Concept Note. Repurposing current business assets into new products and services to construct and equip MODSTONE Medical Center Limited (MMC, and Startup Offices for MOD Public Health Foundation (NGO).

 

















Name of the Organization

MOD Public Health Foundation (NGO)

Reg. No. 5533 (INDR155354614NB)

Plot 79 Bukoba Road Toles Jowhetta House

P.O Box 211, Masaka City, Uganda

Office:  +256485660637

Mobile +256772675563

E-mail: info@mod.or.ug

Authorized and Contact Person 

Samuel Waliggo, MPH

Executive Director

Mobile: +256706472457

E-mail: samuel.waliggo@mod.or.ug

             samuel.waligggo@gmail.com

Reference Person

1)      Rev. Pastor Sam Mukabi Zema

Patron  

MOD Public Health Foundation

Mobile: +256 772 473816

E-mail: mukabisam@gmail.com

 

 

2)      Hon. Dr. Abedi Bwanika

Member of Parliament

Kimaanya-Kabonera, Masaka City, Uganda

Tel: +256 757 675558

Project Title:

Repurposing current business assets into new products and services to construct and equip MODSTONE Medical Center Limited (MMC, and Startup Offices for MOD Public Health Foundation (NGO).

Project Short Name:

MOD Post Covid-19 Recovery, Resilience & Sustainability (RRS) Project.

Project Area

Kantungamwe, Kingo, Kimaanya Kabonera Sub-County

 

Target Beneficiaries

Direct: 5755 Patients Per Year (480 Patients Per Month)

Indirect: 17,265 People

Project Duration:

FY: 2022/2023

 

Project Budget:

 

$163,748 (UGX 627,250,000)

Table of Contents

ACRONMS. 3

Executive Summary. 4

1.0         ABOUT MOD PUBLIC HEALTH FOUNDATION.. 5

2.0         SOCIO-DEMOGRAPHIC CHARACTERISTICS OF KINGO SUB-COUNTY. 6

2.1         General Uganda Health System.. 7

2.2         MOD’s Contribution to Social Impact in Kingo Sub-County, Masaka District. 7

2.3         DESCRIPTION OF THE BUSINESS DEVELOPMENT SERVICE (BDS) IN 2.2 ABOVE TO SUPPORT YOUR ORGANISATION. 8

2.3.2          Objectives of MODSTONE Medical Center. 8

2.3.3          Our Keys to Success. 9

3.0         ESTIMATED BUDGET TO IMPLEMENT THE REQUIRED BUSINESS DEVELOPMENT SERVICE*. 12

4.0         PROJECT OUTCOME AND IMPACT. 14

4.1         Management Summary. 14

4.2         Market Analysis Summary. 14

4.2.1          Market Segmentation. 14

Table: Market Analysis. 15

4.2.2          Target Market Segment Strategy. 15

4.2.3          Competition and Buying Patterns. 15

4.2.5     Strategy and Implementation Summary. 16

4.2.6          Competitive Edge. 16

4.2.7          Marketing Strategy. 16

5.0         INFORMATION MANAGEMENT AND TECHNOLOGY. 18

5.1         Hardware. 18

5.2         Billing. 18

5.3         EMR (Electronic Medical Records). 18

6.0         LESSONS LEARNT FROM THE COVID-19 SITUATION FOR YOUR BUSINESS SURVIVAL*. 19

7.0         COMPANY'S MEDIUM-TERM PLANNING.. 20

Appendix 1: 5 MOD Post Covid-19 RRS Project-5 Year Financial Projections 2022/23-2026/27. 21

Appendix 2: Project Implementation Schedule. 23

 

 

ACRONYMS

 

AGYW             Adolescent Girls and Young Women

CBC                 Complete Blood Count

CBO                 Community-Based Organisation

COVID-19        Coronavirus Disease

EMR                Electronic Medical Records

HA                   Hematology Analyzer

HC                   Health Center

HMIS               Health Management Information System

HW                  Health Worker

KNOTSA          Knowledge Synthesis Translation and Application

MEL                 Monitoring Evaluation and Learning

MMC               MODSTONE Medical Center Limited

MOD CHIS       MOD Community-Based Health Insurance Scheme

MOD               MOD Public Health Foundation (NGO).

MOH               Ministry of Health

NGO                Non-Government Organisation

NPHC              National Population and Housing Census

PSS                  Psychosocial Support

RRS                  Recovery, Resilience & Sustainability

 

 

 

 

 

 

 

 

 

 

Executive Summary

Introduction: The MOD Post Covid-19 Recovery, Resilience, and Sustainability Project is an innovation strategy for the survival of MOD Public Health Foundation (NGO) in the rapidly emerging public health market. The emergence of Coronavirus (COVID-19) severely affected funding for MOD’s strategic goals and services. Recovery from these negative economic effects is challenging and yet funding for NGOs is continuing to shrink. Therefore, this project aims to repurpose some of the organisation's business assets (Human resources, Land, computers, networking system, and furniture) into new products and services. Specifically, we need financial support to construct and establish MODSTONE Medical Center (MMC) in Kingo Sub-County, Masaka. The project will also establish start-up office space for MOD Public Health Foundation to shift from its rented office premises. MMC will be built on a culture of providing low-cost, specialized, high-quality, and customer-oriented medical care services. MMC will leverage the existing organizational internal systems and health promotion experience to provide services.

 

Social Problem: Kingo is a borderline sub-county between Kimaanya-Kabonera, Masaka City, and Lwengo District with a total population of approximately 36,300 people (17,800 Males, 18,500 Females). Access to quality laboratory and medical care services particularly maternal and child health services is a big challenge in this area. Currently, the sub-county is served by health center IIs namely; Kisansala HCII, Kagganda HCII, Kasaana HCII, and Nkoni Health Center III. Although this sub-county is close to Masaka city, our interaction with the natives indicated that only 1 in 20 people have ever had a chance to interact with a medical doctor for proper medical screening, diagnosis, and treatment. With the increasing human activities; night bars, discos, boda-boda, and expanding housing estates in all trading centers. Many young people between  15-24 years are dropping out of school and engaging in HIV risky sexual behavior; prostitution, drug, and substance abuse (Marijuana and alcohol). Already, access to quality healthcare in Uganda is a critical problem. In the context of the increasing public health challenges, “the poor person in rural areas is meant to die” in Uganda’s failing health system. The biggest challenge is the inadequate human resource for health. 70% of doctors are practicing in urban areas, where only 20% of the population lives, and one doctor is expected to serve 22,000 people in such rural areas.

