Yetunde Ayo-Oyalowo is the Founder of Market Doctors Nigeria, and a Cartier Women’s Initiative Fellow, 2021. She established Market Doctors in 2017, and is increasing access to primary healthcare to the informal sector by taking healthcare to the markets by use of mobile clinics and also locating static clinics in the markets thereby minimising disruption to their economic activities by cutting on journey time and waiting time spent in clinics.
With a background in health insurance and public health, she knew there was a gap in healthcare access. Market Doctor aims to fill this gap. It gives the opportunity for preventive care, early diagnosis and treatment as well as reduction in morbidity and mortality associated with ill health in the natural habitat of the informal sector.
Central to this choice is convenience, physical proximity, little or no waiting and journey time and ability to get services according to their purchasing power. This helps to reduce the cycle of poverty and ill health.
This project has directly impacted more than 100,000 in just two years across 9 states of the federation Rivers, Ondo, Ekiti, Oyo, Anambra, Abia, Kano, Akwa Ibom and Lagos states. Our work exemplifies that anyone, from any background, can have access to healthcare with minimal economic loss and can purchase primary healthcare within their limits of affordability if the model of delivery is suitable.
Working with 14 permanent staff including, doctors, nurses and other healthcare workers and worked with over 300 adhoc staff across Nigeria, they have delivered care to over 100 000 people. They have a mobile clinic and 2 stand-in-clinics in two markets providing quick diagnostic tests, medical consultation and essential drugs.
Their work has great value in diagnosis of Malaria and other infections with point of care kits and standard treatments as well as early diagnosis of non-communicable diseases like hypertension and diabetes with treatment.
These are lifesaving to the informal sector. They are able to address the inequality in healthcare access, create employment and build platforms for organisations to engage this target group for other health programs like family planning and tuberculosis.
They want people to add healthcare to their shopping bags!
They have partnered with state governments, multinationals, International foundations to deliver these projects.
Dr Yetunde has pioneered other health programs including school health clubs in over 10 schools, ‘Doctors Discuss Malaria’, a World Malaria Day program that has trained over 1200 medical doctors over 6 years on best practice in diagnosis and management of malaria.
She has facilitated training for more than 200 medical staff and hospital workers for their Spirit of Excellence Program for healthcare workers and Society of Healthcare Quality.
She is also a senior partner of Preventive Health Managers a health consulting firm providing support for employee health, wellness programs for corporate organisations.
Her education began in University Primary School Ilorin and then Federal Government Girls College Oyo. She studied medicine at the College of Medicine University of Ilorin with a Masters in Public Health from University of Lagos.
She has a postgraduate certificate in Occupational Health and Safety [NEBOSH] from United Kingdom and a Certificate in Managing Occupational Health services Brunel University London.
She is also a certified Customer Service Professional from the Service Quality Institute Minneapolis, USA.
She is a certified Human Resource Manager with the Carrington Heritage Centre for Professional Development United Kingdom.
Oyalowo has a certificate on Marketing and Business Strategy from Lagos Business School, a certificate in Career Advancement and Leadership Skills for Women in Healthcare Leadership, Harvard Medical School Boston Massachusetts.
Yetunde is a member of Consortium of Universities for Global Health [CUGH] USA. She won the award of the most innovative business award by Fidelity Bank SME connect.
For a career of over 16 years, spanning various healthcare administrative management positions, she is today a Senior Partner at Preventive Health Managers, a health management consulting firm.
Memories of Childhood days
I grew up with my parents who were academicians. Dr and Dr (Mrs) Ibikunle . My parents always wanted us to be our best. My parents had compassion. My dad, despite his position, could relate with all strata of the society, had friends that were very rich and influential and had friends who were poor. He always strived for common good of the community we lived in.
I grew up in Ilorin. I was not forced to study medicine but I found myself in med school. You know in those days, you know the right boxes had to be ticked, either you are a doctor, lawyer, engineer or the likes… they just find the profession for you, so I studied Medicine. I had always assumed leadership positions as I was Head girl both in my primary school and high school. My parents treated boys and girls equally and made us know we could achieve all our dreams. I liked Medicine but towards the end, I wasn’t really keen on working in the hospital. I felt I could do much more than that and that was why I ventured into entrepreneurship.
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When and why did you set up Market Doctors Nigeria?
Market Doctors was set up in 2017.We began to pilot late 2017. Market Doctors was set up to create access to healthcare to people, to solve the problem of affordability, accessibility and availability of healthcare services and commodities.
