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Overcoming obstacles to launching effective ultrasound imaging services in Kenya

Hear from one of our health entrepreneurs, Michael Seo, about his journey to testing and launching ultrasound imaging services at primary care level in Kenya.

There is a Russian proverb, “trust, but verify” that guides everything we do in Kenya. Since the beginning of the year as we prepared to launch our ultrasound imaging services I was shocked to calculate how much time I was spending pursuing reliable information. Two-thirds of the day was chasing information, trying to reconcile it and then validating it.    

Context is critical

In the midst of our launch preparation, I participated at South by Southwest (SXSW) Health and Wellness, where I moderated the panel, “Value-Based Care (VBC) from Sweden to Brazil”. The goal of VBC is to consistently deliver the highest quality health outcomes at the lowest possible cost. In the US and at panelist institutions, Albert Einstein Jewish Hospital (Brazil) and Karolinska University Hospital (Sweden), technology and data analysis are vital to successfully implementing and delivering VBC. In the informal communities we work, health records are likely to be paper-based and data capture happens as an excel spreadsheet. While we are still guided by the same principles and desired outcomes, the context of the challenges is vastly different. 

The key to VBC is stability and predictability; creating it and ensuring it. For ReaMedica Health, stability and predictability comes from partnerships and it started with the partnership we have with the Johnson & Johnson Corporate Citizenship Trust (Trust).  One of the most overlooked factors of effective partnerships is patience.  Rarely do plans transpire as envisioned. ReaMedica Healthcare, a Trust Accelerator grantee, received its Kenya company registration in January 2018, but had experienced only previously disastrous launch attempts in 2017. However, we had what most start-ups do not, the luxury of time. The Trust provided us with feedback and encouragement, but most importantly gave us the support and leeway to reevaluate and iterate our service model based on what we learned.  

Being “less wrong”

In the beginning of the year, prior to launching our services, we conducted a health entrepreneur workshop (i.e. Gordian Knot) and focus group, in Kisii Town (300 kilometers west of Nairobi), to analyse and critique our proposed service model. What we learned from midwives, nurses, hospital administrators, clinic owners and Ministry of Health was that our assumptions about pricing and the availability of nurses and midwives with imaging experience was simply wrong. While I am not sure we are spot-on with our adjustment we are confident that we are less wrong. A few months later we returned to Kisii Town and Bosongo Hospital to officially launch our co-branded ultrasound services. In fact, we were introduced to Bosongo Hospital in Kisii Town, by Dr. Omache an Innovating Health for Tomorrow alumna who generously supported and organized our February workshop and focus group.

In Nairobi we have had expected and unexpected obstacles. The dearth of nurses and midwives with ultrasound qualifications is par for the course, but the cost of transportation is about twice as anticipated. With these challenges aside (which doesn’t mean we solved them), we launched our Nairobi services with Crescent Medical Aid in June. We’ve been working together offering antenatal screenings throughout June and the beginning of July. Atif Dar, CEO of Cresent Medical Aid explained: “There is a lot of potential in the ultrasound services programme with ReaMedica Health and so a pilot makes sense. If we can get this right, we can scale the programme and explore further collaboration opportunities.”

If six months from now we are spending one-third, not two-thirds, of our time dedicated to validating information I would say we were doing pretty well.  

By Michael Seo, Health Entrepreneur, ReaMedica and Recipient of J&J Trust Accelerator Grant

Read more about Michael’s innovation journey here.