Accompanied Health Initiative (ACHI)

Today, Uganda does not have a national health insurance scheme. With some of the highest out-of-pocket costs in the East-African region, health inequity is mostly suffered by the elderly population(55+years), majority who are breadwinners for their families, and 80% reside in rural Uganda, earning less than $2 a day. This problem is worsened by an unregulated and expensive private health system that is unaffordable to this group. As a result, the elderly are chronically unable to afford quality healthcare hence premature deaths from otherwise preventable illnesses. The ripple effects are detrimental to economic prospects at both household and national levels. With increasing life expectancy in Uganda in the last twenty years, the elderly population projected is to rise over 5% of our national population by 2030. Their healthcare needs will only increase. This calls for urgent attention to healthcare innovations and policies that prioritize the needs of this growing demographic.

At ACHI, we envision healthy thriving African families where all especially the elderly in last mile communities attain dignified healthcare. Our mission is to advance access to quality and affordable healthcare to elderly (55+years) in rural and urban poor communities of Uganda. We employ a network of health professionals embedded in rural and urban poor communities to provide home-based care, clinic-based care via model community clinics, and tele-health services through a toll-free helpline. Through a unique healthcare financing model; the ACHI Family Health Fund, family members or well
wishers in country or the diaspora contribute in advance towards the healthcare costs for their elderly. To ensure equity, the ultra-poor elderly are covered through a grant-based program. By providing home-based care and tele-health services, we prevent severe disease, improve quality of life and ultimately reduce healthcare costs.

ACHI brings a holistic approach to addressing healthcare injustices suffered by Uganda’s elderly, an issue that was exacerbated by the Covid-19 pandemic. For the first time, the elderly will have an opportunity to access trained health professionals in the comfort of their homes or communities through our home-based services and community clinics. The foot soldiers of our model are physician assistants and community health fellows(volunteers) aided by medical officers and specialists within our partner provider networks. Secondly, for the first time in rural Uganda, elders, and their care takers with the use of a basic phone will have unlimited access to medical consultation through a toll-free helpline. Thirdly, through
the ACHI Family Health Fund, family members within Uganda or in the diaspora can make advance contributions/remittances towards healthcare costs of their elderly. This serves as a form of micro health insurance and
hence sustainable funding for their healthcare. To ensure equity, the ultra-poor elderly are covered through a grant-based program. By providing home-based care and tele-health services, we prevent severe disease, improve quality of life and ultimately reduce healthcare costs. 

Over the last ten years my family of seven suffered effects of losing our father at 56 as the sole breadwinner. My dad succumbed to kidney failure following a late diagnosis of hypertension due to limited access to healthcare in rural south-western Uganda. Throughout my clinical practice, I notice that these mid-aged family heads continue to be diagnosed late with complications of diabetes and hypertension among others. My dad’s passing was a first-eye opener into this growing problem. While studying at UC Berkeley in 2019, the problem reared its ugly head when from miles away, I had to support my single mother to get needed medical attention. I knew then, it was time to create a platform that would forever change my family's life and the entire community of the elderly in Uganda and across East Africa. Hence the birth of the Accompanied Health Initiative (ACHI) aimed at advancing access to quality and affordable healthcare for the elderly aged 55+ years in rural Uganda.  With my own lived and professional experiences, complemented by a diverse team, we are best positioned to deliver the ACHI innovation to achieve maximum impact. Our cofounder and cheif strategy officer, James Kassaga brings such a rich and relevant experience to ACHI; at ten-years-old, James lost his entire family of 7 to HIV/AIDs and other preventable diseases in rural Uganda. Raised by his elderly grandma, he became a social entrepreneur to afford children and the elderly dignified education and healthcare that he and his grandma struggled to have. As CEO & Co-founder at Teach for Uganda has raised over $5,000,000 in the last 5 years growing 304 leaders impacting 26k students.

ACHI is currently at Prototype Stage. As an early-stage start-up, below are our Achievements to date: 

1.Carried out Needs assessment surveys for
our target customers (elderly and working adult Ugandans and
potential service providers (healthcare professionals) where 98% of
respondents showing great need for ACHI services. 

2.Legal Registration of the ACHI Healthcare as Legal Entity

3.Brought on a team of 5 advisory board members.

