Hope Health Initiative

Access to primary health care remains a global problem, particularly in developing countries like Ghana and others in Sub-saharan Africa. Over 53% of Ghana’s health needs are not met by the current healthcare services due to factors such as poverty, inadequate physicians, and access to healthcare facilities. Although 13.3 million people representing 42% of Ghanaians, live in rural areas, less than 1.9% have access to healthcare services. Most healthcare facilities are in the urban areas leaving several millions of people in rural areas without primary healthcare. In Ghana, about 30% of the population (mainly the rural population) must travel long distances to access healthcare services. As a result, many rural inhabitants resort to other healthcare alternatives such as the usage of traditional medicine and often seek proper healthcare when their condition has worsened, making it difficult to treat them. Unfortunately, this issue is similar in other countries on the African continent, with estimates of 800 million (58%) people living in rural areas with its associated lack of access to healthcare services.

OKB Foundation has developed a multifaceted solution by utilizing a mobile clinic set up in a van equipped with multiple diagnostic machines that goes to the underserved and remote areas in Ghana to provide medical services to these people at subsidized or no cost. Due to the lack of physical healthcare facilities and physicians in rural and some urban areas, our approach seeks to: 

1. Ameliorate the issue of accessibility by bringing healthcare to people’s doorsteps from one community to another.
2. Staffing the mobile medical vans with an interdisciplinary team of physicians, dentists, lab technologists, nurses, and other relevant healthcare providers to provide more comprehensive screening and treatment
3. Overcome the financial constraints and poverty by offering subsidized or no-cost primary healthcare 
4. Provide health education to patients and utilize innovative technology such as telehealth, short message service (SMS), and others to supplement education and healthcare 
5. Provide culturally and religiously sensitive care through utilizing healthcare personnel and training native community members to provide care for their communities 

This approach of mitigating the deficiencies of the current healthcare system in Ghana is adaptable to several other healthcare systems in Low and Medium Income Countries (LMICs). Additionally, our primary care services help to complement the existing healthcare system in several areas such as early diagnosis and treatment, immunizations, maternal and child health, health education, providing potable water, and improving sanitation. 

Additionally, our healthcare professionals are fluent in multiple local languages, facilitating improved communication of illness and treatment plan and higher patient satisfaction. Social histories are incorporated into the physical and medical examinations to identify the social determinants of health for individual patients and communities. The healthcare personnel utilizes the Electronic medical record (EMR) units on board the mobile van to document patients’ medical information, which helps to keep accurate patient data, promote patient safety, and facilitate better continuity of care. 

Our target population is rural inhabitants located in Southern Ghana who live at least 16 miles from the nearest healthcare center and live on less than $2.50 per day. For instance, in the Mobia community, one of our target areas, more than 60% of its population are illiterate and farmers. The average person there lives on less than $2.50 daily, and the nearest healthcare center is about 18 miles from the community. With our solution, these people do not have to travel long distances to receive desperately needed care or strain their finances.

I was born and raised in Ghana and lived there until the age of 19 years. Access to healthcare was non-existent in my community. Many sick patients had to undertake a journey of several miles, traveling for days to receive care in hospitals in major cities. These experiences became the driving force for starting a non-profit organization in Ghana. 

Beyond my own experiences, our administrative team and medical staff members have been raised or have lived in Ghanaian communities and are aware of the healthcare challenges these communities face. Their understanding of different local cultures and attitudes around healthcare is central in shaping our approach in each community.

Additionally, all the work we have undertaken in various rural communities has been guided by the community members. For instance, the implementation of our health van was guided by a patient dissatisfaction survey we conducted during our market research. 80% of the people we surveyed mentioned that they would rather self-medicate when sick than walk several miles to the hospital and spend the whole day. In addition to our medical services, we train willing community members to engage in public health education and other administrative duties.

Our key market advantage is providing subsidized and accessible medical care to underserved communities. We hope that this challenge will help us with our technical needs, such as developing apps for mobile and tablet devices for training medical personnel and volunteers and implementing a telehealth system. Furthermore, we believe that this challenge will help us expand our services to different rural communities by providing us with the needed financial support to acquire additional Electronic Medical Records (EMR), medical supplies, and equipment.

In 2007, Ghana established a Community-based Health Planning Services (CHPS) center as a national strategy to improve access and utilization of the healthcare system and reduce inequities. However, due to its immobility, most rural Ghanaians still have to travel at least 16 miles to get care at the CHPS center. Additionally, because of its location and distance from the urban areas, health personnel are less inclined to utilize the CHPS center to deliver healthcare, which often leaves the center understaffed. Mobile clinics have proven to be effective and innovative in providing care in rural areas in both low- and middle-income countries. For instance, mobile clinics were shown to provide healthcare for large numbers of adults and children on a routine basis in studies conducted in rural areas of Malawi, where the shortage of district health personnel was a barrier to accessing primary health care. However, most of these vans do not have the full repertoire of a functioning clinic, such as doctors, nurses, medical diagnostic equipment, and personnel. With our mobile clinic, we would be able to provide more comprehensive healthcare and education in various rural areas within the shortest possible time. Moreover, healthcare practitioners who are less likely to utilize the CHPS centers for the reasons mentioned above would be brought on our van to deliver care to our members.

In addition to providing healthcare to underserved Ghanaians, we want to revolutionize how rural Ghanaians think about healthcare. Currently, many Ghanaians are hesitant to seek medical help - whether because they are unaware of the importance of early diagnosis and treatment or mistrust the system. By forming partnerships with local faith-based groups and community leaders, we can enter communities with trust, allowing us to reach more individuals who need our help.

