Clinic+O

Guinea is a low-income country in West Africa, and has a fast-growing population of about 13.4 million people. For the majority of the population, health services are inadequate and inaccessible. 75% of Guineans (approximately  10 million people) lack adequate access to primary care in close proximity to their home: primary health facilities can be 10-15 km away from people’s homes, mainly in rural locations and due to limited public transportation, it can take patients an average of 2-4 hours to reach these facilities, either by foot (to save money) or using public transport with multiple stops along the way. 55% of people live in poverty, the majority are situated in rural areas, where primary health facilities can be 40-50 km away from people’s homes.

For patients who need to visit hospitals, another significant barrier to access is that individuals incur a range of hospital-related fees, in addition to the cost of the health services themselves, which can significantly increase the overall cost for treatment, along with the cost of any medication that is prescribed. Expenses for outpatient services are the key driver for healthcare costs in Guinea. In addition, Guinea faces a shortage of skilled health workers (Table 1), with only 27,857 health workers across all cadres for the national population of >13 million: more than half of these being community health workers. 

Clinic+O’s primary care solution integrates digital health and community healthcare, on a platform that is interoperable with Guinea’s Ministry of Health at the Department of Community Health, as well as public and private sector partners. By training and equipping local Community Healthcare Workers (CHWs), community health centers, and medical professionals with our technology, we have reached 45,000 underserved community members, and enrolled 15,000+ on our platform to receive digital health records, medical ID cards, with access to in person and virtual primary care services closer to where they live. 

Clinic+O uses a technology-enabled network of healthcare providers and partners to deliver a hybrid model of in-person care via homecare visits and virtual care via telehealth, to help eliminate the long distance travel and high transportation costs that are preventing low-income communities in rural Guinea from accessing primary care services. Clinic+O’s platform is the first in Guinea that integrates digital health with community case management, connecting patients with care providers directly.  Our technology provides a menu of select outpatient healthcare services to rural clients in proximity to their homes through CHWs, medical professionals and SMART Smart Care Hubs. Through this integrated technology, beneficiaries access health information, diagnosis and medication, and stakeholders and governments access health data that is recorded and shared in the healthcare value chain.

Our partnership with the Guinea Ministry of Health focuses on digital health training, upgrading technology and systems, and ensuring our patient health data is interoperable with the country’s DHIS2 health database. Without these measures, the national health resources face significant barriers to addressing critical health challenges, including outbreaks and pandemics that have regional and global impact, as we have seen in recent years.

In addition to our primary care network, we work with public and private sector partners for additional services and health subsidies that reduce or remove the fees required for treatment. These partnerships provide us sustainable revenue while building capacity to scale impact in the coming years.

Guinea is a low-income country in West Africa with a fast-growing population of about 13.4M people. About 75% of Guineans (approximately 10 million people) lack access to primary care in close proximity to their homes: 

1. Primary target population - the direct beneficiaries

• Health facilities can be 10-15 km away from where they live and it can take patients an average of 2-4 hours to reach these facilities, either by foot (to save money) or using public transport with multiple stops along the way. 

• About 55% of these people live in poverty, the majority being in rural areas, where primary health facilities can be 40-50 km away from their homes. 

• These members of the community are reached with tailored and tech-enabled primary care services via a combination of home visits and tele-consultations with physicians, lab diagnostics, prescriptions, and follow-up care.

2. Secondary target population - the healthcare network

• In addition to low-income communities, Clinic+O trains, equips, and employs healthcare providers to deliver healthcare services. Community Healthcare Workers (CHWs) are equipped with digital health tools and mobile devices to perform outreach, rapid testing, and provide medicine for basic care and diseases like malaria, COVID-19, and tuberculosis. 

