FrontDoor mobile clinics

Common complications of pregnancy and childbirth contribute to maternal and neonatal deaths annually, 80% of which occur in developing nations with limited access to basic healthcare services (UNICEF,2019). FrontDoor mobile clinics operating in spacious mid-sized buses equipped to provide antenatal and post natal care as well as handle emergency obstetrics ensures that larger under-served populations can be reached by fewer providers. Vulnerable groups such as people living with disabilities, the poor, pregnant teenage girls will be direct beneficiaries as their special needs such as accessibility, inability to afford healthcare, stigma etc are taken into consideration. This promotes social inclusion and strengthens these communities. Analysis of trends will inform policy and help in scaling up interventions.

According to UNICEF 2019 report, maternal and child deaths have reduced globally due to improved access to affordable, quality health services.

Despite progress the same report reveals vast inequalities worldwide with women in Sub-Saharan Africa still facing a 1 in 37 lifetime risk of dying during pregnancy and childbirth.

Uganda still ranks among the top 40 countries in the world with approximately 15 pregnant women dying every day from pregnancy related complications (Uganda Demographic Health Survey, 2016). Analysis of the most common complications including hemorrhage, eclampsia, unsafe abortion, infection among others shows that with routine antenatal screening and timely interventions the majority of these deaths would not occur. Unfortunately in under-served communities most pregnant women cannot readily access or afford quality healthcare. Moreover vulnerable groups such as people living with disabilities face further challenges including stigma, physical barriers having to travel long distances to the nearest health center with unfavorable infrastructure.

With the present covid19 crisis, in Uganda pregnant women nearing delivery have struggled to access healthcare. Without transport to the nearest facility, many have ended up delivering in their homes and suffered preventable complications and even death.

FrontDoor mobile clinics bring free quality lifesaving obstetric and newborn care to the front door of under-served communities by use of innovative technology in terms of well-equipped spacious mid-sized buses. The mobile clinics have three major components

• Routine antenatal screening to monitor maternal and fetal health, detect early danger signs and prepare a birth plan. This section of the clinic is equipped with couch, portable ultrasound machine, blood pressure machines, STD screening tests, pregnancy tests, malaria test kits, basic drugs and pregnancy supplements
• Emergency delivery section for normal deliveries equipped with delivery bed, delivery sets, vacuum extractors, neonatal resuscitation equipment, oxygen cylinder, delivery sundries gloves, antiseptic, iodine, alcohol etc. A rapid and efficient referral pathway will be in place for complicated deliveries requiring a more capable facility.
• Post natal care services given to mother and newborn immediately after birth up to 6 weeks. This includes counseling and health education on danger signs, training on routine care practices such as exclusive breast feeding, adequate nutrition, emotional support  
• Reproductive health services including use of contraceptives, importance of delaying subsequent pregnancy, STD screening, outreaches to sensitize and encourage young girls to stay in school and delay sex

Our FrontDoor mobile clinics use innovative technology to bring lifesaving healthcare to the front door of under-served populations including rural areas, remote locations, vulnerable populations, high risk groups such as underage pregnant girls taking into consideration their unique circumstances and experiences. Our vision is to improve maternal child healthcare access beyond backgrounds, cultures and borders with the goal to promote social inclusion and strengthens community health systems. With the help of village health teams, we mobilize local communities and encourage them to share their health needs and express opinions as main project beneficiaries. Ongoing stakeholder engagements for formulation and dialogue to advise on existing policies and gaps and support project implementation. FrontDoor mobile clinics will bring quality, free, accessible and assuring maternal child heath services and reduce mortality rates from common preventable causes.

Most maternal and child deaths in Uganda are due to lack of access to quality lifesaving healthcare. Vulnerable populations have poor health seeking behavior due to poverty, lack of access and prevailing high costs with further unique challenges for people living with disabilities such as mobility constraints, stigma, long distances to nearest health facilities as well as unfavorable infrastructure.

FrontDoor mobile clinics bring free lifesaving care to the front door of these vulnerable communities thereby expanding access to high quality affordable care for women, new mothers and newborns in resource constrained settings.

Our solution is innovative in that we are utilizing existing technologies to efficiently deliver efficient and quality lifesaving health service. By contrast, traditional methods of health service delivery rely on regional hospitals or health centers and remote populations suffer constraints of accessibility, lack of adequate trained personnel, drug stock outs, broken down equipment, unfavorable infrastructure among others. A simple concept of FrontDoor mobile clinics creates a new dimension of performance by bringing quality health services to the front door of remote communities to improve healthcare access. With the current increase in mobile phone technology we keep track of referrals at household level by communicating with Village Health Teams via phone calls/messages. We have a clear referral pathway for more complicated cases that require a hospital. We also coordinate  activities of the project using the same platforms  to analyse and identify trends and improve project execution. For data management and proper record keeping we could employ digital solutions like cloud, online platforms so that data can be accessed anytime and anywhere

FrontDoor mobile clinics utilizes automobile technology to reach the front door of remote populations for which the nearest health center is miles away. This technology negates the problem of lack of access as larger populations can be reached in timely and scheduled manner. W e are developing a digital platform where all antenatal visits will be recorded to ensure subsequent follow up appointments are attended. With the use of mobile phones we are able to communicate with village health teams at household level to remind mothers to attend their scheduled antenatal appointments. Updates of new referrals can be reviewed remotely, anywhere and anytime. A clear referral pathway to regional hospitals is also available for complicated cases that need immediate attention.