 4.Created a website and social media platforms for ACHI. 

5.Partnered with an international Fiscal sponsor-Omprakash and won a partnership development grantof$1000 as well as raised $1,200 through crowdfunding campaigns.

7. With the founder's financial investment of $12000
on Feb 1st, ACHI launched the 1st Pilot model clinic in a low-income
community in Kampala where the ACHI Model will be operationalized,
and strategically aligned to scale to 5 regions in Uganda so as to
reach every elderly who needs our services in the next 5 years. Currently, we are working on the protocols for operation but have not yet enrolled any elderly into our program. 

We are still testing out and operationalizing the model of ACHI through the ACHI pilot clinic, however, we are not yet serving any of our target clientele.

To deliver on our strategic plan for 2023/2024, ACHI will need total of $309,400 with each operational year needing at least.
$154,700 to fully operationalize the model and establish two model community clinics in central and south-western Uganda.
These two clinics will be serving a catchment area of at least 1,000 elderly and their families. Funding would be fundamental to ACHI's growth strategy at this stage as it will inject the much-needed funding to jumpstart our model from its early-startup stage to strategically operationalizing our two model community clinics in central and south-western Uganda. We believe that being a part of the MIT Network will open up opportunities to connect with the right investors and funders interested in this cause.

Being a part of the MIT network of innovators in health technology will also help ACHI founding team in setting up the following pieces of technology that we aim to leverage to deliver quality and affordable healthcare:

1. Tele-health services; with the aid of basic phones, the elderly will have unlimited access to medical consultations through
a toll-free helpline. Upon remote triage, our medical team will dispatch medical support as needed.
2. The ACHI Mobile App; This will serve as a central platform for managing client's health and demographic data, collecting performance data. It will also help collect funding contributions by working adult Ugandans and remittances from the diaspora into the ACHI Family Health Scheme towards healthcare costs of their elderly and family members.
3. Remote and RealTime health monitoring for the elderly using potentially cost-effective wearable mobile devices by our elderly clientele connected to the ACHI Mobile App for close health monitoring, data management and informed health interventions for better health outcomes 

ACHI brings a holistic approach to addressing healthcare injustices suffered by Uganda’s elderly, an issue that was exacerbated by the Covid-19 pandemic. For the first time, the elderly will have an opportunity to access trained health professionals in the comfort of their homes or communities through our home-based services and community clinics. The foot soldiers of our model are physician assistants and community health fellows(volunteers) aided by medical officers and specialists within our partner provider networks. Secondly, for the first time in rural Uganda, elders, and their care takers with the use of a basic phone will have unlimited access to medical consultation through a toll-free helpline. Thirdly, through the ACHI Family Health Fund, family members within Uganda or in the diaspora can make advance contributions/remittances towards healthcare costs of their elderly. This serves as a form of micro health insurance and hence sustainable funding for their healthcare.

Expected outcomes and impact.

Over the next 5 years, we hope to test, and transition the ACHI model to make it operational Uganda by realizing the following outcomes.

• An established 5 operational ACHI Model Community Clinics and tele-health centers in 5 regions of Uganda serving at least 5000 elderly and their families.
• An established ACHI Family-Health-Fund with at least 500 subscribers
•   An operational toll-free help line to provide tele-health service for our elderly.

We will measure impact with key performances indicators as listed but not to the below:

• Total number of elderlies receiving care from ACHI per year
• Total number of elderly and families subscribed into the ACHI Healthcare fund.
• Number of tele-health consultation conducted per day/week/month/year
• Number of Home-based care visits performed by the ACHI medical team per day/week/month/year
• Number/percentage of chronic disease patients such as that hypertension/diabetes that have attained stability or reported significant improving under the ACHI care.
• Percentage Reduction in yearly clinic visits for the elderly- a measure of gaps filled by homecare and telehealth services as well as quality of care.
•  Reduction in healthcare costs for the elderly per household per year

ACHI brings the first of its kind home-based healthcare in rural Uganda. Research has proven that home- based care for the elderly is much safer and cost-effective compared to frequent hospital visits. The COVID19 pandemic made it more difficult for the elderly to have safe access healthcare services without acquiring the infection(s) in the process. By providing home-based care and telehealth services through the ACHI toll free center and clinical care through our community clinics, we reduce unnecessary transport costs as well as intervene at the earliest opportunity possible to prevent occurrence of severe disease that is more costly to treat. Additionally, the ACHI Family Health Fund affords elders and their caretakers a reliable and affordable health fund for their healthcare needs. To ensure equity, ACHI covers through grant-based programs the healthcare costs of the ultra-poor elderly without any form of family support and unable opt into the ACHI family health fund.

