Healy Nurse: Providing Affordable Home Healthcare and Nursing Services

 

This article articulates the reasons for establishing Healy Nursing Services, also known as Healy Nurse. And highlights the framework for providing affordable home healthcare and nursing services to Nigerians.

Did you know that the average Nigerian spends six hours 12 minutes on every general hospital visit? 

This is according to a 2017 report by researchers from the Nigerian Bureau of Public Service Reform (BPSR).

The findings revealed that, on average, patients spent about three hours, 50 minutes on pre-documentation, 32 minutes on nursing care, and one hour, 50 minutes to get doctor’s consultation. 

Are you surprised when the patient-to-doctor ratio is 3,500: 1? After World Health Organization (WHO) recommends a patient-to-doctor ratio of 600: 1. Did you also know that the patient-to-nurses ratio is 1,000: 1.5 instead of the recommended 1,000: 2.3?

The information above represents a part of the grim state of Nigeria’s healthcare industry.

In this post I will highlight:

1. Who we are.
2. What we do.
3. How we do it.
4. Whom we serve.

Who We Are

Healy Nurse is a healthcare company operating in Nigeria. We incorporated it on 10 December 2020. 

Healy Nurse is a platform that connects you to nurses in your locality. We bring home healthcare and nursing services to your doorsteps.

Responsibilities of Co-founders

Did you know that 75% of startups fail? And one of the main reasons is not having the right team in place to make the company successful. 

Did you also that 65% of startups fail because of management issues? No wonder Olufunke approached me when she spotted a gap in the healthcare industry.

Oluwarotimi Mude (Chief Executive Officer, CEO)

As the chief executive officer (CEO), I’m tasked with overseeing the day-to-day administrative and operational functions of the company. I am relentless in working to increase the opportunities for our services in the market and to carve a niche for us in the industry.

Responsibilities of the CEO

– Setting strategy and direction

– Designing and implementing business strategies, plans, and procedures 

– Making important managerial and operations decisions

– Focusing on the needs of all stakeholders, i.e. customers, nurses, and so forth

– Setting comprehensive goals for performance and growth 

– Establishing policies that promote company culture and vision 

– Overseeing daily operations of the company and the work of executives (IT, Marketing, Sales, Finance, etc.) 

– Evaluating performance by analyzing and interpreting data and metrics 

 

Olufunke Oduyebo (Chief Operating Officer, COO & Nurses Team Lead)

She is a visionary. She dreams big and is extremely passionate about what Healy Nurse could achieve in the future. 

She reports directly to me and is the second in the chain of command.

Responsibilities of the COO & Nurses’ Team Lead

– Creating and animating Healy Nurse’s values, behaviour, and culture

– Hiring and leading nurses

– Leading nurses to encourage maximum performance and dedication 

– Writing reports to the CEO on all matters of importance 

– Assisting the CEO in fundraising ventures 

– Taking part in expansion activities (investments, acquisitions, corporate alliances, etc.)

– Managing relationships with patients/clients

 

What We Do

Two factors lead to the founding of Healy Nurse.

First, is the private sector’s contribution to Nigeria’s home healthcare industry.

With diminishing levels of disposable income among some segments of society and the limited supply of public hospitals that are overstretched and underfunded, there is greater demand for private coverage. 

According to research from Oxford Business Group (OBG), the demand for health services, particularly treatments of maternal health and Non-Communicable Diseases (NCDs), will rise with income and demographic growth. While the low rate of insurance penetration, the economic recovery and policy incentives should create long-term opportunities. 

It also highlights that the Nigerian state has shown an interest in utilizing Public-Private Partnerships (PPP) frameworks to entice businesses to make up the deficit.

Second, on the micro-level, I would refer to Olufunke’s experience as a Nursing Intern working at The General Hospital, Lagos Island, Lagos State. 

She observed that over 90% of people who visited the hospital for diagnoses and treatments were outpatients. 

