive by helping provide a more stable environment at home, with older adults able to provide care for children thereby allowing both parents to work and earn a salary.

Training caregivers to understand the challenges that older adults face, what to do about them when they occur and when to contact a healthcare professional when the problem is not resolved will provide early detection of health issues and more efficient utilization of more expensive healthcare resources which will lower the overall cost burden on the system.

We are in discussions with groups that provide at home and institutional care in Australia, New Zealand, Switzerland and the U.S. by employing caregivers.  These organizations are large and each employ more than 500 caregivers at any one time.  They are interested in our platform for internal training purposes and also for recruitment and training of new staff members.  We could have more than 2000 people on the system within three months of executing these contracts.  

After initial test programs New Zealand and Switzerland, we will expand in Australia and the U.S. and Bangladesh in the first year. over the five-year period we will engage across Europe and translate into French, German, Spanish and Italian to help drive and support market adoption.  Similarly, we will engage in China, India, Japan and Malaysia in support of early ongoing discussions there.

Version 1 of the platform can support multiple languages and up to 25,000 users a month and version 2 would support 250,000 users a month.  Our business model focused on institutional engagement to build platform-load but we also expect to get interest from individuals and family members.

Assuming we have traction with these groups, we would expect to serve 10 organizations and 5,000 – 10,000 caregivers in year one.  By year five, we project to have close to 5,000,000 people on the platform across the geographies we are targeting.

In the first year, we will finish, translate and launch our platform and in Bangladeshi and establish two local centers of training excellence - one in  Dhaka and another in a rural setting in the Feni district.  We will work closely with the government and our partners to optimise our training and educational material which will the enable us to pursue broad engagement across Bangladesh.

Over the next five years, we will work to leverage our collective experience to extend our collective reach and impact across Bangladeshi by training and certifying trainers in Bangladesh who can then go outing the community, across the country, to establish local training facilities that will provide the trading and skills to enable people to become certified caregivers and then serve the increasing needs of the local population or find employment elsewhere within Bangladesh or in other countries where the demand for trained caregivers is very high.

In Bangladesh, 7.5% of the population is considered elderly (12.5 million people) and this number is expected to reach 20% by 2050 (40 million people).  One caregiver can care for 4-10 older adults, depending on the level of support they need.  The data informs us that there needs to be at least one million caregivers to support Bangladesh’s current elder population and that this number will grow to three to four million by 2050.  Additionally, people who become certified as caregivers will also be able to seek employment opportunities outside of Bangladesh.

We will scale across Asia and the world over time.

Bangladesh is a developing country with 160 million people struggling to meet its basic needs including extreme shortage of skilled/ semiskilled manpower for health sector, particularly primary health care industry. Eighty percent people of Bangladesh live in rural area where lack of healthcare services affect peoples’ life and hence the socioeconomic development of the country.  Our project will provide training and education for elder caregivers to create a more skilled workforce, improve quality of life and lower healthcare costs.

As we have now invested the time and money need to create the educational content, our biggest challenges will be:

• Capital: to attract an appropriate amount of scale capital to invest in and support our business growth.  
• Government support: to achieve our objectives and have the broadest impact we need to have strong support at the government level.  
• Scalable platform: we need to anticipate our growth to ensure that our platform is robust enough to carry the load, with an ability to scale rapidly as demand increases.
• People: to attract and retain key talent who are inspired by our vision and ready to make an impact.
• Partners: to deploy locally, we need to find good partners who can help us reach and have an impact at the local level. 
• Cost data: to generate good cost data showing the reduction in care burden that results when staff are trained and certified on our platform.

