Of the approximately 80% of people in South Africa who rely on the public sector for their healthcare needs, at least ten million are employed but cannot afford private-sector pricing. This uninsured market is served by the Unjani Clinic Network, which provides access to quality primary healthcare at a fraction of the usual cost. The name ‘Unjani’ means “How are you?” in both Zulu and Xhosa, and highlights the importance of providing a personalised, hands- on service to patients accustomed to being little more than a number at state facilities.
As a purpose-led organisation, multinational company Imperial Logistics has identified five pillars against which
to measure its socioeconomic impact – people, operations, external stakeholders, impact on the environment, and CSI. This impact is benchmarked against the goals and targets of South Africa’s National Development Plan, the United Nations 2030 Agenda for Sustainable Development, and the African Aspirations for 2063, as defined by the African Union.
Unjani Clinics began as a CSI initiative of Imperial Health Sciences – a division of Imperial Logistics – in 2013. The franchise model saw six container clinics established, with the aim of exploring the fee-for-service model within the primary healthcare arena. The pilot programme aimed to build sustainable micro- enterprises.
In 2014, the programme was registered as a separate legal entity – Unjani Clinics NPC – with Imperial funding 25 clinics to ensure that proof of concept worked before bringing other investors on board. The success of the project has demonstrated how private service providers can play an important role in helping to achieve universal health coverage, removing some of the pressure from overburdened state facilities.
These unique primary healthcare clinics are owned and operated by black nurses, affectionately known as ‘nurse-preneurs’. These women, who are only appointed if they have professional nursing qualifications and dispensing licences, receive financial support as well as business management training, mentorship and more, which enables them to sustain and grow their businesses.
The Unjani Clinic Network – now a partnership with National Treasury’s Jobs Fund as well as other companies – services employed yet uninsured people who face a multitude of health risks in low-income or rural areas. These community members can typically afford to pay only a small fee for healthcare – a standard consultation costs a patient around R200, which includes medication. However, many are grateful to not have to take time off work and travel long distances (paying for public transport) to get to government facilities, where they usually have to wait in long queues.
Each clinic offers its patients ailment diagnosis and treatment, including medication, wound care, family planning, baby clinic and immunisation, basic ultrasound, HIV counselling and testing, laboratory blood services, treatment and management of patients on antiretrovirals, treatment of chronic illness, wellness screening and antenatal care.
Since inception, Unjani Clinics has rolled out 94 clinics (of which 29 are sponsored by Imperial), including two mobile clinics, and the NPC aims to have 100 clinics in place by December 2021. The total investment cost in an Unjani Clinic – as well as the professional nurse and the community she will serve – is just over R1 million. By the end of June 2021, Unjani Clinics NPC had received sponsor funding amounting to R139 million – a testament to sponsor confidence in its transformative value to society.
Social results: serving low-income communities, empowering black women
The network has vastly improved access to affordable, quality primary healthcare and health education for more than two million patients. Accenture’s independent socioeconomic impact assessment of the business in two key markets found that the Imperial- sponsored clinics it evaluated (29 of the 94 in operation) had managed to unlock more than R40 million for surrounding communities, through savings in the cost of healthcare as well as time spent travelling and queuing.
The Unjani Clinic Network has created meaningful job opportunities, as well as providing black women with opportunities to become financially independent community leaders, uplifting members of the communities they have grown up in.
Imperial-sponsored clinics supported 165 direct job opportunities in the 2020/21 financial year, with more than R20 million paid out in salaries, leading to a GDP uplift of R63.6 million. The network supports the creation of several indirect jobs, including those created at the company manufacturing the container clinics. Through Imperial’s contributions to Unjani Clinics, Accenture estimates that 340 000 lives were affected in the 2020/21 financial year, which includes patients, employees, and their family members.
During the Covid-19 crisis, Unjani Clinics doubled up as Covid-19 screening facilities. From the start of the pandemic until June 2021, the clinics had conducted over 520 000 screenings, thereby potentially breaking the infection chain closer to the source.
Business benefits: Serving the healthcare sector, enhancing reputation
Aside from the broad-based black economic empowerment, brand and reputational value Unjani Clinics creates for Imperial, there is synergy with the company’s growing healthcare division, which seeks access to difficult-to-reach markets in Africa. New diagnostic technologies are tested in local markets, which the healthcare division markets and sells into the healthcare sector.
Unjani Clinics perform an estimated 40 000 antenatal scans a year. In 2021, the clinic network indicated that at least ten new clinics would need ultrasound devices to expand this service to other communities, while five of the existing clinics would benefit from additional ultrasound capacity. Imperial’s Market Access Healthcare division, which is developing a presence in South Africa, donated 15 much-needed, point-of-care ultrasound devices to help meet these antenatal care needs. At the same time, it was able to assure prospective clients that its new, cutting-edge technology had been tested and could be safely acquired.
Business relationships have been strengthened as Imperial has successfully engaged clients and companies in the healthcare sector to collaborate on the project, which has reaped benefits for all parties. Imperial’s association with Unjani Clinics has contributed favourably to Imperial’s brand and reputation in the eyes of stakeholders, particularly as the initiative has won a number of awards, including the Institute of Risk management SA Award for healthcare (2017).
“The development of the nurse-preneurs concept in container- based micro-clinic form is a brilliant, much-needed innovation. Imperial is to be commended on this ‘base of the pyramid’ initiative. The excellent data, and the work done with independent evaluators to assess health and financial impact, is commendable and makes this initiative a strong winner this year. This is one of the strongest examples we have received over the years, in terms of the effort to build a business model that is sustainable in the South African context. The initiative is closely aligned with the company infrastructure and partner/supplier network, as is clear from the supporting documentation. It brings quality, affordable healthcare to multiple communities.”
The programme in numbers
R42 million: Total Imperial Logistics expenditure on project since inception in 2014 to end-June 2021
R139 million: Total sponsorship from all partners since inception in 2014 to end-June 2021
94 clinics: Number of Unjani Clinics as at June 2021
2 048 356: Cumulative number of patients serviced by the network from inception in 2014 to end-June 2021
56 430: Average number of consultations per month
346: Number of jobs created in the seven years since inception in 2014
R63.94: Average investment per patient (calculated as cumulative investment cost for all cumulative beneficiaries since inception in 2014)
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