She also noticed that hospital staff spent an inordinate amount of time before attending to patients. I highlighted this state of affairs in my introduction. 

The stress of navigating the ever-tedious Lagos traffic to-and-from the hospital also compounded patients’ conditions.

As an Empath, Olufunke felt an urge to ease the stress patients went through, convincing her to contact me.

And as we began researching the most cost-effective way to intervene, it led us to home healthcare and nursing services.

Home Healthcare

 

 

Medicare.Gov defines home healthcare as a wide range of health care services you receive in your home for an illness or injury. 

Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility (SNF). 

The goal of home healthcare is to treat an illness or injury. Home healthcare helps you:

• Get better
• Regain your independence
• Become as self-sufficient as possible
• Maintain your current condition or level of function
• Slow decline

Outline of our services

1. Routine checkup.
2. Disease management.
3. Administration of medications.
4. Catheter care.
5. Pain management.
6. Infusion therapy.
7. Post-surgical care.
8. Family planning services.
9. Wound care.
10. Specimen collection.

Routine checkup

This is a physical examination our nurses perform to check overall health. We also know it as a wellness check. 

It’s a good way to check cholesterol, blood pressure, and blood sugar levels. You don’t have to be sick to request one.

Disease management

Chronic conditions require lifetime management. Our nurses don’t just focus on stabilizing your health; they teach you how to manage your condition independently. 

During your initial assessment, a nurse evaluates your health, reviews your medication, and assesses your home for all risks.

Administration of medications

We offer excellent medication administration by educating our clients about their medication, and stating the purpose and most common side effects. 

We can use this service for medication administration, scheduling injections, help with medication compliance.

Catheter care

Insertion of an indwelling urethral catheter is an invasive procedure only a healthcare provider should administer to drain the bladder, for investigations, to measure urine output also to relieve retention of urine. We maintain proper hygiene when in situ.

Pain management

With home management, there is not a single solution. Research shows that almost every treatment from pills to physical and psychological solutions decreases pain by 30%. 

The trick for pain management is making a nursing care plan that layers solutions and provides multiple options for breakthrough pain or bad days. This, our nurses can make possible.

Infusion therapy

This offers our clients a comprehensive and innovative source of healthcare options in the comfort of their homes. Easing long and unnecessary stays in the hospital, our home infusion team administers IV therapy and treatment in a safe and comfortable setting.

Post-surgical care

Our nurse’s visit will ensure your wound is healing properly and does not get infected. They check any drains or IVs that are left in place, and follow any post-op orders that are given for blood draws, wound care, and drain care. 

They also teach your family members how to do as much of your care as safely as possible.

Family planning services

Depending on your medical history and lifestyle, our nurses are there to assess and explain which methods of family planning will be best for you.

Wound care

Assessment and care plans are essential to treat wounds aseptically.

Specimen Collection for Laboratory Tests

Just like phlebotomists, we send our nurses to draw blood and other specimens from patients for laboratory analyses. Our nurses do this in the patient’s home instead of a doctor’s office or hospital.

Benchmark for Our Home Healthcare Services

A study by BMC Health Services Research on the relationship between patient satisfaction with a country’s healthcare system and a set of socio-economic and healthcare provision indicators concluded that: 

“Based on 31 countries and four years, our findings document the significant role of healthcare provision indicators such as the number of physicians and nurses provided in the healthcare system and support that there is a strong association between patient satisfaction level and the number of hospital beds, nurses and physicians per 100,000 habitants, with the latter being the most important contributor. Among the socio-economic variables, public spending on health plays a prominent role on patient satisfaction as shapes and positively relates to patient satisfaction, while private spending on health-related negatively…” 

Going by the conclusion of the BMC research, the healthcare system dissatisfies Nigerians. This is because of the low ratio of hospital beds, physicians, and nurses compared to the population.

