Women driving clinical innovation during a crisis
An all-female roundtable moderated by Gillian Stewart, Industry Strategist - Life Sciences & Healthcare - Deloitte, discussed how female healthcare organisations can emerge stronger post-COVID-19.
The panel included speakers from Aga Khan Foundation, Ghana Health Service HQ, Pharmacess Foundation and University of Cape Town.
When prompted, all had a different idea of what female leadership entailed.
Prof Maswime, Head of Global Surgery at University of Cape Town, shared her perspective on leadership, in that it was about "getting things done" using skill, expertise and social intelligence. Women are furthermore "more collaborative", among other special skills, as leaders.
Dr Mary Eyram Ashinyo, Deputy Director - Quality Assurance - Ghana Health Service HQ, measures leadership in the form of "contribution to humanity", influencing and nurturing others and the ability to surmount obstacles.
Dr Elizabeth Wala, Global Advisor, Health and Nutrition at Aga Khan Foundation, believes that everyone has the capacity to give guidance, and looks forward to the time when women leaders are spoken of as "leaders".
Njide Nidili, Country Director - Pharmacess Foundation commented that it takes a special type of skill to secure buy-in, and that humility and passion are important to the leadership role ("everyone supports one another").
On specific challenges facing female leaders within the past six months, Nidili began by saying that the majority of people accessing healthcare are women and children. Women were dying from all ailments during COVID-19, because they were afraid to access hospitals. Her organisation, Pharmacess Foundation, made a concerted effort to support state government in putting out correct information.
Pharmacess Foundation supplied PPE (almost 65,000) to hospitals, as women were being sent away by hospitals - there were fewer people, and less money to buy PPE. The effect of the pandemic was "devastating".
Nidili added that compounding this is the fact that a large percentage of doctors are women, but not all are decision-makers. The issue of access and how to level the playing field needs to be addressed, and that's why innovation in Africa is critical.
Dr Ashinyo's observation was that in Ghana the pandemic has heightened existing mindsets. Most women needed to create space for themselves, as the pandemic "pushed them further into the background" because of perceptions that the crisis required strengths (associated by men with men). They had to do their own situation analysis, and provide solutions to gaps, which was how they entered into the limelight. Much work remains however, conceded Dr Ashinyo.
The moderator introduced the fact that in South Africa the ceasarian rate has dropped because of COVID-19 because women are not going to hospital. Neo-natal care has dropped to virtually nothing.
Prof Maswime in reply indicated the disparity between public and private care; in South Africa only 20 percent can afford private. A lot of the issues go back to disparities. Furthermore, pregnant women in South Africa are anxious at this time, owing to the pandemic, and they require more support. Some are having to give birth alone.
Dr Wala highlighted a considerable reduction in funding for shelters, meaning some shut down; and the issue of job losses in an economic downturn. Teenage pregnancies because of school closures was another challenge, as was a reduction in access to care. Many community workers (majority women) were fearing going into houses as they didn't have PPE.
Some policies were not gender-specific, Dr Wala added. Women were reduced to taking minutes in meetings, rather than making decisions and having a proper place at the table.
The impact of COVID-19 on breast cancer management
Breast cancer patients and care providers have found themselves in a difficult and uncertain position since the pandemic began. COVID-19 has affected the screening, diagnosis, treatment and follow-up of breast cancer patients. The outcomes of women with breast cancer are dependent on timely and high-quality interventions. And any delay in timely management will impact both the physical and psychological state of these women.
One of the challenges that breast cancer providers had to address was the fact that many patients did not seek care out of fear. Even patients with diagnosed breast cancer were hesitant to come into a healthcare facility to receive further management knowing that they are immune-compromised.
“As a result of this, we are now seeing many breast cancer patients with advanced disease,” said panellist Prof Dr Rasha Kamal. “As breast health care providers, it is our duty to tell patients to not fear the Coronavirus because you might not get it, but you do have breast cancer and that needs to be treated.”
Dr Kamal emphasised that hospitals need to re-evaluate the flow of patient care to minimise personal interactions in order to prevent the transmission of the virus while keeping both patients and breast care providers as safe as possible.
SMEs in the healthcare supply chain
Supreet Singh Manchanda, Managing General Partner at Raiven Capital, moderated a panel comprising speakers from Stanford Seed, Kizo Ventures and iJenga, who discussed how to increase the performance of SMEs in the healthcare supply chain and the competitive advantage of SMEs in the healthcare supply chain ecosystem.
The panel was asked for perspectives on healthcare in the current pandemic context.