Our Business Development Service (BDS), innovation, and Budget: The construction and establishment of MMC will help people in underserved rural communities of Kingo and Kimanya-Kabonera to access high-quality medical care services. MMC will integrate health promotion experience to promote a healthy lifestyle and behavior change among targeted beneficiaries. The project will be implemented in eight (8) phases at a total cost of $163,748 (UGX 627,250,000) for one year (2022/2023.

Phase 1: Registration with URSB and Allied Medical Council: $1,488 (UGX 5,700,000)

Phase 2: Resource Mobilisation activities: $1,436 (UGX 5,500,000)

Phase 3: Construction of MODSTONE Medical Center at Kingo Sub-County: $49,599 (UGX 190,000,000)

Phase 4: Procurement of Essential Medical Equipment and Supplies: $40,593 (UGX 155,500,000)

Phase 5: Establishing a Patient Health Management Information Systems:$4,699 (UGX 18,000,000)

Phase 6: Product Development, Branding, and service marketing: $3,798 (UGX14,550,000)

Phase 7: Capacity Building and Launching Business Development Service (BDS): $4,699 (UGX 18,000,000)

Phase 8: Procurement of Ambulance referral System and Startup: $57,430 (UGX 220,000,000).

The investment will allow MMC to provide high-quality medical care, medical camps, and health promotion services to 5,755 patients annually. Enhance public health research, knowledge synthesis, and translation through public health workforce development and placements while building MOD’s resilience and sustainability of her strategic goal, objectives, product, services, and social impact.

Return on Investment: Upon implementation of MOD Post Covid-19 Recovery, Resilience & Sustainability (RRS) Project in the first year (2022/2023), the established MODSTONE Medical Centre (MMC) will serve an average of 5755 patients annually. During the first five years MMC will get sales/income from; Doctors' Consultation fees, Medical Care Services, Laboratory Services  Ambulance Services, Dispensed Medicines (pharmacy), and Health Promotion Services. MMC’s starting annual sales turnover is projected to start at UGX 431,625,000 in the second year (2023/24), and thereafter grow annually by 5% to UGX 464,487,500 in the third year (2024/25); UGX 497,350,000 in the fourth year (2025/26); and UGX 530,212,500 in the fifth year (2026/27) of trading[1]. The return on investment (Net profit) will be UGX 79,475,863 in the second year; UGX 96,288,259 in the third year; UGX 103,100,655 in the fourth year; and UGX 109,913,051in the fifth year  of operation respectively[2]. The RRS project will make MOD public Health Foundation more stable and resilient in addition to donor funding. This will give capacity to the organisation to strengthen its internal systems and process to implement its strategic goals and objectives.

 

 

1.0       ABOUT MOD PUBLIC HEALTH FOUNDATION

MOD Public Health Foundation is a non-profit public health organization (NGO) registered in Uganda (INDR155354614NB), with headquarters offices based in Uganda on Plot 79, Bukoba Road, Johwetta house, Masaka City, 135km, South-Central of Kampala. MOD was founded by a team of experienced public health professionals as a Community-Based Organisation (CBO) in August 2018, is and now registered as an NGO with a five-year (5) permit and mandate to operate countrywide. MOD is positioned as a local, low-cost but efficient implementing partner with 25 years of combined experience in designing and implementing innovative public health programs in the field of HIV/AIDS, Maternal and Child Health, Psychosocial Support (PSS), and socio-economic development programs.

 

1.1       Our Vision

We envision healthier communities accessing low-cost emerging public health innovations and solutions.

 

1.2       Our Mission

To achieve universal health care coverage in under-served communities and sub-populations through accelerating optimal translation, uptake, and impact of new public health knowledge and practices.

 

1.3       Our Organisation Culture

Our Business Approach is built on the PIFT culture of;

1.      Passion and Innovation

2.      Flawless Execution and

3.      Team Building to sustain our innovation and impact.

 

1.4       ORGANISATION’S  FINAL PRODUCTS/SERVICES

 

MOD's products and services are designed in accordance with Organisation's Second Strategic Business Plan II (SBP) 2020/21-2024/25 and are aligned with Uganda's National Development Plan (UNDPIII) 2020/21-2024/25. Our strategic social goal is to contribute towards the realization of universal health care coverage among 750,000 people from under-served communities and sub-populations in Uganda by 2024. MOD’s products and services include;

1.       Community Engagement for Health Promotion and Behavior Change/Social impact programming

2.       Knowledge Thesis, Research, and Translation

3.       Community-Based Health Insurance Scheme (MOD-CHIS)

4.       Health and Organizational Systems Strengthening

5.       Public Health Workforce and Leadership Development

To effectively implement our strategic goal and objectives, MOD cultivates a balanced public health and research ecosystem and builds partnerships with Government, Private and Public health institutions, professionals, and researchers to source, translate, synthesize, and deliver emerging public health promotion and medical innovations. MOD uses a Knowledge Translation Synthesis and Application (KNOTSA) model to close the do-know gap in the emerging public health sector. Our work is defined by asking and answering two fundamental questions:

a)       What is the newest, most promising public health evidence and solution?

b)      How can we accelerate the translation of this knowledge to practice within communities and sub-populations where new solutions are needed most?

 

This project aims to repurpose current business assets into new products and services through the construction and establishment of MODSTONE Medical Center Limited (MMC) and startup offices for MOD Public Health Foundation (NGO). The innovation is a post-Covid-19 recovery, resilience, and sustainability strategy for MOD Public Health Foundation to scale up and sustain social impact. Therefore, the short name of the project is "MOD Post Covid-19 Recovery, Resilience and Sustainability (RRS) Project”.

