Anneke Roy's Blog

Refine the detailed income statement for your venture for two years (at six month intervals) or a more appropriate time scale. Explicitly state the assumptions that underlie your financial model.

Refine the Business Model for your venture based on your revenue model. You may use the Osterwalder BMC to refine your business model but prepare one or more visuals that explain how your venture will work and accomplish your BHAG.

Our Business Model helps us reach our BHAG because, by working directly with Community Health Workers or CHWs, we are able to bring the test strips directly to pregnant women in more rural communities.  The innovative aspect of our project is not the test strip itself but the way we distribute and bring healthcare to the people in the communities we are trying to serve.

Develop an M&E plan for your venture.

Metrics of Success

1. Maternal Mortality
2. Profit

Long Term

• Maternal Mortality
• Number of people tested positive, and then pursued treatment
• Number of districts / countries
• Expansion into other Sub-saharan countries

Short Term – collected by DM on the ground reported back to Lehigh time digitally, along with PDFs of original documents

• Catchment Population
• Number of PHUs onboarded
• Number of people tested positive
• Number of test strip boxes sold
• COGs and Overhead costs
• Number of women tested
• Number of clinics

Financial Model and Assumptions

Design Phase Funding: We are no longer in the design phase of development.

Implementation Phase Funding:

1. Crowdfunding campaign during Summer 2019. This is a good fit for the venture because it shows the commitment and validity of the venture as a whole and allows us to achieve one of the main goals of the operation: a self-sustaining method of funding. Although this crowdfunding campaign is not directly self-sustaining, it contributed to the implementation of Ukweli Test Strips in Sierra Leone through the community health worker backbone that will create a self-sustaining system of revenue.
2. World Hope Internationalàmatched the crowdfunding campaign contribution. This is a good fit because of the aforementioned reasons above, but it also shows the commitment of WHI and formalizes that meaning of the word “partnership” to a greater extent than what was previously established.

Partnerships Forged/Needed:

1. World Hope International – provide logistical support to the Ukweli operation as they are a well-known nonprofit organization with a presence already established in Sub-Saharan Africa.
2. Community Health Workers – these form the backbone of the Ukweli system by a CHWs inherent level of trust and credibility within their communities. By leveraging this partnership, Ukweli is able to gain credibility with the people it aims to serve.
3. Sierra Leone Pharmacy Control Board – approval from the organization allows Ukweli to legally distribute the test strips within Sierra Leone
4. Sierra Leone Ministry of Health and Sanitation – Formal partnership still needed in order for the Sierra Leonean government to eventually take over the Ukweli system and manage its operation
5. Liberian government- preliminary proposal in the works to expand into Liberia, the support of the Liberian government will be needed in order to make this partnership permanent and allow Ukweli to reach millions more people.

1. Refine your Business Model Canvas

1. Ten practical lessons from the business (revenue) models of ventures we reviewed today (or others you research) as they relate to your venture.
   1. Envirofit uses large distributors but also smaller, local businesses in order to distribute their product to more rural areas.  We can look at this and see how we might scale up in the future in order to make the test strip widely available
   2. Envirofit heavily focuses on the impact they’re making on the people, not necessarily the product→ when reaching out for funding proposals or competitions, we can use Envirofit as an example of how we should market our product. 
   3. Envirofit does impact reporting where they call their customers to evaluate their products and collect information on cooking habits and what it’s being used for. We could translate this into our project through the testing of the WhatsApp communication system.
   4. Envirofit’s Impact of 1 Million Stoves highlights the company’s real-time data that they are collecting on their website.  Being able to include something like this on our website in the future could be incredibly useful for displaying our impact. 
   5. Reel Gardening really focused on simplifying the gardening process and making it easy for users to participate.  Our test strip is designed to make it easier and cheaper for medical staff and patients to use. 
   6. Reel Gardening provided a simple step-by-step tutorial for their users to even further simplify the process.  Our group could look at doing informational videos or messaging for CHWs and the women in the communities on the symptoms and risks of UTI/Preeclampsia going undetected.  Offer a more visual option.
   7. Reel Gardening offers an “Our Blog” section on their website.  It provides customers with information pertaining to gardening.  From different recipes to how to collect rainwater, Reel Gardening provides its customers with all information that’s relevant to the product.  Through our WhatsApp communication system, we can look at different ways to engage UHWs with the test strips and ultimately encourage increased testing.
   8. Greystone Baker has an open-hiring policy and not only pays its employees but also goes above in beyond in providing benefits for them.  Ukweli may not be able to fund benefits/opportunities like Greystone, but we can look at providing some sort of reward or benefits for becoming a UHW.  Making certification to be a UHW something that is exciting and exclusive, while maintaining our accessibility, could encourage word-of-mouth marketing between CHWs.
   9. Barefoot College really looked at spreading their knowledge through already established social networks.  For example, they trained grandmothers in order to educate and spread the use of solar power. Similarly, we are using already established social connections through CHWs to distribute the product.  We could also potentially look into using and encouraging certified UHWs to spread the word about Ukweli and the test strips to increase interest and testing. 
   10. Barefoot College works to empower women directly by giving them the tools to establish solar power in their rural communities.  We could potentially look at a way to work directly with women so we know they’re seeing an impact and feel empowered to seek medical care. 

