eHealthNews recently interviewed Swiss business entrepreneur and coffee enthusiast, York Zucchi, about his current initiatives in Africa and his attraction to the primary healthcare industry.

What attracted you to healthcare in Africa?

 Africa is the capital of innovation for the world – when problems are encountered on the ground, solutions and systems are developed for the whole spectrum, from very basic usage to the most advanced. I believe there is a global market for African healthcare innovations, Africa just needs to realise its capability to export its healthcare solutions to the rest of the world.

Which part of healthcare excited you the most?

I believe nurse-based primary healthcare is the future. Primary care is important not only in Africa but on a global scale. Nurse-based environments can treat up to 80% of all ailments, and can refer patients upwards to doctors or more specialised healthcare facilities, which would dramatically lower the cost of care delivery for governments.

Primary care is also a great middle ground for the current South African healthcare setting; it’s an ideal solution for those who don’t want to go to public hospitals where you can expect to wait in queues for hours, but on the other hand can’t afford private healthcare.

Despite the potential of primary healthcare, it’s currently operating in a vacuum; diagnostics, nurses and medically equipped vehicles are all separate industries that aren’t working together. There’s an opportunity for entrepreneurs to unite these services.

What impact can eHealth have in primary care?

The implementation of eHealth innovations, such as an effective electronic management system, can not only reduce admin work but also dramatically increase productivity.

In my experience, 90% of nurses are good, caring people but they spend most of their time doing admin work and drug prescriptions. Through an e-management system the total time spent on admin work can drop from 40% to 2%, giving nurses more time with their patients and in most cases that results in an improvement of patient care.

Not only are nurse admin workloads reduced, but the system also acts as a measuring stick for the quality of care delivered. Records can be pulled up years later to see how many patients they were responsible for, what sort of care these nurses delivered and even find health episodes to cross reference against ailments or disease the patient is currently experiencing.

What about from the patient perspective?

By reengineering the business of healthcare and the utilisation of eHealth, it is possible to deliver healthcare to many more patients.  For example, we’ve worked with clinics in Zambia to develop their electronic systems so that more patients can be seen and treated. Now when a patient sees a nurse their details and vitals are recorded and displayed on a screen in a doctor’s consultation room. This innovative eHealth solution allows the doctor to see six patients in the time it would previously have taken to see one.

What are your views on developing healthcare systems suitable for Africa?

There is no point in importing healthcare systems from more advanced countries to say, South Africa, and trying to adapt them; rather use a system that was developed locally that is designed for the South African context.  It makes more sense from a cost and implementation point of view.

What are the key challenges for the African health sector?

Healthcare in general is fragmented across the continent.

Nigeria’s health sector is an example of extreme fragmentation; doctor-led clinics are widely dispersed, and are only slowly being integrated in a region that lacks basic infrastructure such as consistent power supply. However – to quote our Nigerian partner and Managing Partner of EpiAfric, Dr Chikwe Ihekweazu:  “as the sector is gradually overcoming the infrastructure issues there is a growing demand for  technical support to provide systems that record and store information about who is providing what care to whom.”

Healthcare in South Africa is also fragmented, though to a lesser extent. The AIDS and TB pandemics have put a strain on the South African public health system. So efforts should focus on decentralising health services to the local primary care or clinic level. Reducing the cost of care and improving service access and utilisation are priorities. Health Systems Trust (HST) has released an interesting paper about the primary healthcare industry in South Africa.

What are some examples of the benefits that primary care innovation can bring to South Africa?

A prime example is the BMM Reproductive Health Centre. It is a clinic located near a taxi rank in Randburg that is run by two nurses who offer affordable, high quality Sexual and Reproductive Healthcare (SRH) services. These two nurses have not only become business owners, but they are making a positive impact on their patients.

There are also mobile clinics delivering affordable but still profitable primary healthcare to those living in rural areas that don’t have access to traditional clinics. By offering nurse led care, a patient can see a nurse who diagnose them according to their ability, or refer them to a doctor or hospital and still make a small profit per patient for a cost of under R40 to the patient.

What’s the best way to attract people to the primary care industry?

I’m currently involved in an initiative that’s focused on creating businesses out of mobile clinics and offering healthcare professionals the opportunity to own their own business. We ask a few questions: Where are you from? Would you like to go back to your community? Would you like to make an impact? Would you like to own a business? By answering yes to those questions, an enterprise in primary healthcare is born.  Starting a business that makes a positive social impact, as well as a profit is a genuine win-win opportunity.

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