Equally, the healthcare system dissatisfies Nigerians because of low public spending. The Medic West Africa Report estimates that public and private spending will increase to NGN5,762.016 billion in 2021 up from NGN5,318.016 billion in 2020. This represents an increase of 8.35%. In 2021, however, estimates on healthcare spending will be 2.94% of Nigeria’s GDP down from 3.08% in 2020.

Therefore, going by healthcare indicators and macroeconomic variables in our country, HNS does not have standards with which to benchmark patients’ satisfaction.

What Is The Alternative To Providing Affordable Home Healthcare to Nigerians?

The story is not all gloom and doom, as there are studies that have extrapolated factors that determine outpatients’ satisfaction. 

A ResearchGate study is a case in point. They titled the study Factors Associated with the Quality of Outpatient Service: The Application of Factor Analysis—a Case Study. The conclusion of the exploratory factor analysis showed that outpatients’ satisfaction comprised four factors, namely:

1. Professional care.
2. Availability of services.
3. Waiting time.
4. Satisfaction with laboratory services.

And so, we have accepted to use the four factors to benchmark our home healthcare and nursing services. From now on, I will attempt to explain who we serve and how we deliver our services.

Whom We Serve

As I stated earlier, Healy Nurse is a healthcare platform operating in Lagos State, Nigeria. Healy Nurse commits to delivering quality home healthcare and nursing services to our client’s doorsteps. 

And our primary target market is the under-served residents of Lagos. By this, I mean people who do not have the information, inclination, resources, or access to basic healthcare services.

Our Target Market

Without boring you with marketing mumbo-jumbo, we have used income as the basis for our target marketing.

That includes the entire segment of Nigerians earning NGN137, 430 (USD 381. 75) per year. 

This translates into a total addressable market of 83 million people according to The World Bank’s Living Standard Measurement Study. 

At the risk of using broad categorizations, I classify our target market into two groupings: 

1. The Lower-Middle-Class: Those who belong to the lower-middle-class category primarily access private hospitals and general hospitals.

2. The Lower-Class: Most of the lower-class access state general hospitals, chemist shops, drug hawkers, and traditional health practitioners that are ubiquitous in society.

However, their healthcare-seeking behaviour is not static. There are cases where the lower-middle-class segment seeks healthcare associated with the lower class and vice versa. 

Providing Affordable Home Healthcare To Nigerians

We have set our prices with the income of our target market in mind. To ease the customers’ financial burdens, we made consultations free.

While each scheduled nurse’s visit costs between NGN2,000 – and NGN 4,000 (up from between NGN1,500 – and NGN3,500 due to increased transportation and service input).

As a platform targeted at the underserved segment of the Nigerian population, we maintain low input costs for diagnosis and treatment. We achieve this by building capacities in the purchase of cheap and authentic home healthcare inputs like drugs, syringes, and so forth. 

This is because we’re committed to providing affordable home healthcare to Nigerians.

Do We Accept Insurance?

I say no. We operate outside of the traditional health insurance system.

The fact is that the majority of Nigerians pay out-of-pocket for access to medical services. Over 170 million Nigerians are without health insurance.

We have adopted CASH PAY because of the low purchasing power of our target market. 

Our clients have different expectations since they pay-out-pocket for healthcare delivery. That’s why we prioritize customer experience and value. 

How We Serve 

Every business has its methods for delivering its products and/or services. And Healy Nurse is not an exception. 

We are a startup operating for less than two years and have validated our business concept. We have used a simple idea of iterating and fine-tuning our business as we progressed. 

This method allows us to accommodate most of the vagaries in our operating environment. 

Let me remind you we are bootstrapping the business, as we’re yet to source outside funding.

Therefore, in choosing a method for delivering our services, we used a gig economy model. 

Let me quickly state that the gig economy model is not perfect. It is still in its infancy and has a lot of limitations.  

But the gig economy model will be one of the dominant business models soon. It already affects the economy and society.

Adopting the gig economy model has massive implications for the recruitment of nurses and ancillary staff. We will rely on them—and their skill sets and competencies—for our service delivery.

