Wellness MicroCare™

According to data from the World Health Organization, the maternal mortality rate in Nigeria is estimated to be about 814 per 100,000 live births. 1 in 22 Nigerian women has a high risk of dying during pregnancy, childbirth and postpartum. UN Global data shows that infant and under-five mortality rates are 74 and 117 deaths per 1000 live births. 1 in 13 of every Nigerian child dies before age 1 and 1 in every 8 children does not survive until their 5th birthday. Maternal, infant and under-five deaths are closely related for key socioeconomic and geographic reasons. Studies have shown a child from the poorest of households is twice as likely to die before their 1st birthday than a child from a wealthy household. These rates are higher in rural areas and low-income communities. 

Current evidence suggests these high rates of maternal and child mortality in Nigeria are linked to untimely maternal health care, delay in receiving maternal health care services, lack of appropriate health commodity services, inequalities in access to health services that are low cost, affordable and easy to share and access, as women in resource-poor settings are least likely to receive adequate, timely and affordable health services by skilled personnel. Improving the quality of maternal and child primary health care services goes beyond assessing only the supply aspect of care, tracking of health commodities and health care service delivery would lead to a reduction in maternal and child mortality rate, while also promoting the health and wellbeing of pregnant women, nursing mothers, new-borns, children and the general community at large.

The Wellness MicroCare approaches this problem through a technological-driven approach that forms a common stakeholder platform for monitoring and tracking the delivery, and possibly the use of Health Commodities in real-time and a feedback loop that includes micro-planners and other critical stakeholders in the Nigerian Health system. Our technology uses a cloud-based system with health-related indicators configured; the approach will work for various health campaigns beyond Maternal and Child Health. It helps indicator tracking in real-time and establishes a seamless feedback loop between decision-making around the campaign at the micro-level. Wellness Microcare provides real-time tracking of health commodities and services delivery, and this would promote accountability and provide accessible insights and data on the delivery and use of the health commodities and services delivered, to the primary health care providers, administrators, funders and stakeholders and also to the targeted community. An increase in the quality of care provided at a health institution does not always translate to an increase in the utilisation of the health services by the individuals who need them, this solution would be used to optimise and measure the performance of primary health care for pregnant women, nursing mothers, newborns, children and the general community. The idea was developed in 2021 but it is now enhanced to include a geo-mapping system that sets out to identify communities that are; remote, hard to reach and/or at-risk, with the intention of flagging the gap and addressing it through impact evaluation and change management.

Hypothesis

Health campaigns are successful with effective microplanning. Micro-planning has to be inclusive and objective in order to be effective. Inclusion will be achieved when the communities are involved in developing outreach plans and strategies that are considered the priority needs of the community. Objectivity will be achieved when information is collected, collated and provided for shared feedback on the public delivery and use of Healthcare information commodities and services, and micro-planning becomes indicator-based and leverages existing local Government planning systems by connecting to Communities, Primary Health Workers and service (campaign information) providers.

Project Design and Implementation Plan.

Wellness MicroCare™ will be used to evaluate the impact of the Health Campaign for a period of 12 months across every Local community in Pilot states in Nigeria using specific indicators. Nigeria currently has 774 Local Government areas with Primary Health centres including many that are hardly reachable. In numbers, if 10% of a Local Government is unreached, this will mean about 232,500 Nigerians are unreached. 

Wellness MicroCare targets pregnant women between the ages of 18 - 51 years of age, nursing mothers between 18 - 51 years of age, infants, under-five children and the general community beyond mothers and children, who do not have easy or regular access to primary health care due to factors such as poverty, lack of resources and lack of knowledge, to mention a few. Achieving a low maternal and child mortality rate and an increase in the general health and wellbeing of the community beyond mothers and children requires everyone to have access to the healthcare commodities and services they require when the needs arise without any form of barrier or limitations.

Many primary health care centres in the rural areas are not in close proximity to get the health commodities and service deliveries which they need to adequately care for the communities they serve and this, in turn, leads to the target communities which include mothers and newborns in rural and low-income areas being unable to get access to these deliveries which they need. Through Wellness MicroCare, primary health care providers would be able to receive real-time tracking and first-hand knowledge of the deliveries, and other stakeholders and partners involved in health can track the utilisation of the delivered commodities to improve the primary health care of all individuals in the community beyond mothers and children.

For the purposes of this assignment, we have put together a team of sub-consultants and staff made up of professionals, all based in Nigeria, most of whom have worked with, or under the direct supervision of the proposed Team Leader, Dr. Adesina Ayodele Fagbenro Byron. The team has strengths and hands-on innovative experience in implementing community healthcare services delivery and evaluation of performance in a commodity.

We have also worked with targeted communities in South-West states in Nigeria and have witnessed first-hand the issues pregnant women, nursing mothers, infants and children face due to a lack of needed healthcare resources and quality healthcare services. The team has conducted research and has found that a lack of information and lack of a verifiable tracking system for the delivery of healthcare commodities and services has led to inappropriate use, mismanagement and wastage of beneficial commodities and services which can be adequately utilised in the treatment of the mothers, children and the general community who need them. This is where Wellness MicroCare comes in, we tried our solution with a handful of public health care centres in the community and there was a notable improvement in the health and general wellbeing due to the on-demand availability of the health commodities and services needed to effectively care for the people that need them. Our results have shown this innovation would lead to a massive reduction in the maternal and child mortality rate in the community and also impact the health and general wellbeing of the entire community positively.

We would like to upscale the need for Wellness MicroCare in more Primary Healthcare centres in Nigeria, as a way of improving quality healthcare delivery across 774 identified local communities in Nigeria. 