2.0       SOCIO-DEMOGRAPHIC CHARACTERISTICS OF KINGO SUB-COUNTY[3]

 

Kingo is a borderline sub-county between Masaka City and Lwengo District. The sub-county has six(6) parishes namely; Kagganda, Kasaana, Kisansala, Kiteredde/Kingo, Nkoni, and Ssenya. There are 76 villages with a total population of approximately 36,300 people (17,800 Males, 18,500 Females). Access to quality medical services particularly maternal and child health services is a big challenge. Currently, the sub-county is majorly served by health center IIs namely; Kisansala HCII, Kagganda HCII, Kasaana HCII, and one Health Center III (Nkoni) which is private and owned by the Catholic Church of Masaka Diocese.  Subsequently, access to quality laboratory services is also rare and most patients are treated by symptomatic presentations.  Although this sub-county is close to Masaka city, our interaction with the natives indicated that 1 in 20 people have ever had a chance to interact with a medical doctor for proper medical screening, diagnosis, and treatment. Most people are engaged in self-medication mostly with pain control drugs (paracetamol) and antibiotics. Such practices increase their risk of liver disease and antibiotic drug resistance respectively. The Uganda National Population and Housing Census 2014 further indicated that 25.8% of the households in Kingo are 5 Km and above from the nearest Public Health Facility. 32.1% of the households are without access to safe water, 1.9% have no toilet facility and 14.4% of the population are still eating less than two(2) meals a day.

Additionally, Kingo sub-county also has other unique demographics; It is the closest area to Masaka City from the west. Recently, the Government has enhanced efforts to install night streetlights in most of the trading centers around Masaka city. This has brought vibrancy to the trading centers and has increased human activities such as night bars and discos, boda-boda stages, expanding housing estates, and construction in trading centers. The risk here is that these activities come with various risky sexual behaviors. For example, many young people mostly those 15-24 years have dropped out of school and are engaged in construction activities, prostitution, drug, and substance abuse (Marijuana and alcohol) which are key risk factors for diseases such as HIV/AIDS, Accidents and Emergency and other related non-communicable diseases. The sub-county also experiences extended dry seasons which makes access to clean water and food very challenging. The number of neglected old people in households without access to basic social and medical services is also increasing.

2.1       General Uganda Health System

 

It is known that access to quality healthcare in Uganda is a critical problem[4]. In the context of the socio-economic impact of the COVID-19 pandemic and the increasing public health emergencies like Ebola, “the poor person in such areas is likely to die" in Uganda's failing health system. People living in rural Uganda have poor access to basic and quality healthcare services. The biggest challenge for Uganda is the inadequate human resource for health services. One doctor is meant to serve approximately 8,300 Ugandans. With 70% of the doctors practicing in urban areas, where only 20% of the population lives, the coverage in rural areas is much worse: one doctor in a rural area is expected to serve  about 22,000 people[5]. Therefore, many people don't have a chance to see a doctor for a correct diagnosis. Patients are faced with long waiting times at health facilities, poor attitudes of health workers, lack of drugs and medical equipment, and uncoordinated referral system. This uneven service discourages patients from seeking professional care, especially those who are coming from deeper rural areas with longer travel times. The continuous emergency of public health emergencies such as the Ebola, and COVID-19 pandemic has further constrained Uganda's health system as most resources are diverted to fight the pandemic in a very corrupt situation. The double effect of public health emergencies and poverty is also increasing cases of mental health problems. The need for psycho-social support (PSS) including spiritual counseling in rural communities is evident.

2.2  MOD’s Contribution to Social Impact in Kingo Sub-County, Masaka District

MOD Public health Foundation established an underground pipe water source in Kantungamwe village, Kingo Subcounty. The water source has enabled over 500 households to have access to clean tap water at a maintenance cost of UGX300 per 20-liter Jerrican. Over 80 farmers pick water from this source to irrigate their crops during the dry season.  Before this water source was established families from Kantungamwe and Kitambuza used to buy the same quantity of water fetched from unprotected sources located almost 10 meters in a valley and shared with animals at UGX500-1000.

 

In collaboration with Rakai Health Sciences Program (RHSP) and PEPFA small Grants, MOD is implementing

·         Focused demand creation project for Voluntary Male Medical Circumcision (VMMV) among 2400 Males and Young Men aged 15 years and above in Masaka Region. This is one of the combination prevention strategies for HIV epidemic control. 629 men were circumcised in Kimanya-Kabonera Sub-County, Masaka District by September  2022.

In Addition, MOD has successfully implemented complex projects such as DREAMS[6] programming for 35,000 Adolescent Girls and Young Women (AGYW) in Seven districts in the Mubende region. DREAMS project was a 5-year community-engaging project funded by the Center for Disease Control and Prevention (CDC) through Mildmay Uganda at a total cost of $834,715. The technical and management skills that were required for the implementation of these projects provided MOD with credible experience to deliver this urgently needed RRS project.

2.3       DESCRIPTION OF THE BUSINESS DEVELOPMENT SERVICE (BDS) IN 2.2 ABOVE TO SUPPORT YOUR ORGANISATION.

 

2.3.1    Construction  and Establishment of MODSTONE Medical Center Limited (MMC)

The construction and establishment of MODSTONE Medical Center (MMC) will help Ugandans in rural underserved communities at Kantungamwe, Kingo, and Kimanya-Kabonera to access specialized and quality medical and surgical care with customer care-focused service. The facility will give a chance to many patients in Kingo the to see a medical doctor for the first time for consultation, correct diagnosis, treatment, and referral for specialized services when needed. MMC will brand her service with health promotion activities to engage communities in healthy living and behavioral change practices to sustain social and health outcomes. Already MOD is a Ugandan local and grassroots organization, with an outstanding reputation in Program design, health promotion, efficient service delivery, quality care, and patient satisfaction. Our result is a very cost-effective model. MMC will also form part of our Organisation's recovery and resilience plan from the effects of COVID-19 to sustain our social impact.

2.3.2    Objectives of MODSTONE Medical Center

 

The objectives for MODSTONE Medical Center will include:

·         To create a medical practice in Kingo that will exceed patients' expectations.

·         To integrate public health experience in patients’ care and practice for health promotion and behavior changes.

·         To provide high-quality health care to residents of the area.

·         To create a medical practice that helps serve the community's needs.

·         To form a healthcare practice that can survive off its cash flow in 12 months or less.

·         To increase the number of patients by 20% per year through superior performance and word-of-mouth referrals

·         To develop a comprehensive website that includes online booking capability, as well as additional information about the practice, hours, demographic information, health information, and much more

2.3.3    Our Keys to Success

 

a)      Patients

·         Focus on patient care

·         Integration of health promotion education to patients on the importance of preventative care and yearly check-ups.