1. Develop a Business Model for your venture using the Osterwalder Business Model Canvas.

Value Propositions

For mothers in Sierra Leone, our Ukweli Test Strip is a simple, affordable testing strip for UTIs and preeclampsia that could save their lives and increase their quality of life by identifying potential health issues.

Customer Relationships

Co-Creation

User Communities

Channels

Community Health Workers

Customer Segments

Women in Sierra Leone 

Community Health Workers 

Revenue Streams

Funding from Organizations

Selling of the actual test strips to CHWs

Key Resources 

Test Strips (OEM)

CHWs

Intellectual→ Connections on the ground Hassan and his connections, data collection, 

Human→ Hassan, Allieu, Bockarie

Financial→ Funding from world hope and other organizations

Cost Structure 

Sell strips to UHWs/NICs to distribute to the catchment population–>bottle of strips cost 50,000 SL

Key Activities

*big idea 

For the Lehigh team, we need to continuously be 

• Communicating and directing on-site UHWs (Ukweli-certified Health Workers) 
• Collecting, storing, managing, and communicating data from fieldwork to necessary stakeholders
• WhatsApp communication with CHWs in order to maintain relationships 

Key Partners

World Hope

CHWs

Hassan, Allieu, Bockarie

1. List ten lessons from the Business and Operations model of the Aravind Eye Hospital.
2. Franchise system for eye care, same delivery and quality
3. Important to identify those who need help in the first place
4. Developing a system which integrates the communities
5. Hub-and-Spoke model: base hospitals, vision centers, managed hospitals
6. Use technology to increase accessibility
7. Fixed pricing which takes into account 
8. Focus on non-customer, grows market
9. Gave a lot away for free, had those who could pay cover the costs of the free treatments
10. Created competition by training other hospitals and cheaper consumables, result is beneficial to patients
11. Cost is not directly related to quality or efficiency of care
12. OWN THE PROBLEM – create compassion, encourage people to act

1. List five compelling take-aways from the Art of the Start. 

1. Your Mission Statement should be more of a Mantra.  No more than 3-4 words that emphasize your values.
2. You shouldn’t use more than 10 slides for a presentation.  You want to keep your slides/presentation quick and simple in order to maintain the attention of your audience.
3. Polarize People.  If you aim to make everyone happy, you will land at mediocrity.  
4. You want to find your business “soulmates”.  You want to find people who balance you out/studied in different disciplines that way your business isn’t too heavily focused on one aspect of development. 
5. Think Different.  You aren’t going to get anywhere by making another dating app.  Think outside the box and add something new to the market. 

2. Articulate your value propositions for your diverse customer segments. 

For Mothers in Sierra Leone, who are susceptible to UTIs and Preeclampsia, our Ukweli Test Strip is a straight forward, affordable testing strip for UTIs and Preeclampsia that could save their lives and increase their quality of life.  

3. Discuss your Total Available Market and Total Addressable Market. List all your assumptions and hypothesis.

Our Total Available Market right now is all the mothers in Sierra Leone.  That would be a catchment population of about 3 million women. Our Total Addressable Market is the women that are currently served in our catchment population, so women who have a Ukweli Certified Health Worker in their community.  This population is about 300,000 women according to the data we have received so far.

1. Summarize and report out on the results of the SKS exercise. 

Our group has done an excellent job when it comes to assigning roles and should keep doing this. Our jobs are based on current project needs and what people have expressed interest in pursuing and/or are strong in.  Everyone has been happy and interested in the work they are doing individually but when we need to collaborate, our communication has faltered. We need to start communicating directly in more explicit terms and stop being so passive. Part of that requires us to be open to constructive criticism and constantly be willing to improve. Our goal is to lower the maternal mortality rate and improve millions of people’s lives, so we must check our egos at the door. Being able to listen to your teammates is just as important as being able to speak up.