• Doctors & Nurses and nurses are recruited to provide diagnosis and consultations both in person and virtually, supported by in-person CHWs who connect patients via mobile devices and can support the "teleconsultation"

• Clinic+O staff are embedded at Community Health Centers to provide support for the local medical team in digital health and referrals to ensure patients can receive the services they need in closer proximity to their homes

• Community Leaders & Public Officials receive training in digital health and primary care services to be able to support and refer their community members to receive proper treatment and care, both from Clinic+O and regional community health facilities

3. Tertiary target population - the stakeholders

• Clinic+O partners with the Guinea Ministry of Health to provide digital health training, upgrading technology and systems, and ensuring our patient health data is interoperable with the country’s DHIS2 health database. 

• This partnership enabled Clinic+O to pilot its digitally-enabled community health model, sharing our data and results with the MOH. The MOH is eager to integrate digital health into their CHW training curriculum, but is not yet able to fund the program.

• Clinic+O targets government, NGO, and Corporate partners with data visibility and knowledge management, so as to gain evidence-based insights of local health conditions. Without these measures, the national health resources face significant barriers to addressing critical health challenges, including outbreaks and pandemics that have regional and global impact, as we have seen in recent years. 

Clinic+O operations are locally-led by trained professionals with a deep understanding of local context, who can navigate complexity when working with beneficiaries, communities, partners and public officials. Our digitally-trained CHWs work alongside local doctors and nurses, pharmacies, and laboratories, to effectively, affordably, and safely expand access to patient-centered primary care for marginalized populations. 

The Government views Clinic+O as a health and technology leader, having seen us participate in a hackathon at the Harvard Health Systems Innovation Lab. Clinic+O continues to build inroads with the Government by aligning with their digital priorities. Since the Ministry of Health wants to digitize major health centers in Guinea but does not have the resources or experience, they see Clinic+O as a likely partner to help.

Nasser Diallo, Clinic+O's Founder & CEO, is a recognized International Public Policy and Political Communication expert with over 10 years of experience in developing innovative programs facilitating impactful digital connectivity between citizens, businesses, and governments in the United States, Europe, and sub-Saharan Africa. 

Initially trained as a journalist in Guinea, Nasser arrived in the US in 2010 as a political refugee. He set to work learning English and pursuing career and educational opportunities that would set a foundation for a career focused on global impact. Along with a number of policy-related roles in local and global development, Nasser earned a BA in Political Communication at George Washington University, and a Master’s in Technology Policy at Oxford. Upon graduating from Oxford, Nasser began working at Facebook in Public Policy and Economic Recovery in Sub-Saharan Africa and the European Union. It is through this work in particular, that Nasser gained the experience and insight that would develop into Clinic+O.

Clinic+O has operations in 6 low-income communities with a population of 1.2 million residents, where our medical team and CHWs provide technology-enabled primary care services using our mobile application to ensure patient health data is securely recoded. Working with government, NGO, and private sector partners on several pilot projects in the past two years, Clinic+O's healthcare services have reached 45,000+ people, provided screenings, consultations, and treatment for 15,000+ people who are enrolled on our digital platform to receive ongoing care.

Clinic+O is applying to Solve to help us scale our solution nationally in Guinea, with the goal of expanding to additional countries in Sub-Saharan Africa. To date, Clinic+O has partnered with Guinea’s Ministry of Health, NGO, and private sector institutions to pilot our services in 6 rural communities, and shown meaningful results. 

To scale our services across the country, we have a number of technical and market barriers that we need to overcome, and see that MIT Solve can help us advance our solutions further. Our technology needs to be responsive to the needs of hundreds of thousands, if not millions of patients in Guinea, while still maintaining the simplicity needed to train and activate healthcare providers and patients to use it effectively. Additionally, we aim to build a sustainable business model, combining grants and commercial revenue, both in Guinea and other parts of Sub-Saharan Africa that face similar conditions. 

Clinic+O is the first solution in Guinea that provides patients and healthcare providers in Guinea with a platform that integrates digital health and community healthcare, to ensure that anyone in the country has access to primary care services, wherever they are, while reducing the cost of care and travel required. We currently deliver PHC services in Guinea via Home Care, Teleconsultation and Mass Consultation, with subsidies for low-income patients and free services for marginalized communities. 