·         Implement an aggressive and accurate recall system in which to remind patients to have regular checkups.

b)     Staff and Office Organization

  • Recognize that the office staff is crucial to the success of the business.
  • Create incentives to motivate staff to deliver quality patient care.
  • Create a streamlined office system to minimize patients' waiting time

c)      Finances

  • Keep a low overhead
  • Optimize the number of patients we can see in an hour while providing quality medical care
  • Use the latest method in electronic billing for all income and expenses.
  • Use this medical clinic business plan to review and guide management decisions

d)     Marketing and Sales

  • Aggressively market and create a presence in the community by giving high school talks, ER calls, hospital talks and doing volunteer work, business society meetings
  • Network to obtain referrals from other government and private health facilities, professionals, such as doctors, Gynae Specialists, Hospital Admissions
  • Have an office front on a busy street with accessible parking
  • Locate in an area with a high patient-to-doctor ratio
  • Located close to the Medical Surgery Centre, a regional referral hospital with easy access to specialty care.

 

2.3.4    BDS Project Implementation Approach

 

As part of its post-COVID business recovery plan and building long-term resilience, MOD is repurposing its current business assets (Plot of Land Kingo, computers, networking system, and furniture) and leveraging on existing organizational internal systems (Finance Management, Monitoring Evaluation, and learning-MEL) into establishment medical facility i.e., MODSTONE Medical Center (MMC). Because of MOD's strategic location in Masaka city and positioning in the public health market, MMC is designed to provide high-quality, customer-oriented specialized medical and surgical services. This BDS support will enable MOD to accelerate the Organisation’s core business recovery plan. Specifically,  the BDS is needed to;

a)      Construct MMC at Kantungamwe, Kingo Sub-County.

b)      Procure and Equip MMC with basic medical equipment and supplies.

c)       Establish a Patient Health Information Management System HIMS. The HMIS will inter-link MMC departments (Reception, Pharmacy, Laboratory, doctor's Rooms, Dispensary, Admission Rooms, and Inventory) for quality and proper patient flow, care, and management.

d)      Establish patient ambulance systems

e)      Support product development, digital marketing, and client engagement platform.

f)        Support launching, startup, and development of management policies and protocols.

g)      Improve management technical capacity to adapt to systems change, product development, promotion, and branding.

h)      Provide start-up office space for MOD Public Health Foundation (NGO) to shift from its current rented office premises. This will increase value for money and organizational resilience for sustainability development.

 

2.3.4.1   Project Implementation Phases

 

The MOD Post Covid-19 Resilience and Sustainability Project will be implemented in Eight (8) phases namely.

Implementation Phase

Key Activities

Phase 1: Registration with URSB and Allied Medical Council

 

·       Name Reservation

·       Developing memorandum and articles of association (MEMARTS)

·       Registration of MODSTONE Medical Center with URBS and Allied Medical Council

Phase 2: Resource Mobilisation strategies

 

 

·       Developing proposal and Business Plan

·       Donor or Investor Mapping

·       Design and approval of architecture plan

Phase 3: Construction of MODSTONE Medical Center at Kantungamwe, Kingo Sub-County.

 

·         Construction of medical facility and Startup Offices for MOD Public Health Foundation (NGO).

·         Plumbing, Wiring, and Networking

·         Furnishing

Phase 4: Procuring Essential Medical Equipment and Supplies.

·         Ultrasound Scan

·         Hematology Analyzer

·         Chemistry Analyzer

·         Centrifuge

·         Microscope

·         Medicines and logistical supplies.

Phase 5: Establishing a Patient Health Management Information System (HMIS)

·         Designing or procuring and Installation of patient HMIS

 

Phase 6: Product Development, Branding, and service marketing

 

·         Design key products and services

·         Develop marketing materials (Brochures etc.

·         Develop an online app and website

Phase 7: Launching Business Development Service (BDS)

 

·         Recruitment of staff

·         Training of staff on customer care and patient HMIS

·         Organize launch ceremony.

·         Procuring an ambulance vehicle for the referral.

Phase 8: Procurement of Ambulance System and Startup Capital

 

·         Procurement of Equipped Vehicle for Ambulance Services & Referral.

·         Human Resource-Salaries and Benefits-6 Months

·         General Administrative -Utilities and Supplies-3 Months.

 

2.3.4.2   Services

In general, MMC will provide general care for all ages, as well as providing multiple procedures to create a complete healthcare solution. The costs will depend upon the materials used, the physician's time, and the amount designated for each procedure.

 

MMC's philosophy is that optimal health and performance can be attained through the proper balance of exercise, nutrition, and education. Our goal is to educate our patients as well as treat them. Therefore, our services will also provide group classes and teaching sessions for our patients. Subjects could include nutrition, diabetes, hypertension, and much more. Through collaboration with other development partners and Universities, MMC will integrate both behavior and clinical research for evidence-based practice and patients care.

 

The medical center will focus on each case. After each procedure and where appropriate, each patient will be offered education in rehabilitation, nutrition, and exercise as it relates to each particular case. Our goal is to create the most well-rounded experience for each patient to optimize their health. MMC will maintain privacy according to Ministry of Health rules. All patients will be welcome, including the ones with no insurance. No one will be turned down for medical care. Our clinic will hold no prejudice to race, creed, color, or socioeconomic status. Everyone will be welcome for a great medical care experience. The medical center will provide the following services, among others:

 

a)      Adult Medicine

·         Preventative and Routine Medical Services

·         Orthopedics and physiotherapy

·         Ocular Conditions

·         Hypertension-specialized cases.

·         Diabetic Teaching

·         Nutritional/ Dietician Services

·         Exercise and Obesity Counseling

·         Cardiology

·         Palliative care

·         Home Based Care medical services

·         Emergency Ambulance Referral System

·         Comprehensive HIV/AIDS care services

 

 

b)     Maternal and Child health services and Gynecology

  • Reproductive Health such as family Planning Services and PAP Tests.
  • Acute Gyn Problems
  • Newborn and Infant Care
  • Immunizations services

c)      Dermatology:

  • Removal of minor lesions, skin tags, moles, and warts
  • Biopsies of suspicious dermatological lesions and/or referral
  • Tetanus
  • Immunizations

d)     Minor Surgery:

  • Laceration Repair
  • Lesion Removals

 

3.0       ESTIMATED BUDGET TO IMPLEMENT THE REQUIRED BUSINESS DEVELOPMENT SERVICE*

Ref.