Wellness MicroCare is an innovation that is leveraged on cloud-based technology with a real-time tracking system to aid stakeholders in the Nigeria health sector; scaling across Africa to collaborate on planning, accelerating and tracking delivery systems & networks in place by connecting to communities, primary healthcare workers and service (campaign information) providers, to ensure an improvement in the primary health care needs for individuals in the communities. 

Active knowledge and participation of caregivers in these communities as per quality healthcare commodity administration, service delivery, decision making, health records and history would lead to a general increase in the effective utilisation of the resources allocated for the treatment of individuals including mothers and children in the target community.

Some of Microcare features are:
• Geomapping.
• Modification of health performance indicators to suite different sectors.
• Realtime tracking and data gathering using SMS and USSD.
• Multi-stakeholders Dashboard view.

• To reduce the maternal and child mortality rate and increase the health and wellbeing of communities by at least 50% through our approach of assessing maternal healthcare quality and healthcare commodity and service delivery needs.
• To actively speed up the achievement of the Sustainable Development Goal (SDG) 3 of an annual 7.1% decline in maternal mortality in Nigeria.
• Increase the amount of antenatal and postnatal registrations by pregnant women and nursing mothers in rural and low-income communities by over 50% due to the availability of needed resources to provide primary health care services for them.
• To improve healthcare service and commodity delivery across 15000 primary healthcare centres in Nigeria.

Progress Indicator 1: Development of the platform and finalising it with the requirements needed for it to launch and be adequately adopted by healthcare workers and key stakeholders across various local communities.

Progress Indicator 2: Data collection and data entry by trained community volunteers, primary healthcare professionals, the mothers themselves and their trusted guardians to increase the number of users and stakeholders of Wellness MicroCare by over 100%.

Progress Indicator 3: End preventable deaths and reduce the maternal and child mortality rate by 2040 through access to early treatment and primary health care services throughout the course of their pregnancy and after childbirth.

Progress Indicator 4: Reduction of maternal and child mortality rate by at least 7.1% and also ensure healthy lives and promote the well-being of all members of the community regardless of gender and age, before 2030. (Indicators from SDG 3)

Activity 1: Promote awareness and increase registration

Community training for primary health care professionals and community volunteers on how to set up and register on the platform for pregnant women, nursing mothers and the general community.

Output: Inform the community in general on the benefits of the platform for their health care commodity tracking and service delivery.

Outcome: Public participation and engagement, Generate media coverage and stakeholders' interest.

Impact: Increase public interest and registration.

Activity 2: Data Entry

Establish registration centres which are in close proximity to the primary health care centres for pregnant women, nursing mothers and all community members who need assistance to complete registration.

Output: Registration services are available within reach.

Outcome: Publicity and community advocacy

Activity 3: Improving maternal and child care and general well-being.

Send regular reminders and updates of the platform to patients to remind them about issues as regards their health care, commodities and services delivery.

Output: Target audience becomes familiar with the platform and can effectively utilise it.

Outcome: Significant decrease in maternal and child mortality rate and increase in the health and wellbeing of the community members at large.

A cloud-based system with health-related indicators configured using a multi-dashboard with an over-the-internet display to aid data entry and display of patient information and commodities in stock. The patient's bio-data is filled in and recorded in a google docs drive which is safely protected and available for use upon request. Google cloud platform services are most suitable because it facilitates easy collaboration and sharing; they can accommodate large amounts of data; you get complete access to accessing the data from anywhere at any time via Google’s web apps, and it can be used both online and offline.

The data collection approach is done through the Wellness MicroCare device for Healthcare providers and identified stakeholders to ensure the delivery of quality health services and commodity management across local government. 

OUR WORK POLICIES IN DIVERSITY, ENVIRONMENT AND INCLUSION

At Wellness Healthcare Technologies, we work to become one of the most diverse and inclusive organizations in Nigeria, a place where everyone feels valued and respected. We are taking steps to create an environment where everyone – from our employees to our consultants, partners and suppliers – feels valued, respected and has a strong sense of belonging. To achieve this, we must ensure all people are treated fairly, irrespective of their race, color, religion, age, gender, sexual orientation, gender identity, marital status, disability, ethnic origin, nationality, or other status.

Every day we work to provide an environment where all employees feel valued and included, able to nurture their talent as individuals and as part of a collaborative team. A diverse and inclusive workplace, embedded in our principles of honesty, integrity and respect, brings together remarkable people and enables them to be themselves. One will be able to apply and develop skills and knowledge as part of a collaborative team that is helping to innovate and play a part in building a better organization in the area of consulting.

Within our organization, we will achieve an equitable culture through progressive policies and practices which eliminate bias and discrimination. We are proud to have achieved gender balance across our management of Wellness MicroCare, but there is more work to do – for women, and for other people. 

In providing our real-time monitoring system to improve Healthcare performance, we intend to save cost that occurs as a result, of poor performance measurement and management in delivering quality healthcare in Nigeria.

Our products and services are provided through digital and traditional engagements (SMS, USSD and Application) data entry mode, where primary and secondary healthcare workers and stakeholders utilise the Wellness MicroCare to monitor health commodity management and service delivery in real-time.

This is a subscription-based revenue model. We charge an agreed fee for Healthcare workers in each primary and secondary healthcare centre, to pay for our services on real-time monitoring and evaluation of Healthcare and commodity service delivery across States in Nigeria. We would also apply for Health grants and develop a long-term partnership

We have deployed a B2C model with Wellness MicroCare agents moving from households across Mushin (local community) in Lagos state, Nigeria, in order to deliver quality healthcare services at the cost of $1 per head, as well as to take data of their health records and administer periodic checks weekly via our mobile application.