Soravar Singh, Managing Director: Real Estate Development & Investments - iJenga, compared his experiences in Kenya with Canada, where he'd spent the early part of the COVID-19 pandemic.
There were similarities in both countries where there was mobilisation of health researches, from communications to how healthcare was administered (in Nairobi he witnessed some differences in how communication was conducted). In Canada there was heavy reliance upon community, with community participation working across economic statuses.
Laurie Fuller, Executive Coach, Strategic Advisor - Stanford Seed highlighted how, from her perspective, the pandemic has shown inequalities in access to healthcare. COVID-19 aside, natural disasters have accelerated in frequency around the world, presenting a challenge to keep people safe in the "new normal".
Regina Njima, Co-Founder & Managing Partner - Kizo Ventures, commented on the need to wait for N95 masks from China, requiring the use of surgical masks in the interim. She added that mental issues and anxiety have emerged through the pandemic alongside other challenges.
The talk quickly turned to innovation emerging in the healthcare supply chain.
Fuller highlighted two innovations: a company using the opportunity to go straight to the manufacturer and disintermediate the supply chain, reducing the price significantly and giving quality feedback; and the other being a digitalisation of services.
On this last point, she explained this as teleconsultations, and used the example of a hospital that recouped revenues through digital services that would have been lost otherwise. This is now an established vertical of the business - a standalone business, as well as complementary.
She that it was interesting to see Africa transfer technologies to the US, for example Zipline matching blood with hospitals in Africa through use of a "high-tech" drone and who are now doing this in the US.
However, what is especially empowering is the relationship between low tech and high tech in Africa. She gave the example of LifeBank, who also match blood with hospitals but use the more low tech method of motorcycles, or "blood riders".
Singh commented on the building of robust cold chains so that vaccines may be accessed by rural settlements. He referred to a "Melinda Gate-ism" in that people may receive a cold coke, but not a vaccine at the right temperature, and that people were trying to understand the economic and social viability of that.
On her part, Njima offered the example of fintech empowering the pandemic response, with Kenya at the forefront of this. M-Pesa [mobile money service in Kenya] was extremely instrumental in cashless transactions between vendors and suppliers of goods and services, and Safaricom [Kenyan mobile network operator] allowed transactions under 10 dollars to be free of charge.
This aside, in West Africa, Senegal experienced Ebola in 2014, and based on set up a system for communicable diseases. Under this system they were able to launch test kits for one dollar when the country was struck by the pandemic and provide results within 24 hours.
Workshop: Focusing on the communicable diseases’ agenda in Nigeria
Communicable diseases remain the top cause of deaths in Nigeria and don't look like they are going to be eradicated soon. The workshop brought together eminent personalities from Nigeria’s healthcare industry, who spoke at length about the need to change the narrative through partnerships between the public and private sector.
Dr Chibuzo Opara, MD/Chief Executive Officer, DrugStoc, said: “There is consensus that there will be another pandemic. We have understood the importance of needing to strengthen the healthcare infrastructure. It is essential to realise that we need to go beyond the front-line of defence."
One of the major lessons, said Mories Atoki, Chief Executive Officer - African Business Coalition for Health (ABC Health), is that COVID-19 happened without preparedness and readiness and that other countries did not come to support as everybody was fighting this battle. Therefore, it is crucial to ensure that the next time a need for crisis management comes around, countries need to be better prepared.
“What I saw in the private sector was that the element of competitiveness was replaced by the need to come together and bond. They are demonstrating an appetite to the region that they can’t thrive on an economy that doesn’t exist. The healthcare industry should work along with the private sector to ensure the possibility of another pandemic ends,” she emphasised.
Another issue that has come to the forefront is that people are not wearing masks, and this is a sign of the lack of personal recognition of risk, explained Dr Caroline Jehu Appiah, Director, Nigeria Country Office, Bill & Melinda Gates Foundation.
She said: “The issue around enforcement and education is that the government doesn’t have enough resources for it, and, therefore, the responsibility falls on each of us. A kind of fatigue has set in because people are not seeing the gravity of the pandemic. If people begin to understand the epidemiology, they would begin to wear masks.
“Also, at the national and state levels, budgets need to be reprioritised towards COVID-19 response. However, in the medium-term, it would be better to use the funds to strengthen the health systems, so that it can be used in fighting other diseases as well. In the long-term, it should be about revenue generation and to maximise on efficiency gains.”
Other priority areas the workshop highlighted included vaccine-preventable diseases, maternal-child health, malaria, tuberculosis, scaling up digital services, building a resilient supply chain, behavioural change communication, increasing research and development, and showing the close link between economics and health – staying true to the adage health is wealth.