BUDGET ITEM

COST (UGX)

COST (USD)

1.1

Phase 1: Registration with URSB and Allied Medical Council

1.1.1

Name Reservation with URSB/URA

200,000.00

$52

1.1.2

Developing memorandum and articles of association (MEMARTS)

2,000,000.00

$522

1.1.3

Registration of MODSTONE Medical Center with URBS and Allied Medical Council

3,500,000.00

$914

Sub-Total

5,700,000.00

$1,488

1.2

Phase 2: Resource Mobilisation Strategies

1.2.1

Business Planning and Development

1,500,000.00

$392

1.2.2

Transport and Fuel to potential Donors  or Investors

1,000,000.00

$261

1.2.3

Designing and approval of Architectural plan

3,000,000.00

$783

Sub-Total

5,500,000.00

$1,436

1.3

Phase 3: Construction of MODSTONE Medical Center at Kantungamwe, Kingo Sub-County.

1.3.1

Construction of medical facility and Startup Offices for MOD Public Health Foundation (NGO).

150,000,000.00

$39,157

1.3.2

Plumbing, Electricity, and Networking

10,000,000.00

$2,610

1.3.3

Furnishing (Theater, Maternity & Examination Beds, etc.)

30,000,000.00

$7,831

Sub-Total

190,000,000.00

$49,599

1.4

Phase 4: Procuring Essential Medical Equipment and Supplies

1.4.1

Ultrasound Scan

19,000,000.00

$4,960

1.4.2

Hematology Analyzer (CBC)

15,000,000.00

$3,916

1.4.3

Chemistry Analyzer-Capacity: 5-10 Test

80,000,000.00

$20,884

1.4.3

Centrifuge

5,000,000

$1,305

1.4.4

Microscope

6,500,000

$1,697

1.4.5

Medicines and other Supplies

30,000,000

$7,831

Sub-Total

155,500,000.00

$40,593

1.5

Phase 5: Establishing a Patient Health Management Information System (HMIS)

1.5.1

Designing or procuring and Installation of patient HMIS

15,500,000.00

$4,046

1.5.2

Management costs in year one.

2,500,000.00

$653

Sub-Total

18,000,000.00

$4,699

1.6

Phase 6: Product Development, Branding, and service marketing

1.6.1

Design key products and services

5,000,000.00

$1,305

1.6.2

Develop marketing materials (Brochures etc.

3,000,000.00

$783

1.6.3

Develop an online app and website

6,550,000.00

$1,710

Sub-Total

14,550,000.00

$3,798

1.7

Phase 7: Launching Business Development Service (BDS)

1.7.1

Staff Recruitment Costs

3,000,000.00

$783

1.7.2

Training of staff customer care and patient HMIS

5,000,000.00

$1,305

1.7.3

Organize launch ceremony with Medical Camp

10,000,000.00

$2,610

Sub-Total

18,000,000.00

$4,699

1.8

Phase 8: procumbent of Ambulance System and Startup Capital

1.8.1

Procurement of Equipped Vehicle for Ambulance Services & Referral.

150,000,000.00

$39,157

1.8.2

Human Resource-Salaries and Benefits-6 Months

60,000,000.00

$15,663

1.8.3

General Administrative -Utilities and Supplies-3 Months

10,000,000.00

$2,610

Sub-Total

220,000,000.00

$57,430

Grand Project Total

627,250,000.00

$163,748

 

Return on Investment: Upon implementation of MOD Post Covid-19 Recovery, Resilience & Sustainability (RRS) Project in the first year (2022/2023), the established MODSTONE Medical Centre (MMC) will serve an average of 5755 patients annually. During the first five years MMC will get sales/income from; Doctors' Consultation fees, Medical Care Services, Laboratory Services  Ambulance Services, Dispensed Medicines (pharmacy), and Health Promotion Services. MMC’s starting annual sales turnover is projected to start at UGX 431,625,000 in the second year (2023/24), and thereafter grow annually by 5% to UGX 464,487,500 in the third year (2024/25); UGX 497,350,000 in the fourth year (2025/26); and UGX 530,212,500 in the fifth year (2026/27) of trading[7]. The return on investment (Net profit) will be UGX 79,475,863 in the second year; UGX 96,288,259 in the third year; UGX 103,100,655 in the fourth year; and UGX 109,913,051in the fifth year  of operation respectively[8]. The RRS project will make MOD public Health Foundation more stable and resilient in addition to donor funding. This will give capacity to the organisation to strengthen its internal systems and process to implement its strategic goals and objectives.

4.0       PROJECT OUTCOME AND IMPACT

4.1      Management Summary

Additional employees the BDS is likely to hire as a result of this support *

The BDS support will add ten (10) multidisciplinary staff to MOD namely; 1 Medical Doctor, 2 Clinical Officers, 2 Nurses, 1 Laboratory Technician, 1 ICT Specialist, 1 MEL Expert, and 2 Causal personnel.

MMC will initially have five employees: A medical doctor (Parttime), a Medical assistant (Clinical Officer) (full-time), a Registered Nurse, Laboratory Assistant, and a receptionist. They will be paid hourly wages and have health and dental benefits. As the facilities grow, we will add additional personnel to help with referrals and additional responsibilities that will be needed at that time.

During the first year, MOD Public Health Foundation will hire a part-time physician,  paid hourly and per patient seen, and will be paid directly including all of his benefits and payroll taxes by MOD. Starting in the second year, the physician/owner will draw his salary directly from MMC. We will create a policy and procedures manual that will act as a guide and reference to sick pay, leave, vacation, hourly wages, payment, etc. The philosophies and guidelines in this manual will help maintain proper organizational structure. There will be a mandatory staff meeting on Wednesdays at 06:00 pm. There will be a pre-written list of items that will address ways to improve the practice. Everyone is expected to attend. All employees, including the doctor, will be expected to continue to better themselves regarding both skills and knowledge. The staff of the clinic will have specific duties that they will perform daily. They will be responsible for their duties and must complete them in a systematic time-efficient manner.

4.2      Market Analysis Summary

There is an increasing demand for cost-effective health care in the nation and in the greater Masaka region especially after declaring Masaka Municipality as a city. Specifically, the local population (within 30 Km) is predicted to grow approximately 3% per year and has a population of roughly around 36,300 people as per the National Population and Housing Census (NPHC) 2014.

