Screening mobile center

Nowadays many people in rural community are facing the problem of non-communicable diseases that are getting worse before they even know that they have the disease. This is the case of Diabetes where clients are getting to hospital and got amputated (removal of their body parts) while they did not know whether they have diabetes or not; this is also the case for Hypertension. With screening mobile center, we actively reach the population in the community and screen them for Diabetes and Hypertension and refer them to appropriate health facility.  This screening mobile center also helps in providing appropriate information for covid response for people in rural community as most of information do not access the population in rural community. The screening mobile center, commonly known as screening mobile center also measure blood pressure for the pregnant women when they begin the second term of pregnancy to detect pre-eclampsia.

Non-communicable diseases (NCDs) are highly prevalent globally causing more than 40 million deaths each year. Cardiovascular diseases including hypertension comprise more than 30% of all NCDs  causing 17 million of deaths annually while diabetes account for 1.6 million deaths annually. 

NCDs account for 44% of all deaths in Rwanda. In 2016, I conducted the screening activity in one sector of Northern province in Rwanda and found that among 160 older adult screened, 38% had high blood pressure and did not recognize the condition before, this was also found by other survey team in 2018 and not different from the national figure of hypertension in Rwanda. 

In 2018, the world Health organization mentioned detection and screening of non-communicable diseases among the key components of NCDs response. Hypertension, also known as the silent killer; once detected early through screening, it will be treated and controlled.

Most of the screening services are found in urban area and the rural community is left behind.Using screening mobile center will help the population in rural community to access the screening services closer to them.

A mobile van containing screening equipments to measure blood pressure and blood glucose and a community health nurse will be used to provide screening services from one location to another.

The population in rural community will be able to access the screening service in their community and the service will not be limited to one district and the van will be moving to other places to actively reach the population.

Our solution is to actively reach the community to provide the service instead of waiting people to seek the service at the existing static health facilities

The target population are the population in rural community who need the quality health services usually provided in urban area. They are those old people who are not able to travel long distance to seek screening services and yet they are mostly in need of service. They are those pregnant mothers who find difficult to travel frequently for checking their blood pressure to detect as early as possible the pre-eclampsia condition.

Community engagement will be done when choosing meeting/screening area and screening frequency. For understanding their needs, I will use monthly community work that occur in our country.

Non-communicable diseases are causing global health burden and the screening mobile center is one of the solution to reach the population in rural community who are able to reach the services because most of the screening services occur in urban area.

We provide easy access to healthcare services at affordable cost through our mobile services. We screen for non-communicable diseases so that people should know their health status as early as possible before the conditions worsen. Unlike the existing services which are static and mostly located in urban area far from the rural community, we actively reach the population with our mobile van and we want people to travel less and access affordable health services to remain healthy.

The screening mobile center is innovative health care service in Rwanda. We provide screening services on mobile basis, which makes easier for the population in rural community as we move from one location to another to provide the services closer to the community. While other screening services are offered at public health centers, Screening mobile center actively reach people near their homes and it minimizes the travel cost and saves their time. Unlike the current health services offered at the public health facility in static way and people could only be examined if there are sick, Screening mobile center services are unique as they will be offered in the rural community on a mobile basis and actively reach the population near their homes using a car from one location to another to provide screening services.

Most of non-communicable diseases can cause premature death; yet they are preventable if detected early through screening. Our aim is to facilitate the population in rural communities to access quality health care. 

We usually use cars in public transportation, transport of goods and it is rarely useful in providing medical services other than ambulance and Pharmacy services. We are changing the process of healthcare delivery from static to active, using existing and available resources and use them in other way.

A car equipped with medical equipments and health care personnel reaches the community in the morning and leave in the evening. It works on mobile basis, so the quality health services move around the community to reach each and everyone.

This is a transformational health service delivery in Rwanda.

Mobile clinics, clinics on wheel already exist in other continents like US, Europe, in some African countries like Ghana but this is new in Rwanda. The World health organization use and recommend mobile clinic in remote area where access to health care services is not easy.