We have developed concrete plans and strategies to address and overcome the barriers we face as described the previous section:

• Capital: after self-funding this initiative thus far, we have three paths to secure funds: (a) grants which we are pursuing, (b) strategic partnerships which we are considering; and (c) external venture capital with whom we are discussing investment.  
• Government support: we are seeking to engage at the government level in the geographies we have targeted to ensure alignment and support and have good success thus far in Asia and Europe.
• Platform: we have identified our core platform and learning management system and have prioritized scalability in the initial architecture and product selection.
• People: we have a growing network of qualified and interested people who want to be part of this new initiative but will need to be careful about how we manage growth.
• Partners: we are evaluating potential partners and strategically choosing those who we think would be best as we focus on specific geographies.
• Cost data: we need to work further on this topic with the right people in conjunction with the payers or healthcare agencies to develop a robust data collection methodology.

n/a - planning to expand solution to Bangladesh

In Bangladesh today, 7.5% of the population is considered elderly (12.5 million people), this number is expected to reach 20% by 2050 (40 million people).  The World Health Organization highlights the need to empower a new vocation of caregivers to help address the issues of successful ageing.  In Bangladesh, policymakers have cited the need to take effective steps for ensuring various necessary services for the poor, middle-class and urban affluent ageing population.  

There is currently no education system in place capable of establishing, training and empowering caregivers to meet this challenge.  We have created the educational content and platform to support the creation of the vocation of caregivers in Bangladesh, through the on-line platform as well as the proposed hub and spoke delivery models including a train-the-trainer program.

One caregiver can care for 4-10 older adults, depending on the level of support they need.  The data informs us that there needs to be at least one million caregivers to support Bangladesh’s current elder population and that this number will grow to three to four million by 2050.  Additionally, people who become certified as caregivers will also be able to seek employment opportunities outside of Bangladesh.

To address this, our expansion plan is to establish training facility and presence in Bangladesh (Dhaka) with the support of our JBFNI while revising our context for local context and translating it into Bengali.  We are also partnering with Anandapur AA Saleh Ahmed Community Hospital. located in Feni, to provide an opportunity for trainees to experience in rural environment.

n/a - selected hybrid for-profit and non-profit.

We have a lean organization with four full-time staff members and 6 part-time staff and four independent contractors.  As we move into the scale up phase, we will recruit more full-time team members to advance our content development and digitization work, for customer support and training.  Our back-office function is largely out-sourced and we will start to internalize when and where it makes sense from a market-responsiveness and cost-effective perspective. 

Peter Nicholson, MBA is Managing Director of ALTEKA, a healthcare consultancy.  Through his 35-year career in the biotechnology and healthcare he gained global exposure to the challenges and opportunities related to the ageing demographic.

Francis Hughes, RN, PhD, ONZM has more than 35 years of experience working in healthcare with particular specialty in mental health and disability. She has worked in over 18 countries, having held positions with WHO, Chief nurse in New Zealand and Queensland Australia and more recently the CEO of the Swiss-headquartered International Council of Nurses.

Julia Hennessy, RN,PhD, MEd is President of the globally-recognized Auckland Institute of Studies, one of New Zealand's largest tertiary learning organizations.  An experienced educator and healthcare professional, her career has focused on the development of healthcare and social services progress at local and international levels.

Marion Clark, RN, MPP, has a 30-year career of management and leadership in the health sector focused in clinical (nursing), hospital management, health public policy analysis and policy management, health professional regulation and health international development working with governments, NGOs and industry.

Mohammed Ali Ershad, PhD is an experienced development administrator and researcher with focused experience managing development projects funded by the government of Bangladesh, the World Bank, ILO and ADB in the areas such as poverty, literacy, rural development, disaster management.  A former civil servant of Bangladesh he understands the country’s socioeconomic aspiration, capability and has vast knowledge in the area of education and training supportive for building healthcare professionals in developing countries.

We will partner with Japan Bangladesh Friendship Nursing Institute (JBFNI) to establish a center-of-excellence in Dhaka where hands-on training will be provided as a complement to our on-line curriculum to facilitate competency development as well as train other trainers who would then take the programs into other areas in Bangladesh to extend knowledge and create a new workforce capable of improving care for the elderly country-wide.    

