To become more financially sustainable, Nurture Africa implemented a cross-subsidy payment model in the previously free primary health care clinic. This resulted in a significant decline in the number of patients accessing primary health care services at Nurture Africa.
The goal of our research was to obtain insight into the motivations, perceptions and satisfaction of patients, as well as the attitudes of clinic staff towards the transition to a social enterprise model. Data was collected from three main stakeholder groups: current patients, former patients and clinic staff. All research was conducted in Nansana, a peri-urban community in the Wakiso district of Uganda. Among current patients we administered 72 written surveys, conducted 64 structured interviews and 4 focus groups with 35 total participants. Among former patients we conducted 12 semi-structured, in-home interviews and 3 focus groups with 22 total participants. We also conducted 12 informal interviews with Nurture Africa staff.
1. Vulnerable families in Nansana cannot afford to pay for health care services. Nurture Africa’s paid health care services are more affordable than private clinics nearby. However, many vulnerable families still cannot afford to pay for primary health care services at Nurture Africa.
2. Patients are unaware of the new payment system. Awareness remains low regarding the new payment system amongst all stakeholders. Six months after the new system was implemented, many patients still come to Nurture Africa expecting free health care services, unaware that the system has changed.
3. Primary health care patients are not accessing Nurture Africa’s other programs. These patients are not aware of other health and non-health related services offered by Nurture Africa. Such services include antenatal and maternity care, safe male circumcision, educational sponsorship and microfinance loans.
Patient Journey Map. We created a document that illustrates the entire arc of patient engagement with Nurture Africa. A diagram of the patient journey is accompanied by a detailed description of the patient’s actions, motivations, questions and barriers at each touch point between the patient and Nurture Africa. The Map will aid the organization in identifying areas of strength and those that can be improved in order to better the patient experience.
Transition Analysis. In this comprehensive report, we provide recommendations to Nurture Africa’s management to aid them in their transition to a social enterprise business model. These recommendations seek to align Nurture Africa’s business management practices with the Patient Journey Map.