Start:

Communicating Better/Listening to each other

Pushing Each other

Keep:

Assigning Roles/Jobs

Making sure everyone is happy/fulfilled by the work they are doing

Stop:

Being passive

2. Develop a detailed Collaboration Plan for your team clearly articulating your Goals (Small g and Big G), Roles,Procedures, and Relationships.

Does your work require IRB approvals? If Yes, articulate your detailed IRB strategy. If No, explain why you don’t need IRB approval and identify situations when you might need IRB approval.

Our work in Sierra Leone will require IRB approval because we are working with pregnant women, who are considered to be a vulnerable population. 

We may have to submit to Sierra Leone IRB (depending on some alternative avenues that may or may not work out), and we will have to resubmit for continuing review to the Lehigh IRB as this project was approved in the past. However, as we expand operations, we will have to outline further details for the IRB at Lehigh and the stakeholders in Sierra Leone (CMO and other officials). Within those details, we will have to outline specific methods/controls we will have in place during our data collection process and procedures to ensure the safety and well-being of our vulnerable participants.

Develop an outline for your mid-semester presentations. What supporting evidence will you provide for each point? How will you boost your credibility every step of the way?

• Explain the problem/opportunity being addressed from a macro perspective – a bird’s eye view can be the world at large, country, region (and/or relevant combinations). Use your judgment.

• • • Highest Maternal Mortality rate in the world 
    • Little-to-no access to easy to healthcare and preventive measures

• Explain the problem/opportunity from a micro perspective – how does the problem affect the individual, the family, or relevant entity? What secondary problems does it cause?

• • Expectant women face travel challenges when looking to access healthcare
  • The high maternal mortality rate is often a result of easily-preventable conditions that are worsened due to lack of early identification of the issue
    • UTIs and preeclampsia can be identified early but lead to devastating health consequences if left unchecked
    • Any cost of healthcare will take away from the opportunity for the individual to earn money and work in a given time period
  • Cultural issues may also interfere with a woman’s comfort-level when seeking guidance on a sensitive/personal issue regarding their pregnancy
  • Difficulties and limitations with reliable shipping methods/oversight

• Explain your approach and exactly how your proposed solution is supposed to work.

• • Work with World Hope International (WHI) to train and sell Ukweli UTI test strips to certified UHWs in order to increase accessibility and affordability to Sierra Leoneans to preventive healthcare measures relevant to the maternal mortality rate
  • Test our population for markers indicative of UTIs and preeclampsia to provide them with information necessary to determine whether or not they are at risk for common contributors of the maternal mortality rate
    • These test strips cost 2 cents per strip
  • Collect data relevant to the number of people tested for UTIs and preeclampsia and follow each participant’s health outcomes to the extent possible (e.g. if testing positive, did they follow up with a provider?)

• What larger context/system does your project exist in? Illustrate how the various constituent sub-systems work together, and how the system interacts with external systems?

• • Sierra Leone Healthcare System 
    • Peripheral Health Units (PHUs) vary in their capability across the country
      • Consist of a nurse in charge (NIC) with multiple community health workers (CHWs) who report to the NIC
      • NIC reports to the District Medical Officer (DMO) who then reports to the Chief Medical Officer of Sierra Leone (CMO)
      • Very hierarchical system that requires us to go through a rather bureaucratic process when gaining required approvals for any aspects of our project
        • This can make things a bit inefficient, but it is also necessary for us to maintain a good working relationship with the government of Sierra Leone
    • We mostly work with the Community Health Workers within the Sierra Leone Healthcare system.

• Summarize what has been done before. What did you inherit this semester?

• • Test Strip tested and finalized→ 2 cents for a 3 parameter test strip with a 92% accuracy rate under ideal conditions/Registration as a medical device
  •  Bombali District Staff and Connections/Contracts established/Distribution process
  • Training manuals setup

• Discuss the results of literature reviews, prototyping, experimentation, interviews, simulation, or modeling. Essentially, any work you have done this semester and plan to do.