4.2.1  Market Segmentation

According to the National Population and Housing Census (NPHC) 2014, the largest age group in Kingo area was between 10-39, with 17,787 people (49%), followed by children aged 0-9 with 13,068 people (36%). Residents over 40 make up 16% (5,808) percentage of the population here than the regional average. Since we will be open to patients of all ages, our market segmentation breaks potential patients out into local population (within 30 Km) and patients from the surrounding region (within 60 km).

There are currently 1-2 medical practitioners in rural areas for 22,000 people living within 30 km. These are favorable statistics that offer an excellent patient-to-doctor ratio, in addition to the limited number of surrounding family medical practitioners.

 

 

Table: Market Analysis

Market Analysis

 

 

 

 

 

 

 

 

 Year 2023

 Year 2024

 Year 2025

 Year 2026

 Year 2027

A: Potential Customers

Growth Rate

 

 

 

 

 

B: Local Population

3%

36,300

37,389

38,511

39,666

40,856

C: Surrounding Region Population

3%

72,100

74,263

76,491

78,786

81,149

D: Total

3.0%

108,400

111,652

115,002

118,452

122,005

E: MMC Annual Target (5% of D)

 

5,420

5,583

5,750

5,923

6,100

MMC Monthly Target (E/12)

 

465

479

494

508

524

 

The investment will allow MMC to provide high-quality medical care and health promotion services to an average of 5,755 patients annually and 494 patients monthly from the local areas surrounding Kingo Sub-County in Masaka Region.

 

4.2.2  Target Market Segment Strategy

 

MMC will locate and focus its efforts on the entire local population (within 30 Km). Our segmentation strategy is geographic for several reasons:

  • The rural and semi-rural patients of this area will not, and often cannot, travel more than 25Km to see a doctor. They would rather "wait it out" on all but urgent matters.
  • Our clinic is a general family practice and will treat patients of all ages, incomes, physical abilities, races, and ethnicities. As a family clinic, there is no need to create marketing materials targeted at only one or two of these groups, but we can appeal to all with a similar message.
  • The expected growth of the local population, at 3% a year, makes this an ideal location for a broadly geographic marketing approach.
  • The existing uncoordinated patient referral system makes the need for an ambulance system evident to enhance timely emergency referrals to regional referral hospitals.

 

4.2.3  Competition and Buying Patterns

 

In general, competition among fellow medical practitioners, and private clinics in our town and the surrounding area is still small. The growing population base and the limited number of doctors create a great potential for meeting our patient load goals. When choosing a family doctor, most patients look for someone knowledgeable and skilled who will listen carefully to their health concerns. They are more likely to return to a doctor whose location and hours are convenient and accessible, who has short waiting times for getting appointments and sitting in the waiting room, whose staff is friendly and helpful, and who works effectively with their insurance provider. The relative importance of each of these factors will vary by patients' age range, medical needs, and level of sophistication in managing their health.

 

4.2.5  Strategy and Implementation Summary

 

Our strategy for a successful start is based on quickly creating a high profile and name recognition within the community through community engagement, medical camps, public speaking, networking, promotional events, and print advertising. These marketing tools will be followed up with a sales strategy that relies on a pleasant and accessible location, well-trained, highly motivated employees, and a commitment to provide the best care and patient experience possible in every interaction. The advantage of this strategy is that every element of it is within our control.

With few local doctors for this community, competition will be less of a concern than will education of potential patients about the benefits of seeing any doctor at all and encouraging preventive health care.

4.2.6  Competitive Edge

 

MODSTONE Medical Center will have a competitive edge based on position, timing, quality of care, availability to the patient, after-hour care, weekend hours, quality time, pleasant staff, and office environment. All of these factors will result in patient satisfaction and high referral rates.

In general, competition among fellow medical centers in our town and the surrounding Kingo area is small. The growing population base and the limited number of doctors create a strong opportunity.

4.2.7  Marketing Strategy

Upon opening up MMC, it is important to create momentum before the actual day of opening. In conjunction with a Marketing and Advertising Group, this momentum will be created 1 month before the opening date. We will first try to get our name recognized in conjunction with promoting the location and the services we can offer.

We feel that the most important way to become established is to create a presence in the community. The best way to create this is through a combination of the strategies outlined below, to accomplish greater visibility to prospective patients and institutions.

4.2.8  Marketing Materials

All written materials used to promote the medical office will share a professional and polished look and feel. Our office will carry our leaflets, to be made available to all patients, containing factual information about the services provided. This leaflet will also contain some biographical information, location, photos, and other promotional material. This leaflet will be used to help promote MMC  both as handouts for patients within the clinic, as well as potential patients outside the clinic.

4.2.9  Accessibility and Flexible Hours

MMC will adopt several strategies to ensure patient satisfaction and word-of-mouth advertising. First, our hours will include after-hours care and allow patients to come into the clinic after they get off work. We will also be open on Saturdays. This means there will be several weekdays that we will be open till 7:00 P.M. and that we will be open on Saturdays. We will also take walk-ins to provide the best possible convenience for the patient.

4.2.10            Environment, Appearance, Etiquette, and Overall Patient Experience

 

The building will have a bright and cheerful appearance with flowers and plants to decorate the outside and inside of the office. There will be colorful and informative signs that will help them find the clinic. Upon arriving and entering the clinic, the patient will be greeted with a smile.

Patients' needs and concerns will be addressed, and they will be asked politely to have a seat in the waiting room. Upon arrival to the waiting room, they will experience comfortable seating, good lighting, soft music, or T.V, reading material and the general comforts appreciated by any patient. The walls will have beautiful art and there may even be a fish tank. The clinic rooms will be professional, clean, and organized and the walls will be decorated with medical posters that will help explain the most common conditions. During the consultation, the doctor will have a white coat and tie and will conduct himself professionally and courteously. After the consultation, the doctor or the nurse will escort the patient to the front where all further arrangements will be made. A courtesy reminder card will be filled out for patients' convenience.

Pricing Strategy:

The pricing for consultations and visits, as well as any procedures, will be billed according to industry standards. We will be consistent with our competitors and the national averages. Most pricing will be dependent upon agreements with the five largest insurers in the area.

