Table 3

Summary of the top three social innovations identified through the crowdsourcing challenge

Organisation details
Organisation nameDrugmedics Healthcare LimitedParker’s Mobile ClinicUkana West II Community-Based Health Insurance (CBHI)
Founding year201820192014
Founder namesChiamaka JibuakuDr Charles UmehChief Michael Akpabio
ImplementerChiamaka JibuakuDr Charles UmehBoard of Trustees (BOTs) and representatives from local governments, SMOH and National Health Insurance Scheme (NHIS)
Founder nationalityNigerianNigerianNigerian
The current head of the organisationChiamaka JibuakuDr Charles UmehChief Michael Akpabio
Organisational structureLimited liability companySocial enterpriseSocial enterprise
Main value propositionA digital solution that provides access to health information, offers access to healthcare and supplies medicines to Nigerians.A mobile clinic that provides affordable or free home healthcare to underserved individuals, including those who live in remote rural areas, thereby addressing the challenges of non-affordability and inaccessibility of healthcare among the target populations.The CBHI scheme was initiated to improve equitable access to quality and affordable healthcare services, especially in rural communities through an all-inclusive health insurance scheme.
Project stage
Project sizeOne IT staff member, one project manager, volunteer health personnel (doctors, physiotherapists, pharmacists, etc). Twenty clients served from inceptionOffice space, improvised mobile clinic service, 1 doctor, 4 regular nurses, and ad hoc staff comprising IT professionals, business developer, driver, nurses and community health extension workers. The project is yet to record satisfactory patronage, particularly from remote rural communities.One health centre. Staff engaged in the scheme include: project consultant, project manager, finance officer, Monitoring & Evaluation (M&E) officer,desk officer, Information and Communications Technology (ICT) officer, community mobilisation officer and 1 volunteer, all supervised by a 7-member BOTs who were democratically elected from the community and 3 stakeholders with 1 representative each from the Local Government Council (LGC), MOH and NHIS. The scheme is supported at the current facility, by a total number of 8 health centre staff members who are government employees and has a total of 6800 community members enrolled on the scheme.
Main income streamUser fee chargeMicrogrants from foreign NGOs, bills payment by beneficiariesAnnual premium paid by members and grants
Annual income from drug medics₦30 000–₦50 000 ($78.9–$131.6)Profit over 1 year about ₦1 100 000 ($2894.7)₦14 000 000 ($36 842.1)
Operational details
Country/countries of operationNigeriaNigeriaNigeria
Type of beneficiaryEveryoneElderly, handicapped, incarcerated and chronically sick individuals, and rural dwellersEveryone is open to being a beneficiary. But mostly consists of elderly persons, women and children who are low-income earners and who reside in the host rural communities.
Number of the beneficiaries (annually)101006800
Cost per clientCost per client for medical consultation=₦500 ($1.3) one-off; ₦1000 ($2.6) monthly subscription; ₦10 000 ($26.2) yearly subscription; free for indigent persons
Cost per client for drug home delivery=₦500 ($1.3) within the state, ₦1000 ($2.6) outside the state (minus the cost of the drug)		Varies with the type of service offered. It is either subsidised or free.₦5000 ($13.1) each expectant woman; ₦3000 ($7.9) children; ₦5000 ($13.1) others
Local engagementNot applicableYet to achieve grassroots engagement, ownership and participationThe scheme is fully implemented and operated by the project staff and health centre staff, under the governance and supervision of the BOTs and representatives from the LGC, NHIS and MOH.
Innovative elementsInnovative elements of the model are:

  1. Drugmedics.com is the only digital health platform digitalising both access to healthcare and medicines on the same platform.

  2. Drugmedics.com also provides health awareness and educational campaign.

Innovative elements of the model are:

  1. Relatively new solution that takes healthcare to the doorsteps of people.

  2. Targets the underserved population.

  3. Leveraging on existing information technology systems.

  4. Convenient and affordable.

  5. Widely distributed network of nurses.

  6. Potential for multisectoral collaboration.

Innovative elements of the model are:

  1. Community-owned and managed health insurance scheme.

  2. Resource mobilisation and establishment of a community health trust fund to pay the premium of the most indigent members of the community.

  3. Positive health belief and health-seeking behaviour changes in the catchment area due to improved awareness of the benefits of CBHI.

  4. Multifaceted collaboration between the community, partners and stakeholders to achieve the objectives of CBHI.

Scaling considerationsThe solution would be scalable if funds are provided to:

  1. upgrade the Drugmedics.com website.

  2. develop a mobile app for the solution (for IOS and Android users).

  3. increase marketing activities.

The solution will be scalable under the following conditions:

  1. Adequate and sustainable funding.

  2. Intensified efforts at reaching a significant proportion of the target population at an affordable cost.

  3. Diversified network of healthcare workers.

  4. Community engagement, participation and ownership.

  5. Strong collaboration with relevant stakeholders in healthcare delivery including government and local NGOs.

  6. Establishment of an organised referral system.

  7. Efficient coordination of activities, quality control, adequate monitoring and evaluation.

The solution will be scalable under the following conditions:

  1. A community with functional democratic governance structures.

  2. Take-off grant, technical support/partnerships and collaborations with relevant government agencies, NGOs and individuals.

  3. Health centre staff willing to oversee the implementation.

Sustainability considerationsThe sustainability of Drugmedics.com will be based on these aspects:

  1. Initial start-up capital to build a comprehensive online solution.

  2. User fee charged to clients.

  3. Voluntarism of health personnel to augment the shortfall in a user fee charge.

The sustainability of the solution will be based on the following:

  1. Identifying sustainable sources of funding.

  2. Exploring community health insurance scheme.

  3. Community engagement and advocacy for ownership.

The sustainability of the CBHI will be based on the following:

  1. Annual payment of premium by enrollees. Continuous expansion of the scheme through the enrolment of new members.

  2. Accessing grants, resource mobilisation and establishment of community health trust fund to pay the premium of the most indigent members of the community and maintain the scheme.

  3. The willingness by community leaders, members and healthcare facility staff to volunteer their time to own and implement the scheme.

  4. Supporting income-generating activities in the catchment area so that more people can afford to self-enrol on the scheme.

  5. Support by traditional and religious leaders in the community.

Health systems lessonsKey lessons:

  1. Information and communication technology could be leveraged to increase the delivery of healthcare.

  2. Given the current health financing strategy in Nigeria, voluntarism is a key factor for achieving universal healthcare particularly if health services are to be offered to persons in lower socioeconomic strata.

Key lessons:
Adequate funding, community involvement and collaboration with relevant stakeholders are key to the success of healthcare-related projects.		Key lessons:

  1. The community requires initial and continuous intense sensitisation, to understand, adopt and own the scheme.

  2. Practical demonstration of the benefits of the scheme and testimonies of beneficiaries have a ‘snowballing effect’ on self-enrolment.

  3. Due to the high poverty rate, the scheme cannot self-sustain on premium alone. Additional funding is required through grants and resource mobilisation.

  4. Most political actors who decide what happens in the health system have a poor understanding of CBHI. They require more enlightenment to understand, support and sustain the scheme.

  5. By owning the scheme, the local community can introduce new ideas in line with local peculiarities to make the scheme more inclusive.

  • IT, information technology; MOH, Ministry of Health; NGOs, non-governmental organisations; SMOH, State Ministry of Health.