• Work Done

• • • • (Not done yet but should be finished before the presentation) Data Collection Forms/Database
        • As well as setting up a dashboard: Forms 1A, 1C, 1B and weekly/monthly spending

• Planned Work

• • • Establishing WhatsApp UHW communication groups/ drafting messaging 
    • radio programming?
    • Draft out UHW Bylaws
    • By summer/July 2021, Ukweli should have a catchment population of about 3 million→ Expand into the Bombali District, Tonkolili District, Karene District, Western Area Urban District, Western Area Rural District. 
      • In order to do this, we need to hire new distribution employees
    • Eventually, Expand into Liberia

• • Identify research/design challenges and detailed plans to address them 
    • Communication between Hassan is limited so making sure he is not only uploading data one time but correctly is key.  Having him upload the paper forms as well will give us the ability to double-check his data entry points 
    • 1C: CHW Data Collection Form→ no way to verify that the CHWs are accurately filling out the forms instead of just creating data in order to buy new boxes. One way we can address this is looking over the data entries and looking for any obviously fake data (e.g. pregnant male)

List ten things that make you feel human. 

1. Emotional/Physical Pain
2. Empathy→ makes me feel like I’m apart of a larger human experience
3. Failure
4. The feeling of the warm sun on your skin after a cold winter
5. The smell of Thanksgiving dinner being prepared
6. Binge-watching shows with my family on a rainy Saturday
7. Saying “I love you”
8. Being told a secret
9. Laughing until my cheeks are sore 
10. Sleeping through my alarm

Articulate your philosophy of engagement as it pertains to your work with the GSIF / LVSIF. 

As a white person, it is incredibly important for me to define my philosophy of engagement, especially when going to a country that has had a strong history in neocolonialism and the issue of the white savior complex.  I’m engaging because there is an opportunity to improve the lives of mothers in Sierra Leone, which has the highest maternal mortality rate in the world. How we go about this engagement is, arguably, the most important part. To start, this opportunity works within their current healthcare structure so the system can be easily maintained after the Lehigh group removes itself from the process.   Forcing a product onto a community is not how you establish meaningful impact and change. We must also remember when doing fieldwork that we do not know better or more than any of the people we are working with. Having that mentality is what leads to the white savior complex and changes your goal from trying to help to trying to fix. The people we meet will have more knowledge than any of us on the cultural and geographic landscape of the area.  It is incredibly important for us to engage with all members of the community in order to spread the information on UTIs and Preeclampsia. We want to empower the women to take control of their health and wellness so making sure there is widespread information is key. A major challenge for me personally will be dealing with the different outlooks on time and being direct. I’m usually passive, especially with people older than me, so being direct and clearly outlining the schedule for projects might be difficult.   

My epitaph would read  “Loved by Many, Known by Few”.  The value of being kind and loving to everyone you encounter was instilled in me at a very young age and I want to leave this Earth having made an impact on people whether big or small, hence the “Loved by Many”.  The “Known by Few” stems from the importance of a strong, close “inner circle”. Having a support system made up of very close friends and my immediate family has always been incredibly important to me and I tend to be slightly more introverted.  It will also make me seem way more mysterious than I actually am.

1. *Based on your life experience, skills and interests, what would a design process that is both uniquely yours and effective look like?

Our group decided to do this question separately since it was so personal.  It is beneficial to be aware of your group members’ different design processes that way you can adapt and see where they are coming from in times of disagreement.  For me, visualization is a huge part of my process.  I not only have to define the problem but be able to actually see or picture it in my head.  It can’t just be a high maternal mortality rate.  I need to see the whole picture.  Before identifying my personal limits, I think it is important to brainstorm any and all ideas.  No idea is too big and too far fetched at this stage.  If you limit yourself based on what you THINK you can accomplish, you may miss out on your best idea.  After I compile my list of ideas is when I look at what I can actually do.  You don’t want to restrict yourself from certain ideas too early on in the process because after some research you may find out something far fetched isn’t actually that far out of reach.

2. *Identify your three most important stakeholders and list five UNIQUE attributes for each one of them. 

Mothers→ low income, located in rural areas of Sierra Leone, price sensitivity goes up during the wet season, Religions: Islam and Christianity, low education level 

World Hope International→ Organization, Core Values: Transformation, Sustainability, Empowerment, and Collaboration, Christian, Motive: “To empower the poorest of the poor around the world so they can become agents of change within their communities.” (https://www.worldhope.org/about-us/), some staff members located in the U.S. and Makeni, Sierra Leone

The ordinary citizen of Sierra Leone: this is a key stakeholder because of the importance of mothers in the Sierra Leone household. Attributes include: dependence on the mother’s contribution to the household, personal interest/stake in the life of each mother, ability to encourage/support the mother throughout their pregnancy, influence on the mother’s mental well-being, and the motivation they may provide the mothers to seek better health when they think about how their health (the mother’s health) affects the whole family unit.