ACHI plans to leverage technology in advancing access to quality and affordable health for elderly in Uganda through the
following platforms;
1. Tele-health services; with the aid of basic phones, the elderly will have unlimited access to medical consultations through a toll-free helpline. Upon remote triage, our medical team will dispatch medical support as needed.
2. The ACHI Mobile App; This will serve as a central platform for managing client's health and demographic data, collecting performance data. It will also help collect funding contributions by working adult Ugandans and remittances from the diaspora into the ACHI Family Health Scheme towards healthcare costs of their elderly and family members.
3. Remote and RealTime health monitoring for the elderly using potentially cost-effective wearable mobile devices by our elderly clientele connected to the ACHI Mobile App for close health monitoring, data management and informed health interventions for better health outcomes

Diversity, equity and inclusion is one of core values at ACHI. We are more interested in talent and the capability to do the ACHI in such a way that we impact our intended target populations in the most positive way possible. It does not matter your gender, tribe, race or religion. Currently, our board of directors and advisors has 4 females and 5 males; out the 9 people, 1 is of Rwandese origin, 3 are Ugandans, 3 are Americans and 2 are of Chinese (Asian) origin. The ACHI pioneer team currently consists of 6 members hailing from 4 different regions/tribes. 4 of these are females and 2 are males. We intend to also involve the international community when it comes to onboarding the Community Health Fellows- basically volunteers who are already healthcare professionals interested in community service. Our Human Resource Policies will continue to be fine-tuned to ensure utmost diversity and inclusion at all levels of the organization.

We employ a network of trained health professionals embedded in communities to provide the following services.
1.Home-based elderly care
2.Tele-health services for the elderly through a toll-free helpline
3.Elderly specialized clinical care through our community clinics and partner providers
Revenue generation
1The ACHI Family Health Fund where;
a) Ugandan working adults support their elders’ healthcare costs by making annual, quarterly or monthly advance
contributions towards healthcare costs of their elderly
b)Remittances from the diaspora-Ugandans and friends who support their elderly in Uganda to opt into ACHI Family Health
Fund
2. Fee for Service by walk-in non-elder patients and their families
3. Partnerships with retirement pension funds and private health insurance schemes

Sustainability Plan

ACHI will leverage on the following potential revenue opportunities to ensure sustainability of our impact post the project year.

• Remittances from the diaspora- we plan to market our services and opportunities to Ugandans and friends in the diaspora who support their elderly in Uganda to opt into ACHI Family Health Fund.
• Fee for Service- by walk in non-elder patients and their families in our community clinic
• Partnering with private health facilities that have the capacity to offer the same service as the ACHI model community clinic
• Sourcing for grant funding from foundations, CSR, and Individuals interested in our model.

To date, we have raised funding as categorized below tow achieve milestones to date.

1. Founders Investment: $12000
2. Individual Grants: $2,233
3. Omprakash Partnership Development Grant: $1,000

As an early-stage start-up,Milestones achieved to date:

1. Carried out Needs assessment surveys for
our target customers (elderly and working adult Ugandans and
potential service providers (healthcare professionals) where 98% of
respondents showing great need for ACHI services.

 2.Legal Registration of the ACHI Healthcare as Legal Entity

 3.Brought on board a team of 9 advisory board members

 4.Created a website and social media platforms for ACHI. 

 5.Partnered with an international Fiscal sponsor-Omprakash and won a partnership development grant of $1000 as well as raised $1,200 through crowdfunding campaigns.

 6. With the founder's financial investment on Feb 1st,2023, ACHI launched the 1st Pilot model clinic in a low-income community in Kampala where the ACHI Moel will be operationalized, and strategically aligned to scale to 5 regions in Uganda so as to reach every elderly who needs our services in the next 5 years.