Social Media and Dialysis

¶ … For-Profit Dialysis Business Plan Mission Statement Vision Statement Organisation Summary Legal Structure Services Management and Staff Start-up Costs and Operational Expenses Strategy and Implementation Funding Partnerships Marketing and Communication Expansion The increasing burden of chronic kidney disease (CKD) in Kenya presents a major challenge, with young adults aged 20-50 years being the most affected. CKD is primarily caused by hypertension, diabetes, along with glomerular diseases. HIV-associated CKD is an increasing healthcare concern, and frequently offers late "End-Stage-Renal-Disease" (ESRD) requiring dialysis.

In Kenya, dialysis remains out for reach for majority of ESRD patients due to financial constraints, lack of personnel, inadequate renal facilities, as well as lack of national and/or regional registries. Presently, only a few dialysis centres provide service in the country, mainly in a few government hospitals, notably Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital. Nonetheless, the cost of dialysis is high, thereby limiting dialysis to once in a week schedule, instead of the required three times for a majority of the patient population.

The cost of dialysis is even higher in private hospitals, consequently locking out more ESRD patients from treatment. More regrettably, the few dialysis centres available are located in major cities, meaning accessibility to patients in rural areas is difficult. Establishing a not-for-profit dialysis centre in rural Kenya where poverty is more prevalent would mark a significant step towards minimising the country's burgeoning CKD burden. Start-up costs and operational expenses in the first year will require up to $390,000.

1.1 Mission Statement To provide high quality dialysis care to patients in rural Kenya with ESRD and related disorders 1.2 Vision Statement To improve the quality of life of patients in rural Kenya with ESRD 1.3 Goals/Objectives I. Contain the cost of dialysis while maintaining the quality of care II. Optimise patient care and outcomes 2.0 Organisation Summary 2.1 Legal Structure The dialysis centre will be established as a not-for-profit entity. This will provide important advantages from a tax perspective.

A not-for-profit status will also place the centre in a better position to attract donor support. 2.2 Services The centre will provide a variety of services relating to ESRD care. These include haemodialysis, peritoneal dialysis, specialised kidney disease treatment, kidney transplant, CKD education, lifestyle adjustment support, and emergency services. ESRD patients require not only dialysis and medication, but also comprehensive knowledge about CKD risk factors and how they can adjust their lifestyle to manage the condition or reduce risk.

The services will be positioned to be accessible to ESRD patients living in rural Kenya. They will no longer have to travel to big cities in search of dialysis services. The services will be provided at a low cost in line with the goals and objectives of the centre. The goal of the centre is to offer quality ESRD care at an affordable cost. This will earn the centre considerable reputation as far as the provision of ESRD care in the poverty-stricken country is concerned.

2.3 Management and Staff Operating the dialysis centre will require a competent team of management and staff. Indeed, ESRD care is a critical discipline requiring individuals with the right skills, knowledge, capabilities, and experience. The centre will require CKD/ESRD specialists, physicians, nurses, pharmacists, as well as administrative personnel. Cleaners, security guards, and messengers will also be required. It is estimated that personnel costs will cost $20,000 per month, or $240,000 annually. The proposed organisation will have a simple structure comprising an executive director at the top.

The director will be in charge of all personnel, helped by an assistant director. Below the director and the assistant director will be heads of various functions within the organisation, including dialysis and patient care, human resources, finance and accounting, administration, and procurement. The organisational chart is summarised in figure 1 below. Figure 1: Organisational structure Table 1 below summarises the roles and responsibilities of management and staff.

Table 1: Management and staff responsibilities Role Responsibility Director and assistant director • Overseeing the operations of the centre • Mobilising resources • Engaging donors and partners Patient care • Receiving and admitting patients • Delivering dialysis services and overall patient care • Patient education and training Administration • Clerical and front office duties • Supervising non-medical staff • Communication and public relations Finance and accounting • Monitoring expenditure • Preparing financial reports Procurement • Procuring supplies • Inventory management Human resource • Personnel recruitment and management 3.0 Start-up Costs and Operational Expenses Establishing a dialysis centre is a costly undertaking, mainly due to the expensive equipment required.

A single dialysis machine costs between $10,000 and $15,000. The centre will start with two machines. Construction costs will also have to be factored. As the centre will be set up in rural Kenya, locating a real estate establishment that can be rented to house it can be a challenge. Though land for buying or renting is readily available, most rural areas in Kenya are characterised by simple structures that may not be fit for a dialysis centre. Therefore, constructing the centre from scratch would be the best option.

In addition to construction and dialysis machines, other start-up costs will include medical supplies, stationery, computers and related accessories, personnel costs, and medical supplies. Table 2 below summarises start-up costs and expenses in the first year of operation. Table 2: Start-up costs and operational expenses Item Cost ($) Construction 50,000 Dialysis machines 30,000 Machine maintenance 10,000 Medical equipment & supplies 15,000 Furniture and stationery 20,000 Computers & accessories 5,000 Personnel 240,000 Insurance 2,000 Utilities 3,000 Marketing & communication 15,000 Total 390,000 4.0 Strategy and Implementation 4.1 Funding As mentioned above, setting up the centre and operating it in the first year requires a substantial capital outlay.

The funds will be acquired primarily from donors. The centre particularly targets international donors (individuals and corporate organisations), charitable organisations (such as Bill and Melinda Gates Foundation and the Rockefeller Foundation), local corporate organisations, as well as government grants. Donors can give not only cash, but also equipment and supplies. In fact, getting some of the machines and equipment, such as dialysis machines, computers, furniture, and medical supplies, can significantly minimise start-up costs. In addition to donations, fundraising campaigns will also be explored.

With social media, fundraising campaigns are now easier than ever before. Indeed, several social causes in Kenya have in the recent past benefited from social media campaigns. Through social media, Kenyans have increasingly supported their own by donating to drought assistance, disaster relief efforts, chronic disease bills, and other social causes. This option, therefore, will provide a significant avenue for mobilising funds for the dialysis centre.

4.2 Partnerships Setting up and operating the centre will require a great deal of partnerships, in large part due to the inherent establishment and operational challenges. Installing a not-for-profit centre in rural Kenya can be quite challenging without the support of partners. The centre will seek partnerships with not only donors, but also the county and national governments, local media houses, major national hospitals (especially KNH and Moi Teaching and Referral Hospital), as well as major local universities (especially the University of Nairobi, Kenyatta University,.