The unique and systemic nature of our solution is underscored by the following;

1. The existing private/public health care system lacks the infrastructure, resources, and personnel to address the needs of the majority of the population which reside in low-income, primarily rural communities

2. We are replacing the existing healthcare bottlenecks with a hybrid in person & virtual primary care model that is accessible to anyone, regardless of income or location

3. We give health providers the opportunity to virtually record, monitor, and treat patient health conditions for mild and chronic diseases.

4. We aim to enable health providers to quickly retrieve patient medical records, that can reduce the incidence of fatal medical errors
   

Catalyzing Broader Positive Impact

We are working closely with a variety of organizations to ensure coordination and synergy across geographic areas. Clinic+O is in the process of appealing to a wide range of local and international stakeholders that are providing primary care services in Guinea. Our goal is always to adopt a collaborative approach because the challenges are so great. How can we support their work? How can we share learning? And How does that collaboration improve health conditions in Guinea? Through these collaborations, we will avoid duplication of efforts while creating a local “network of care” that shares the same principles and practices of productive synergy and collective success.

Our Goal: To expand access to primary care services for low-income rural communities in Guinea

Outcome: More rural Guineans gain access to primary care services 

1. Output 1: Number of rural Guineans reached by Clinic+O's community health team

• Activity 1.1 Health outreach performed by Clinic+O's community health agents, CHWs, and medical team
• Activity 1.2 Public officials and civic leaders trained by Clinic+O, in digital health to advocate for our care services to their constituents
• Activity 1.3 We train CHWs and medical providers in digital health and equip them with mobile devices

2. Output 2: Number of low-income Guineans enrolled on Clinic+O's primary care platform 

Activity 2.1 Clinic+O's CHWs and medical team provide health screenings and medical consultations
Activity 2.2 We issue our medical ID cards to new patients, to provide access to personalized medical information
Activity 2.3 Our CHWs and medical team provides follow-up care and referrals where needed

3. Output 3: Government Community Health Centers to be equipped with Clinic+O Digital Health Services

• Activity 3.1 Clinic+O trains Community Health Center staff in digital health methods and care services
• Activity 3.2 We supply Community Health Centers with devices and Clinic+O's mobile application
• Activity 3.3 We contribute our CHWs to staff Community Health Centers

Impact Goals in 2024-25

Impact Goal 1: 10,000 additional rural Guineans reached by Clinic+O's community health team

Impact Goal 2: 5,000 additional low-income Guineans screened & enrolled on Clinic+O's primary care platform 

Impact Goal 3: (2) Government Community Health Centers equipped with Clinic+O Digital Health Services

Clinic+O's digital health operations have been powered by two mobile web applications, developed in partnership with software engineers in Guinea and the EU. Our CHWs and medical team use mobile devices (smartphones and Android tablets) to survey, screen, and enroll patients on our platform, relying on readily available broadband data. However, in the event of power outages or network connectivity issues, we will be building a mobile application that can record off-line data, which can then be uploaded to our database when connectivity is restored.

As we advance our capabilities and technology, we intend to integrate AI into our screening algorithm and data analysis to improve our ability to address health conditions and crises that may emerge in the communities we serve.

TECH STACK

App v1

• Frontend: VueJS
• Backend: Native PHP
• Front/Backend:Wordpress(PHP, VUEJS)
• DB: MYSQL

App v2

• Frontend: Vuejs, quasar (Progressive Web App (web app))
• Backend: Laravel 10
• Front/Backend: Vuejs, quasar (Progressive Web App (web app))
• DB: MySQL

FULL-TIME - 50

PART-TIME - 75

CONTRACTORS - 50

Clinic+O launched in 2021, our current model of digitally-enabled primary care service delivery has been in operation since 2022.

Clinic+O's leadership team are 80% Guinean who are trained locally, and represent the needs of the community we serve. In all of our work and partnerships, we aim to ensure diversity and inclusion regardless of race, gender, or sexual orientation and protect the rights of otherwise marginalized identities. Our goal is to build a sustainable business and technology using local resources and investment to the greatest extent possible, which can benefit our constituents, and our team, through impact and financial means.