Other existing technology employed in this model include medical devices such as ultrasound machines, blood pressure monitors and others.

A similar technology has been developed by Expandable Healthcare where they use a Hybrid care unit in mobile healthcare delivery to make healthcare accessible to everyone in the world.

Problem: Maternal child deaths due to lack of access to quality healthcare

Activities: Front door antenatal clinics, focused assessment fetal scans, maternal health checks, birth preparedness plans, emergency deliveries, referrals, post natal care including nutrition,exclusive breastfeeding ,contraception, sex education outreaches encouraging girls to delay sex and complete their education

Outputs: Vulnerable women, girls, people living with disabilities in under-served populations, rural and remote areas will gain access to quality live saving health care without constraints of lack of access, high prevailing costs, unfavorable infrastructure

Short term outcomes: Communities will actively participate in utilizing available health service to improve maternal and neonatal outcomes.

Long term outcomes: Reduction in maternal and neonatal deaths, communities empowered to make proper decisions on matters that affect their health. Stimulate development and strengthen vulnerable communities by promoting social inclusion. Aid rural transformation and development. Strengthen health service delivery and referral pathways. Inform policy and help in scaling up interventions.

Since its inception in February 2020, FrontDoor clinics serves one pregnancy crisis home with about 100 pregnant teenage girls. There are ongoing discussions with other pregnancy crisis centers on partnership opportunities to serve them using the same model.

In one year our FrontDoor mobile clinics will expand to serve larger populations especially in rural and remote areas, the estimate number we will be serving in 1 year will be about one million women and girls within the target bracket.

In 5 years the numbers we should have scaled up to about 5 million women and girls as we morph into a specialized center of excellence with experts to offer niche services to communities in need.

Our goal is to deliver live saving healthcare to vulnerable populations beyond boundaries and make healthcare accessible to all. 

Within 1 year we intend to spearhead a comprehensive pilot project to deliver these services to the most in need regions starting with the Northern region of Uganda that has for long been ravaged by war and instability leading to poverty. We will cultivate communication frameworks and create partnerships with government and other developmental partners to support project implementation and continuation.

In the next 5 years we shall replicate the pilot project and extend it to other regions within Uganda and beyond borders. Analysis of trends and project activities as well as lessons learnt within the first year will inform policy and help in scaling up interventions.

Since the target population is below poverty line, there will be need to continue supporting them as part of social inclusion program to lift their lives to a level at which the community can attract resources competitively. This could take a decade.

Financial for acquisition of specialized automobile and necessary furnishings to run the FrontDoor mobile clinics

Technical in terms of integration with governments on already existing traditional system

Cultural barriers where pregnant women and girls in rural areas may prefer traditional birth attendants, herbs, myths over modern medicine hence to break these barriers, sensitization and education is needed

Financial  - approach development partners

Technical- forming communication frameworks with governments to authorize operations in already existing health systems and support project implementation

Cultural barriers will be approached by liaising with Village Health Teams to mobilize and sensitize communities to actively participate in utilizing the available health services to improve outcomes.

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The project team consists of 7 full time members. These include Project director, medical officer, public health educator, sonographer, nurse and 2 field coordinators.

The team is responsible for understanding the project scope, completing assigned work within the budget, timeline and with high quality expectations.

Professional background in health related subjects working with women and girls in reproductive health. (to add details)

Experience working with multicultural and inter-religious populations.

Multi-lingual team able to interact with communities at the grass root in their respective local dialect

The Remnant Generation a teen crisis pregnancy center

Ongoing discussions to extend our work and partner with Medical Teams Uganda, White Ribbon Alliance.

We intend to work with the communities they serve including refugee settlements, slums, rural areas to offer a free high quality antenatal and postnatal service for pregnant women, new mothers and their newborn babies.

We provide free health care to vulnerable populations by bringing the services to the front door of under-served populations.

Our revenue streams are mainly from gifts, donations and fees paid for similar premium services.

Our key activities include delivering quality accessible healthcare, stakeholder engagements, provision of similar services at a premium, health campaigns and outreaches.

We form strategic alliances and key partnerships with development partners for optimization and economies of scope.

Our business model is a 'freemium' (free and premium) where by we integrate premium business activities with the social free programs, The premium business is created as a funding mechanism to enable the mission of our organization.

We also have ongoing stakeholder engagements to discuss sustained donations and grants since the target population is below poverty line. This will promote social inclusion until the community can attract resources competitively. Until then, we shall continue providing these niche services on Research and Grant basis.

I am applying to solve for mentorship in refining my idea and business model to explore ways to deliver best results and scale up the intervention. I believe the intervention is much needed especially in areas of rural Africa where pregnant women die everyday from preventable causes. We need a new and more robust way to deliver healthcare aside from the traditional methods which rely on hospitals which in most instances are very far from reach.

I am also seeking support funding since the target population is below the poverty line to promote social inclusion until a time when these vulnerable communities can attract resources competitively.

We look forward to forming strategic alliances with key partners for optimization of resources through outsourcing, sharing infrastructure and other economies of scale such that we can reach millions of vulnerable groups to deliver quality maternal child health care and improve outcomes.

We would like to partner with organizations and individuals who are passionate about improving maternal child health.

They can advance our solution by identifying potential gaps or bottlenecks and giving suggestions on how to improve.

They can also link us to similar organizations who would partner with us to go further in the cause.

Also to advise on marketing and media exposure.

And finally to offer support funding for project implementation.

Our core focus area of operation is maternal child health to improve access to healthcare for this target group and reduce maternal and child deaths in Africa.