3. *Identify three ways in which you will validate your project concept, technology, usability, and business model.

Validate Business Model→ Does it solve a real burning problem? Yes, Sierra Leone has the highest maternal mortality rate in the world.  A lot of women go untested for UTI and preeclampsia which can lead to birth complications.  

Competitive advantages over other ventures? Strong community connections on the ground, incredibly important for distributing and gaining trust from CHWs.

How do they solve the problem now? Currently people in rural areas of Sierra Leone visit Community Health Posts (CHPs) to receive basic medical care, however they are normally not screened by any diagnostic test due to lack of resources.  

Validate Usability→ How does it compare to the user experience of alternative

approaches? 9 parameter UTI test strip→ much more expensive, more complicated with 9 vs the 3 our strip has (color scheme harder to analyze). 

How easy/difficult is it for each stakeholder to interact with the product? CHWs are shown how to use it and read the results during training. 

Will people use your product? We currently have UHWs purchasing and using the test strips.

4. Give three examples of something very interesting you learned from a friend that was a completely alien concept to you.

1. The Baader-Meinhof phenomenon, also known as the Frequency Illusion, is the thought that something that was recently introduced to you is now suddenly popping up everywhere.  You feel as if everyone is talking about this specific thing and you’re seeing it everywhere but it has nothing to do with how often it shows up.  Your brain can now identify the object and notice when it’s around you.
2. The Six Degrees of Separation is the concept that any two people in the world can be connected by 6 or fewer social connections. For example, my sister’s friend is cousins with Adam Levine so I have 3 degrees of separation from Adam Levine.
3. The Hawthorne Effect is the concept that people modify their behaviors based on the knowledge that they are being observed.   This is a huge issue within the social sciences because it can affect the integrity of data.

List the top 20 questions your team needs to answer to advance the venture forward. Categorize the questions if necessary.

1. Who are the people we are seeking to impact?
2. How is the impact distributed across different groups?
3. How does Ukweli’s success in Sierra Leone impact the international system?
4. Why do we care about making an impact?
5. How is this realistically translated into their lives?
6. How can our model be applied to similar countries?
7. How is our impact measured?
8. How does this venture empower women?
9. What type of connections do we need to branch out of the Bombali District?
10. What is the future of this venture?
11. What are the challenges that we are encountering on the ground right now?
12. How do we leverage our existing social network to expand operations?
13. What are other ways we can strengthen the CHW network within our control?
14. How can we organize data in a way that is easy to understand and accessible?
15. What is some data we already have?
16. What is some data we still need to collect?
17. What are some realistic ways we can quantify the success of our project? (e.g. comparing maternal mortality rates in Ukweli vs. non-Ukweli tested mothers and the challenges associated with timely data collection)
18. How could additional funding assist in our efforts?
19. How can we construct a reliable and sustainable chain of communication with UHW?
20. Are there more effective methods to increase accountability/oversight?

Develop and Visualize the Theory of Change (Logic Model) for your venture. 

SPRING GOALS

• Bylaws on the roles/responsibilities of UHWs: Zach 
• Organize a data collection method that creates an easy way to compile relevant data in a way that can be easily presentable: Spencer, Noah, Anneke
• Establish a chain of communication with Ukweli Certified Health Workers via WhatsApp: Skyler
• E4C Systems approach article: Zach 
• Proposals/abstracts submitted to IEEE
• IRB approvals finalized/submitted/approved for US and Sierra Leone: Rohan
• Service Level Agreement (SLA)
• Submission of Grants to external funding sources: Anneke
• Presentation of quality control outcomes of test strips: Rohan
• Implementation of PHU Data collection books
• Create database of each form to observe trends and running total of # of CHWs trained, amount of strips sold, $ which has been invested

SUMMER GOALS

• Finalization of IEEE Paper 
  • Idea: discussing leveraging the existing social network and the outreach of CHWs and associated training successes/pitfalls in the process
• Implementation of By-Laws to the UHWs by Hassan
• Submission of grants to external funding sources: Anneke 
• Implementation of PHU Data collection books 
• Establish connections/possible operations outside our current realm of operations (Bombali District)
• Initiating the proposed chain of communication with the UHW
• Utilize data from the fieldwork to generate more marketing to support project, specifically $ / lives saved (culmination of other data = number of positive tests, referrals given out)