Our Onboarding Procedures

At Healy Nurse, we are proud to be working in partnership with five nurses. Let me give you a quick rundown of our onboarding procedures:

Step One

Applicants begin by applying to www.healynurse.ng/join-our-team. Applicants will enter personal information such as full name, address, list of qualifications, and areas of specialty. Then submit it.

Step Two

We call or chat with applicants, inviting them to one of our recruitment open days at designated locations.

Step Three

We welcome applicants to our recruitment open day location. Thereafter, I offer them a bit of a background in our business and hand them a registration form to complete.

Step Four

We proceed to a one-on-one interview with individual applicants. During their interview, we discuss:

• Their employment background
• Their nursing experience
• Their interests
• And why they wish to work through our platform.

Step Five

We encourage applicants to take part in a question-and-answer session. Applicants can ask questions about the points we made earlier, technical questions on home healthcare and guidelines, and further information about the company.

Step Six

We show how to use our web app and other project management tools to the applicants. We then send them digital copies of our home healthcare and nursing services guidelines and a link to our web app.

Step Seven

Applicants will provide personal information, including details of their Nursing License. The following are the documents they will upload for background checks:

1. Passport photograph with a white background (PNG or JPEG).
2. Nursing License (PDF Doc).
3. Valid Government issued Identity (ID) Card (PDF Doc)

Step Eight

Applicants will have access to our app after we have verified their licenses. We will inform them of their status by email and SMS. Thereafter, they can start taking home healthcare and nursing services requests.

 

Our Labour Practices

How do we get nurses? Where do their interests lie? How do we get our nurses to love our services and actively promote them? 

The answer lies in having fair labour practices and inclusive company culture. 

Five principles guide our labour practices. We use Oxford University Fairwork Foundation’s five principles that digital platforms should comply with to be considered offering ‘fair work’. They include:

1. Fair pay.
2. Fair conditions.
3. Fair contracts.
4. Fair management.
5. Fair representation.

 

Fair Pay

We will provide evidence that all nurses are guaranteed to take home earnings equal to or above Nigeria’s minimum wage. There continue to be many nurses across the country that take home less than the hourly minimum wage after putting in an hour’s work.

 

Fair Conditions

We have attempted to put basic security and safety nets in place for our nurses.

The app solves the problem of nurses travelling long distances to serve clients. This is because we configured it to connect clients with nurses in their communities, specifically, their local government areas (LGAs). Nurses are aware of the hotspots/danger points in the LGAs. This knowledge guides them in choosing where to go and not go.

Because the app works on USSD technology, it helps us capture a client’s registered and linked SIM/telephone number. In the event of an incident, we will trace the client.

We also require that clients pay before our nurses can attend to them. This also helps us capture their account number with its electronic trail. Again, we can use their account number/BVN to trace them in the event of an incident.

Finally, we have a group life insurance cover for all our nurses.

Our insurance partner is AXA Mansard Insurance formerly GT Insurance. The sum assured is N500,000. For now. We will increase it to N1,500,000 in the next 4 years.

Those are the measures we have taken to guarantee nurses’ safety and security.

 

Fair Contracts

We provide transparent terms and conditions. And abide by the labour laws of Nigeria. Our contracts do not totally exempt us from liabilities that nurses incur in the provision of home healthcare.

 

Fair Management

We have a fair system of due process for decisions affecting nurses. We also endeavour to provide equity in our management process.

 

Fair Representation

Our platform guarantees freedom of association and the expression of the collective voices of our nurses.

Conclusion

Healthcare is a basic human need. And providing affordable home healthcare and nursing services to Nigerians is a fundamental human right. 

You don’t have to deny yourself the dignity of getting healthcare because of Nigeria’s near-comatose health system.

You can use home healthcare platforms like Healy Nurse to treat minor outpatient ailments.

You will get cost-savings in terms of money and especially in time.

With this knowledge, would you still like to spend six hours and 12 minutes on every general hospital visit?