Activity: 

•Screening mobile center provides screening for hypertension and diabetes

Output:

•population in rural community access screening services

•travel less for quality service and save time

short term outcomes:

•early detection of disease and get referral and prompt treatment

Long term outcomes:

•Reduced mortality due to non-communicable diseases and improves lives

•increased productivity

Screening mobile services target the total population of 15,242, and it will be scaled in 3 other districts in next year and will serve around 75,000 people. In five years, we expect that the services will reach population in all provinces and will serve around 1,500,000 people

Next year: scaling the services to other 3 districts

5 years later: scaling the services nationwide and include other screening services such as mammography to screen breast cancer.FIn

Currently we can not raise awareness of the services via monthly community work due to covid 19, other communications used to be in churches where people in rural community meet. there is also financial barrier and we currently do not have necessary deliverables (i.e.fuel) to reach the community around our district.

Proposed strategies to overcome these challenges include communication in rural markets using radio so that people should be aware of services. Use of telephone short messages as some people in rural community have phones.

To overcome financial barrier, we provide services to 3 sectors of one district and we plan to scale to the whole district as funds will be raised.

Screening mobile center is one of the centers comprising Lifespan Integrated Community Health Multicenter (LICH-M) registered in Rwanda Development Board as a social enterprise.

5 full time staff

3 part time staff

Marie Louise Umwangange, is the Managing Director. She  holds Master’s in Public Health from Central University of Nicaragua in academic partnership with Texila American University and Master’s in Nursing (Pediatric specialization)  from University of Rwanda. Marie Louise Umwangange also holds the Bachelor’s degree in Nursing from Former Kigali Health Institute. She is certified in Palliative care, Project management, leadership and entrepreneurship.

3 nurses hold advanced diploma in Nursing

2 social workers with community health experience

1 communication officer

1 driver

We partner with public district hospitals for referral of clients with high blood pressure and high glucose for follow-up and better management.

With its mobile pattern, the screening mobile center avail screening services to the population in the community.  target the population across their lifespan from childhood to adulthood.

Screening mobile center uses market-based pricing to set the prices of its services, and as a social enterprise, some of the services will be low compared to other market to make them affordable to the population in rural community, other services will be the same as in other comparable market. 

Value proposition:

To the population in rural community interested in their health and quick quality health service, we provide easy access to healthcare services at affordable cost through our mobile services. We screen for non-communicable diseases so that people should know their health status as early as possible before the conditions worsen, services which are currently not present in the community of Muyumbu and the surrounding. Unlike the existing services which are static and mostly located in urban area far from the community, we actively reach the population with our mobile van and we want people to travel less and access affordable health services to remain healthy.

Financial Summary

The start up cost included:

Screening materials     for 800,000 RWF

Tents                            for 1,400,000 RWF

Furnitures and Fittings  for 600,000 RWF

Marketing                          for 500,000 RWF

Office stationery                     for 200,000 RWF

Computers                        for 900,000 RWF

Fuel                                      for 500,000 RWF

Advertisement        for 100,000 RWF

Total                                   5,000,000 RWF

sales revenue will increase over the next five years as follows

•             4,500,000 FRW by the end of 2020,

•             15,000,000 RWF by the end of 2021,

•             25,000,000 RFW by the end of 2022,

•             50,000,000RWF by the end of 2023

While the sales revenue will be increasing, the Net cash will also increasing as follows:

•             4,050,000 RFW by the end of 2020

•             12,615,000 RWF by the end of 2021

•             18,479,000 RWF by the end of 2022

•             47,787,000 RWF by the end of 2023

The Net profit will also increase in consecutive years as follows:

•             30,000 RWF by the end of 2020

•             2,615,000 RWF by the end of 2021

•             8,479,000 RWF by the end of 2022

•             27,787,000 RWF by the end of 2023

We apply to Solve to be able to provide my solution to the community, if we get Solve grants, we will be able to buy fuel to be used in our mobile center and be able to reach the population in other sectors of our district. Solve grant will also support us in communication during covid period as we will be able to pay sort messaging services to replace face to face communication used before in churches and community work.  

I would like to partner with organization that are working in Health innovation.

Screening mobile center provides screening services to pregnant women to prevent the life-threatening condition (pre-eclampia). With Women prize, We will be able to include other screening services such as mammography to screen breast cancer and pap smear to screen cervical cancer and be able to provide the mobile antenatal care in community.

Our solution is to support the population in rural community access the quality screening services. With people's price, we will be able to scale the solution in other rural districts in country and have appropriately equipped medical van to provide additional screening services that are found in tertially hospitals in urban area such as mammography.