Almost 90% of South Africa’s population relies on the country’s under-resourced public healthcare system, which is further burdened by many patients who have insufficient knowledge to self-medicate or who seek healthcare from the incorrect levels within the system.
 
This led to Imperial investing R7million four years ago in the Unjani Clinic franchise network, and becoming the first private sector organisation in South Africa to start a nurse-owned and operated primary healthcare network.
 
Says Unjani CEO, Lynda Troussaint, “Unjani Clinics meet the need for primary healthcare in poor communities by providing essential medicines and education at the point of need. In addition, the initiative empowers black women by creating entrepreneurial opportunities for professional nurses to own and operate commercially viable primary healthcare clinics.”
 
There are currently 24 Unjani Clinics in South Africa, mainly in and around Gauteng, with plans to open in other Provinces soon. Since inception, we have served in excess of 140 000 patients.
 
Troussaint explains, “each Unjani Clinic operates from a customised 12m shipping container. Patients pay between R100-R180 for a consultation with a qualified nurse, and receive medicines to treat a range of common primary healthcare conditions.  The qualified nurse running the Unjani Clinic is authorised to prescribe and dispense schedule 1 to 4 drugs. The clinics also sell over-the-counter drugs such as aspirin and various cough and flu medication. Each of the seven clinics sees between 150 and 500 patients per month.”
 
Outlining some of the issues in South Africa’s state health sector, Troussaint notes that the country suffers from a triple affliction: the pandemic of HIV/AIDS/TB, preventable conditions arising from socio-economic determinants and the poverty cycle and a growing amount of non-communicable diseases affected by lifestyle.  She says, “around 88% of the population is dependent on the overburdened public health sector. This is aggravated by the fact that the provision of care is focused on hospitals - or curative care - rather than on health prevention and promotion in communities. The cost implications for the wider health system are huge - with a fee of R105 at a primary healthcare facility compared to a hospital fee of R320.”
 
Troussaint adds that healthcare is better organised and supported in suburban areas compared to informal settlements and rural areas, where so many people cannot access primary healthcare due to time, cost and distance. “There is an urgent need for transformation in South Africa’s health system,” she stresses.
 
Unjani Clinics are in line with the UN mandate of empowering women fighting diseases like AIDS and TB and improving maternal health. The business model is a financially sound commercial opportunity that is empowering women and creating jobs. The ownership model sees the professional nurse increasing her ownership share annually, based on a franchise agreement with Imperial. Further employment opportunities are created due to the need for administration support staff at the clinic, as well as cleaners and other service providers. Each clinic creates between three and five sustainable jobs, and produces real, localised, enterprise development that empowers women.
 
Lynda Troussaint says, “Unjani Clinics provide the under-served, lower income communities with an affordable, accessible and quality healthcare alternative and offer real potential to improve healthcare outcomes in South Africa.”
 
Imperial plans to establish a national network of 400 Unjani Clinics in the next five years. She explains, “we used population estimates, national primary healthcare infrastructure, primary healthcare national expenditure, non-hospital public health expenditure per capita by district, GDP contribution per province and primary healthcare process indicators to determine the number and geographic distribution of these 400 clinics.” 
 
While Imperial’s overriding motivation for this project has been to contribute to the dire need for transformation in South Africa’s health system and create employment, the business logic behind the initiative lies in the opportunity to grow new markets for clients. She says, “catering for  a segment of the population which is currently not being served, Unjani Clinics have huge potential to grow our pharmaceutical and consumer clients’ sales volumes and provide an opportunity for innovation around repackaging traditional offerings for affordability in this market. This is another way in which Imperial is improving our clients’ competitiveness by customising our expertise in outsourced value chain management,” Troussaint concludes.