Our vision is to transform healthcare delivery in rural and underserved communities in Ghana through leveraging technology and accessibility to build sustainable educational health programs, patient-centered care, and cutting-edge research.

 
To achieve this vision, In the next year, We plan to:
 
a) Acquire 10 Hope health vans to serve over 300,000 people a year

b) Invest heavily in building health education and training programs in 300 rural communities  

c) Partner with 15 secondary and tertiary hospitals to ensure a continuum of care for rural inhabitants who might need services that exceed what we can provide in the van

d) Partner with other non-profit organizations and pharmaceutical companies to get cheaper medications, medical supplies, and equipment. 

e) Develop the telehealth system and acquire EMRs 
 
In the next five years, our goals are to: 

a) Acquire additional 32 health vans, at least two vans each for Ghana's 16 regions

b) Expand our telehealth programs to 70 rural communities impacting additional million lives. 

c)Invest in medical laboratories to increase the lab services we offer to our members. 

d) Leverage faith-based organizations' spaces as health hubs to increase access to healthcare services in rural communities.

We currently track the number of patients who use our services each month through our Electronic Medical Record system. This data assists us in making informed decisions on the design of our educational materials and determining inventory for medications as each community we visit has different health needs. For instance, we have provided healthcare services to over 2000 patients based on the data we have collected so far since February 2022. We have identified the top five diseases (i.e., Myalgia, Helminthiasis, Hypertension, Diabetes, and Malaria). This data will assist us in developing tailored educational materials and care for the people we serve.

Inspired by the UN Sustainable Development Goals 3 and 10, our goal is to reduce the mortality rate attributed to malaria, hypertension, and diabetes. Through our test and treat intervention program, we identify community members at risk of various health diseases through our health screenings. Our medical personnel then consult and guide diagnosed individuals in making lifestyle modifications (e.g. changes to diet, exercise, mobility aids) so they can lead healthier lives.

Our education and training program also seeks to train community members to provide primary care for others. Our training modules educate and provide community members with the necessary equipment such as blood pressure machines, glucometers, and rapid diagnostic tests to provide primary health services to their at-risk members. We track data and the impact of these programs and interventions through oral interviews, feedback, and data collection.

1. Accessibility: Providing access to health screening and treatment services via Hope Health Van
2. Activities: Screening services diagnose conditions such as hypertension; Hope Health Van team consults and educates patients
3. Outputs: Community members in rural communities receive health screening, care, referrals, and health education. 
4. Short Term Outcomes:  (a) Improved access to healthcare for people ( b) Awareness and management of their health (c) Individuals make lifestyle changes (e.g., more regular exercise) that allow them to manage their health. 
5. Long Term Outcomes: Improved overall quality of life

Currently, the core technology that powers our solution is an offline EMR system we use to collect patient health records. Our goal next year is to leverage and/or develop other technologies such as mobile health education apps to educate and train community members on how to use medical equipment such as blood pressure machines and glucometers. We plan to develop an SMS technology to help patients keep track of their basic health needs, including vitals, medication reminders, managing health appointments for the van, and specialty referrals. We also plan to develop and extend our telehealth services and technology for rural communities and religious and cultural centers to provide more specialized care.

Our healthcare providers (i.e., physicians and nurses) currently collect the data via our Electronic Medical Record (EMR). They prefer the EMR as it is easy to use and also allows them to provide tailored care to the people they serve based on the data they collect.

Our leadership team comprises a diverse and experienced group of people passionate about serving marginalized communities. OKB’s core team consists of 3 medical doctors, two nurses, and a lab technician with an average of 10 years of experience in the medical field. Additionally, we have eight dedicated board of directors with a plethora of skills in management, strategy, and community engagement. 

Our goal is to increase the diversity among the OKB’s core team in the next three years. To achieve this goal, we work closely with various medical and health alliance universities and colleges to recruit female healthcare providers. Additionally, we plan to develop an internship program focused on training, educating, and empowering young girls to explore various health fields.

We bring transformative healthcare services and life-saving medication to the doorsteps of rural and underserved Ghanaians. Our Hope Health vans are equipped with multiple diagnostic machines, laboratory testing, two traveling doctors, one nurse, and a vast array of medications for immediate patient treatment.

We provide rural communities with subsidized or cost-free preventative healthcare services, medication, and education. These communities need our services as it is not feasible and safe for community members to travel several miles to the nearest hospital, and many people cannot afford their care.

Our Health Van initiative also serves corporations that can purchase regular preventative healthcare services for their employees. Our Health Van initiative overcomes the three main barriers individuals have in healthcare: inaccessibility, lack of education, and financial constraints.

We plan to fund our work through five revenue models.

1. A fee-for-service model where we will provide preventative healthcare and laboratory services and wellness products to corporates and individuals.
2. A subsidization revenue model where we will partner with pharmaceutical companies, health insurance companies, and non-profits organizations to provide free or subsidized medical services to rural and low-income communities
3. Partner with the government to register more people from underserved communities for the national health insurance and generate revenue from health and technical services provided
4. Grants 
5. Crowdsourcing through various platforms

Fundraising -             

We have held multiple fundraising initiatives and raised a total of $27,600 from individual contributions to purchase and retrofit our health van and acquire other medical supplies and equipment.

Co-innovation grant

We’ve received a grant of $8,654 from German Corporation for International Cooperation which we are using to train local volunteers and buy equipment for them so they can provide screening for their communities. This grant also enables us to provide them with a small stipend for their services.

Partnerships with other nonprofit organizations

We partner with Medwish International and AFYA foundation, where we receive medical supplies and equipment to provide care for rural and underserved populations.