Our vision is to bring affordable healthcare services to the doorstep of ordinary Nigerians with minimal disturbance to their economic activities.
While at the University, I knew that there wasn’t equity in healthcare, I knew that people could not afford healthcare right from the time at Emergency Room when people were brought in as accident victims, you found a lot of patients ran away eventually because they couldn’t afford to pay the bills. People discharged themselves against medical advice because they could not afford bills for tests and treatment. Healthcare was not affordable.
Fast forward to when I finished school, I ventured into the old insurance industry because I felt that health insurance could be the answer to creating a situation where people would have access to health care, because even at that time, a lot of people could not afford health insurance, and I am talking of 2006-2007, just about 3 to 4% of the population had access to health insurance, and they were basically people who had cooperate health insurance such that, their offices paid their insurance.
There were also cultural challenges associated with it as well, where people do not prepare for ill health. I ventured into Market Doctors because; there is the need to create access to health insurance for people at the bottom of the pyramid.
Initially, it was just to be like a charity in which I went to the markets with monies and personal phones, and sometimes with friends, and donated funds here and there, creating access to healthcare, little things like medical consultation, medications and just a few tests, and I discovered that people wanted it and were ready to pay for it. So Market Doctors was set up about four years ago.
Achievements so far
So far, Market Doctors has been able to reach 140,000 people when we combine all the people reached in terms of our activities at various markets. We visited over 78 markets and you know we’ve had at least 25% of the people visiting our outreach saying that was the first time they were going to have their blood pressure measured, including some other checks. Such feedbacks are testament to the fact that our work is delivering in value as intended.
Challenges taking health care to the informal sector
It’s challenging taking health care to the informal sector because you have to deal with a lot of things, you have to deal with culture, you have to deal with the language, and you have to deal with acceptability.
The terrain is also not comfortable, you sometimes have to be delivering health care under the sun, and sometimes it is very humid. It’s not been easy, and even considering the location, you know you’re in the market where meat is being sold, dirty water splashing, people grinding pepper and then it enters your eyes to mention a few hazards of doing this, but when you look at the results, you know it’s been worth it.
Sharing your vision in those places where tradition and beliefs are sacred
Speaking on old traditional believes, there’s really nothing you can do about that, you can only continue to tell them and prove what you’re saying, and thank God in a lot of instances, we’ve been able to prove that we’re bringing value. A lot of the beliefs people hold is at the level of their understanding. They can’t believe more than what is within their sphere, and you know within their home is where their workplace is, and that workplace for them is the market.
However, underneath that tradition and belief is poverty. They also won’t want to comply because they cannot afford it and as such, makes it easy for them to take that belief strongly. Let me give an example. Delivering babies in the hospital, most people feel that it’s expensive. The mode of payment also doesn’t work well for them, neither is the money even readily available.
Furthermore, the intricacies after birth also appear burdensome to them and because they can’t do these, they opt for the traditional setting, where you can have your baby and pay for services after. In some cases, you can even get substitute for cash, depending on the location you’re in.
It is quite important to understand their traditional beliefs. I remember when we went to the North; it was difficult to get any woman to come to the outreach. They didn’t come out until we now changed our style. We created a particular scenario that ensured the women were attended to by female doctors and nurses, and that way, they came out and they were able to access care. It is important to learn the culture of the terrain we go for outreaches.
What role does preventive care and early diagnosis play in helping your work?
Preventive care is the real core of our work. Early diagnosis helps so you educate them. People normally have a health problem they’re dealing with, although they don’t say it out, but when you talk to them, they begin to unravel what has been going on in their mind, and you are able to help them seek for early solutions.
For instance, non-communicable diseases, some people just know they’ve been hearing the word hypertension but have never checked their BP. They are actually having symptoms which they do not know as symptoms of high blood pressure. We’re able to advise them on that. We also tell them how often they should check it and some have been given drugs. Some do not know they have to be on the medication for a while.
We have to keep educating them about how the management is a continuous process and about how they need to keep on checking, using their medications, getting consultation and adjusting their medications to suit where they are in the spectrum of the disease.
Sometimes, all you need to do is listen to them so that you can advise them on the kind of food they eat and the need for exercise. Those are simple information that they do not really have access to. These are crucial roles in preventive care and we are glad to be drivers of disseminating this information to them.