4.3      Building business resilience*

The impact of COVID-19 on our business has helped MOD to rethink its business model. Specifically, while our business is in the healthcare sector, we learned that playing at the periphery of the healthcare and medical services value chain made our business extremely vulnerable in the face of strict lockdowns compared to companies that were at the core of the value chain, say, providing medical services. The decision to launch a medical services business, a service core to human survival regardless of the nature of the disaster, is an effort to improve the company's resilience to similar or related shocks in the future.

Secondly, our commitment to investing in the digitization of core functions of the business will also build long-term resilience. Besides increasing efficiency, quality of service, and reducing costs, digitization will help MODSTONE Medical Centre be future-ready to provide virtual or online services in the face of a similar/related disaster. During the next 12 months we shall be piloting how we can take core functions of the business online (marketing, client appointment, basic screening/triage, drug dispensing, and payments). We believe that digitization will make our business adaptable to online services in case of any future disaster.

5.0      INFORMATION MANAGEMENT AND TECHNOLOGY

 

To comply with HIMIS laws and improve the efficiency of billing, we will use a secure, networked, electronic medical records system.

5.1          Hardware

The clinic will use the most advanced computer, server, and software systems, as well as Internet connections, to optimize the potential EMR and PMS systems software as well as in other software and network system utilized resulting in faster verification, efficient patient information transfer, reduction in administrative costs, computer breakdown or malfunction, as wells as allowing outside access for the physician to access important patient information for hospital admissions and in other important situation where information is needed about the patient in optimizing the care of the patient.

5.2          Billing

MMS will utilize an outside electronic medical billing company. This will allow the medical practice to focus primarily on patient care satisfaction. The electronic medical billing company will use electronic claim billing and filing, which in turn will allow us to fully utilize the benefits of electronic claim filing (i.e. faster payment for processing insurance claims) while at the same time allowing us to maximize valuable clinic time and manpower. The billing company charges 5% of the total expenses collected.

5.3          EMR (Electronic Medical Records)

MMS is strongly considering EMR, to secure the success and efficiency of the office. Below are a few of the benefits and features we may expect to gain from utilizing the EMR system. This technology is expected to increase the systematic approach for each patient, while at the same time decreasing risk while maximizing profits. We feel that all of these technological enhancements will increase our chances of success.

 5.3.1     BENEFITS

Increases Revenue by allowing more patients to be seen without working harder or longer, improves collections through management of referral and eligibility data, tracks managed care contracts, and managed care payments/bonuses, provides valuable tools to generate research income, and provides for coding optimization.

 

Reduces Expenses by reducing transcription costs, data analysis costs, paper storage and access costs, staff costs, and paper/forms costs.

Reduces Risks by improving the quality of documentation, maintaining security and integrity of data, checking for drug interactions, helping to analyze payer relationships, and helping keep documentation and coding in compliance with laws.

Improves Quality by improving documentation, presenting, and managing protocols, tracking, and summarizing indicators, alerting providers, and helping to track recalls. The general features of electronic Medical Records include;

  • Document Generation
  • Workflow Management
  • Image Management
  • Electronic Superbill and Billing System Interface
  • Coding Optimization
  • Referral Management
  • Eligibility Verification
  • Contract Management
  • Outcomes Analysis
  • Lab Order Entry/ Lab Result Reporting
  • Follow-up/Recall Tracking
  • Patient Instructions
  • Fax Capability
  • Prescription Generation
  • Graphing
  • Voice Recognition Option
  • Advanced Security
  • Electronic Data Interchange (EDI)
  • Mobile Solutions
  • Scheduling Option

 

6.0      LESSONS LEARNT FROM THE COVID-19 SITUATION FOR YOUR BUSINESS SURVIVAL*

 

The COVID-19 pandemic and the associated economic shock brought many hard lessons for business survival. At MOD we urgently needed to;

·         Re-think how to position ourselves in the rapidly emerging public health market and challenging economy. Consequently, the repurposing to establish a medical center within office premises came along. However, we delayed understanding the potential business opportunities that would come along with COVID-19. MOD's Think Tank has to be up to speed to generate timely evidence-based business innovations.

·         Re-think the relevance of our 5-year business strategic plan, products, and services. We identified key strategies for business creation and survival.

·         Intensify technology application and adaption for business competitive advantage, marketing, and networking by increasing company space online platforms.

·         Strengthen risk profiling and management to guide company investment.

·         Appreciate the need to balance capital investment and availability of cash at the bank for daily business operations. 

·         Create flexible internal systems and processes that acetates innovation and adaptation.

·         Create opportunities for managerial skills in business development.

·         We are now much aware of the need to strengthen research for evidence-based business solutions.

·         COVID-19 demonstrated the need for strong company culture and flexible internal systems to survive the disaster.

7.0      COMPANY'S MEDIUM-TERM PLANNING

  1. (a-f). How will the support affect Organisation’s plans with respect to the following?

7.1          Product(s) *

The DBS Support will enhance technology assessment, development, and adaption at MOD and MODSTONE Medical Center. For instance, when health management information systems are developed, they will improve product costing, patients flow, medical diagnosis, and provision of quality medical services. MOD mobile app technology and promoting our products and service on social media platforms will enhance last-mile distribution of health commodities to underserved communities. 

7.2          Customers *

Support to set up digital marketing and customer engagement channels will help us to reach the middle-income market segments faster than we had planned. Without this kind of support, the business was planning to rely heavily on walk-in customers and word of mouth. Your support would positively disrupt that.

7.3          Competition *

The support will enable MMS to quickly catch up with the competition in Masaka city by offering comparable services and in the case of digital customer engagement, superior to the competitors.

7.4          Market strategies *

This BDS will boost the company’s marketing and sales activity and help MMS to gain market traction, and 5000 clients within 12 months, thanks to improved branding and digital marketing, and client engagement.  

 

7.5          Management *

The support will help MOD to establish better hospital and healthcare management systems and practices than would have been immediately possible. The patient management information system, health care policies and protocols, and customer care training for medical center staff are all good things we had planned for but would be implemented over time in line with the business' evolving financial position.