JBNTI support letter

We also have support from the Bangladesh National Human Rights Commission who will join us working to support this mission.

Bangladesh National Human Rights Commission support letter

We are also partnering with Anandapur AA Saleh Ahmed Community Hospital This hospital is located in rural area, Feni district, which will provide an opportunity for trainees to have work experience in rural environment.

We have support in Malaysia where we have established a relationship with Associate Professor Dr. Siti Halijjah Shariff, Dean Business and Management School, Universiti Teknologi MARA, 40450 Shah Alam, Selangor.

Universiti Teknologi MARA (Singapore) support letter

We also do the same with in India where3 we have established a relationship with Sandip Kar, Ph.D., D.Litt., Chairman, IIMS School of Business located in Kolkata.

IIMS School of Business (India) letter of interest

Our R&D activates are supported and pursued through our Geneva-based non-profit Care Health & Technology Association. Our market deployment and commercial activities will be pursued through our for-profit business, Care Campus S.A.

With Care Campus, we have a hybrid business model.  We partner with organizations to provide training and education to their staff with an annual platform fee and a fee per employee, based on the total number of employees.  To extend our reach further, we also provide training and education to individuals or directly access our information via the internet for a fee.  We also work in partnership with organization seeking to create a center-of-excellence training and education center in a certain geography.

Our pricing is based on the guidelines provided by the World Bank, with organization and individual in wealthy countries paying 100% of the index price, upper income countries paying 60%, lower income countries paying 30% and poor countries paying 10%.  

Because we are a social impact company, we also provide our materials for fee in those cases where there are no resources available.

We are building a sustainable business.  

Initially we will source funding from grants, strategic partners and investors to meet our funding requirements.  Revenue will commence in Q2 2020 following the release of version 1.  This SAAS business model is based largely on an enterprise-to-enterprise growth with relatively modest contribution for the consumer channel, particularly in the initial years.

We can carefully match our growth to the success in the market and provide mid-course changes in strategy or execution should we not generate the expected results.  Thus, we are focused on longer-term sustainability rather than as growth-at-all-costs business model.  We target break-even cash flow in six quarters, once we launch. 

There is a need to develop pragmatic solutions that can be deployed locally in Bangladesh and scaled more broadly across Asia.  Through our platform, we will leverage insights from the best academic and medical centers around the world.  

We are focused on meeting the caregiving challenge by leveraging the use of connective technology, something that Tiger IT Foundation can help us to better understand as we explore how to optimize the integration of technology a home care setting.

Furthermore, we seek to protect the credentials caregivers earn through the use of blockchain technology, thereby preventive issues that can occur in situations of economic, political or climite-caused dislocation.

Bangladesh has recognized the urgent need to develop pragmatic solutions that work across socio-economic levels to provide a pragmatic solution to the ageing challenge.  We can deliver that through Care Campus and create a new group of educated vocational workers that can leverage their new skills to deliver elevated and person-centered care in Bangladesh or elsewhere in the world.

By supporting Care Campus with this grant, Tiger can position Bangladesh to lead Asia and the rest of the world in learning how to proactively and productively address this challenge in a cost-effective manner while creating 21st century jobs.  We can partner together to learn how best to change that face of ageing while enabling a new vocation. 

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Tiger IT Foundation to gain insights into how we can best use connective technology in the setting of home care, to help integrate blockchain to secure and protect individual credentials. To make local connections, help with local recruitment and help gain better engagement.

Japan Bangladesh Friendship Nursing Institute (JBFNI) to establish a center-of-excellence in Dhaka where hands-on training will be provided as a complement to our on-line curriculum to facilitate competency development as well as train other trainers who would then take the programs into other areas in Bangladesh to extend knowledge and create a new workforce capable of improving care for the elderly country-wide.   

Anandapur AA Saleh Ahmed Community Hospital This hospital is located in rural area, Feni district, which will provide an opportunity for trainees to have work experience in rural environment.

Bangladesh government accrediting bodies and other ministers.