The role of technology in helping your line of work in the informal areas
For the kind of people we interface with, it is mostly one-on-one interaction. This is not to say that technology has not helped us, especially in terms of phone calls and video calls. Also, text messages, payments and all of that technology has helped but, the people in the informal sector are taking the adoption of technology quite slow. It’s getting better, but I would say that most of our work with them has had to be face-to-face because they believe in hard copy, what they can see.
Ensuring continuity in already impacted places
We have been to different States and partnered with different organisations on their CSR projects. There are some who carry out Philanthropic gestures, who support this course to ensure we deliver health care services to people from their villages.
We have also had people celebrating their birthdays, who have projects attached to their celebration. They prefer such help to the informal sector rather than having to splash so much money celebrating. They have helped to create access to proper health care for a certain number of people.
Managing staff and ensuring their safety
Managing stuff is a major tough one because as an entrepreneur, you have to deal with rejection especially when you’re doing the kind of work I’m doing. I mean you have doctors and nurses come, and when you tell them about the vision, they tell you that’s not the kind of work they want to do so sometimes, you feel bad and you’re wondering if you will ever be able to get people to buy into this vision.
Top on their mind is also safety. Because we’re constantly outside, we also consider the security of the country. We often use the local security of the area we are visiting and they are usually helpful.
We ensure the use of PPE’s when we go out for protection, especially during COVID-19 (though we were already using it before COVID-19). Thankfully, there’s never been a time when we had a major outbreak within staff. We ensure that our infection prevention control protocols are top-notch, even considering the kind of organisations we work with; we have to put together an infection prevention protocol. It’s one of the things that they’re going to ask for before we even do our work.
How has your work added great value in diagnosis of Malaria and other infections?
Diagnosis of malaria is one of the partnerships we have mostly done. Malaria is endemic in Nigeria. Another challenge is people buying drugs at the pharmacy without ensuring that they are tested to determine if it is malaria they have or not. So, it’s a lot of health education for the people and it’s a lot of treatment, and a lot of support is needed for this.
There are partnerships that have also resulted in provision of mosquito nets. We’ve also had partnerships with government in which they’ve also used our network to be able to create access to people for malaria treatment, so sometimes, at some places, tests could actually be free from us to them.
Partners you have collaborated with
We have partnered with a lot of organisations like MTN foundation; they understand taking healthcare to rural communities. We have also partnered with May & Baker and several others.
These partnerships have helped to carry our medical outreaches even to churches whereby some do see it as a way to give back to the society. Sometimes, the availability of medical expertise within the church also helps to make the work easier. We have also had partnerships with Nollywood stars. We have indeed had several partnerships, but we are looking to be able to scale to partner more with the government and also with the international agencies to be able to reach the nooks and crannies of Nigeria and even other places in Africa.
Health care in the Nigerian environment
The truth is, there is a problem with human resource and healthcare. The problem with human resources is not basically about numbers, it is also about people being able to be responsible to their duties. If the public sector is what it was created to be, the image it is seen today would have been a better one. The average Nigerian cannot have access to health care if he doesn’t have money.
I believe we need a lot of training in health care; we need to understand emotional intelligence and how it works so you can understand the professionals better and even those you want to treat.
Also, I think the budget for healthcare has to be improved upon. We’re still doing about 3.8%, while the recommendation is about 15%. I think we’re still doing lower than what we should do.
I believe the government also has to fund health care more than a lot of programs that are running today. There are some for measles, polio, HIV and all however, I believe that if we are better organised and partnership with private sector is encouraged, the healthcare sector will improve greatly.
Being Cartier Women Initiative Fellow, 2021
It has been an amazing experience, from writing the application to being shortlisted. I should also mention that I had written the application about four times before I finally got selected. I also became better in providing proper details as I reapplied. The process involves a lot of due diligence and of course you have to be very honest. What you write that you do is what you must be doing.
The initiative makes you know that there are a lot of women doing amazing things, doing little things in their corner and creating change in every sector of human and life experiences. I think women entrepreneurs should apply for this because it helps your business grow, helps you see value in what you’re doing, and gives you the ability to turn your business from a local one to global prominence. It also helps you to amplify your voice. I am truly honoured and grateful to have been selected. It means the world to me.
Final words
I encourage all women to seek opportunities where available and maximize them. Nowhere is too small for you to start from, just start and learn through the process as you grow and one day, you will get that opportunity you hoped for. Your dreams are valid and they will come through!
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