 

 


Appendix 1: 5 MOD Post Covid-19 RRS Project-5 Year Financial Projections 2022/23-2026/27

See Attached Excel sheet for detailed Annual Projections

 

ITEM

% of Sales

FY-1: 2022/23

FY-2: 2023/24

FY-3: 2024/25

FY-4: 2025/26

FY-5: 2026/27

Justification, Remarks & Assumptions

1.0

Required Investment

 

 

 

 

 

 

5755 (Average patients to be Seen Annually at MMC)

1.1

Project Support Grant  FY-1

95.4%

627,250,000

 

 

_

_

3,830.58

1.2

Members Contribution: FY-1

4.56%

30,000,000

 

 

_

_

 

 

Total Investment Capital

100%

657,250,000

 

5%

5%

5%

 

2.0

Total Sales (Medical care, Products & Equipment/Technologies)

65.7%

0

431,625,000

464,487,500

497,350,000

530,212,500

Sales include income from the sale of Medical Care Services, Consultancy, Laboratory, Ambulance, Pharmacy, Health Promotion Services.

2.1

Doctor's Consultancy Fees

6.7%

0

28,775,000

30,965,833

33,156,667

35,347,500

Average 5755 Patients Seen at MMC Annually X Consultancy fees (UGX 5000)

2.2

Medical Care Services

33.3%

0

143,875,000

154,829,167

165,783,333

176,737,500

Average 5755 Patients Seen at MMC Annually X Medical Care Fees (UGX 25000)

2.3

Laboratory Services 

20.0%

0

86,325,000

92,897,500

99,470,000

106,042,500

Average 5755 Patients Seen at MMC Annually X Laboratory fees (UGX 15000)

2.4

Ambulance Services

6.7%

0

28,775,000

30,965,833

33,156,667

35,347,500

Average 5755 Patients Seen at MMC X Ambulance Services cost(UGX 5000)

2.5

Pharmacy/Drugs

30.7%

0

132,365,000

142,442,833

152,520,667

162,598,500

Average 5755 Patients Seen at MMC Annually X Cost for Medicine Dispensed (UGX 23000)

2.6

Health Promotion Services and Projects

2.7%

0

11,510,000

12,386,333

13,262,667

14,139,000

Average 5755 Patients Seen at MMC Annually X Health Promotion fees (UGX 2000)

2.7

Direct Cost of Sales

50.0%

0

215,812,500

232,243,750

248,675,000

265,106,250

Indicates direct expenses on purchase of shop drugs and cosmetics

2.8

Gross Margin

50.0%

0

215,812,500

232,243,750

248,675,000

265,106,250

 

3.0

Expenses

 

 

 

 

 

 

 

3.1

Staff Payroll

15.0%

0

64,743,750

69,673,125

74,602,500

79,531,875

 

3.2

Selling, General & Administrative Expense (SG&A)

10.0%

0

43,162,500

46,448,750

49,735,000

53,021,250

Includes sales and marketing expenses

3.3

Depreciation (Depex)

2.89%

0

12,473,963

13,423,689

14,373,415

15,323,141

3.4

Electricity

0.33%

0

1,424,363

1,532,809

1,641,255

1,749,701

 

3.5

Insurance

0.50%

0

2,158,125

2,322,438

2,486,750

2,651,063

 

3.6

Legal Expenses

0.55%

0

2,373,938

2,554,681

2,735,425

2,916,169

 

3.7

Expensed Equipment

1.32%

0

10,000,000

0

0

0

 

 

Sub-Total Expenses

30.6%

0

136,336,638

135,955,491

145,574,345

155,193,199

 

4.0

Net Profit

19.5%

0

79,475,863

96,288,259

103,100,655

109,913,051

 

4.1

Income Tax

30.0%

0

23,842,759

28,886,478

30,930,197

32,973,915

 

4.2

Net Profit after Tax

 

0

55,633,104

67,401,781

72,170,459

76,939,136

 

 

 

 

Appendix 2: Project Implementation Schedule  

Ref.

2.2.4.1

Description Of Activity

           

 

 

 

 T  A  R  G  E  T

Person responsible

External Partner/ Supplier

OCT-2022

NOV-2022

DEC-2022

1Q

JAN-2023

FEB-2023

MAR-2023

2Q

ARP-2023

MAY-2023

JUN-2023

3Q

JUL-2023

AUG-2023

SEP-2023

4Q

OCT-2023

NOV-2023

DEC-2023

Annual

1.1

Phase 1: Registration with URSB and Allied Medical Council.

 

X

X

 

X

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CEO

 

1.2

Phase 2: Resource Mobilisation strategies.

X

X

X

 

X

X

X

 

X

X

X

 

X

X

X

 

 

 

 

 

CEO

Board of Directors

1.3

Phase 3: Construction of MODSTONE Medical Center & Startup MOD offices at Kingo Sub-County.

 

 

 

X

X

X

X

X

X

X

X

 

 

CEO

Board of Directors

1.4

Phase 4: Procurement of Essential Medical Equipment and Supplies.

 

 

 

X

X

X

 X

 

 

 CEO

 

1.5

Phase 5: Establishing a Patient Health Management Information System (HMIS)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 X

 

 CEO

Board of Directors

1.6

Phase 6: Product Development, Branding, and service marketing.

 

 

 

 

 

 

 

 

 

 

 

 

X

 X

 X

 

 

 CEO

Board of Directors

1.7

Phase 7: Launching Business Development Service (BDS).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 CEO

 

1.8

Phase 8: Ambulance referral System and Startup

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X

X

 

 CEO

Board of Directors

 



[1] Appendix 1: 5 MOD Post Covid-19 RRS Project-5 Year Financial Projections 2022/23-2026/27

[2] MODSTONE Medical Center- Detailed Excel 5 Years-Forecasted Financial Projections 2022/23-2026/27

[3] Uganda Bureau of Statistics 2017, The National Population and Housing Census 2014 – Area Specific Profile Series, Kampala, Uganda.

[4] Primary health care systems: A case study from Uganda, abridged version. Geneva: World Health Organization; 2017. License: CC BY-NC-SA 3.0 IGO

[5] Kalibala, S., L. Vu, S. Waliggo, “Retrospective review of task-shifting community-based programs supporting ARV treatment and retention in Uganda,” HIV Core Final Report. Washington, DC: USAID | Project Search: HIV Core.

 

[6] Determined, Resilience, Empowered, AIDS-free, Mentored, and Safe Girl 

[7] Appendix 1: 5 MOD Post Covid-19 RRS Project-5 Year Financial Projections 2022/23-2026/27

[8] MODSTONE Medical Center- Detailed Excel 5 Years-Forecasted Financial Projections 2022/23-2026/27

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