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on a positive impact

Trust Talks with: Eston Njagi Nyaga, Kenya Country Manager at North Star Alliance

Interviewed by Stephen Chick, Director of the Strategic Innovation for Community Health Program and Professor of Technology and Operations Management and the Academic Director of the Healthcare Management Initiative at INSEAD

Innovation, is not just a sense that someone is born with. It is a skill that can be learned and enhanced greatly over time. For years, INSEAD – The Business School of the World, has collaborated with the Johnson & Johnson Corporate Citizenship Trust (Trust) to build health leaders’ confidence and innovation skills to bring new thinking to how we tackle the world’s health challenges. One of the ways we do so is through the Strategic Innovation for Community Health (STICH) program. STICH equips senior healthcare managers working in emerging markets with the skills to design and develop innovative, new approaches for healthcare delivery amid the rapidly changing and extremely challenging global health landscape.

After years of successful implementation at INSEAD’s campus in Abu Dhabi, I am thrilled that STICH will be moving to Nairobi! This move is a fabulous way to deepen our engagement with leaders across Africa and develop their skills and competencies to innovate as well as challenge the status quo of primary care. Our hope is that STICH graduates will play a leading role in improving health outcomes across the region while strengthening and transforming health systems.  

One STICH graduate already doing so is Eston Njagi Nyaga, the Kenya Country Manager at North Star Alliance (North Star), another Trust Flagship Partner. In November 2016, Eston received a scholarship from the Trust to attend STICH. I had the opportunity to interview Eston and learn more about his experience at STICH and how he is applying the lessons learned to meet the health needs of North Star’s patients in Kenya. 

Stephen Chick: How would you describe your experience as a participant at STICH and what did you learn?

Eston Njagi Nyaga: I learned a variety of new things at STICH that made me a better manager for North Star, but three major lessons stand out. First, we learned about prototyping and were taught how to develop prototypes to generate different solutions and determine which will most effectively and efficiently improve service delivery. Secondly, I gained new skills in team development and collective discovery. At STICH, we were taught methods for effectively sourcing new ideas and challenging existing ones as a group. Back at North Star, I’ve used this method to involve the whole team in identifying new approaches to delivering care at the wellness centers and assessing which risks are worthwhile to lead to the best solution. Lastly, STICH encouraged us to look at problems and potential solutions from the customer’s perspective. In doing so, we explored and identified innovative opportunities that shape customer behavior and ensure the customer is satisfied with our services.

North Star Alliance Roadside Wellness Centre in Maai Mahiu in Kenya offers the much needed healthcare services to mobile populations and the communities they interact with. (Photo credit: Dave Chidley)

As the Kenya Country Manager for North Star, you coordinate the activities of North Star’s Blue Box Roadside Wellness Centers in Kenya. These Centers connect hard-to-reach mobile populations to primary healthcare services, HIV testing and health education. What are the major health care issues facing these populations?

Yes, you’re correct — at the Blue Box Roadside Wellness Centers, the majority of our patients are vulnerable populations, including truckers and sex workers who are in transit and do not have consistent access to quality primary care services. These patients are at a greater risk of contracting diseases like sexually transmitted infections, TB and HIV, and for them, stigma and discrimination remain a major barrier to care.  In Kenya and across East Africa, providing access to affordable health care to the general population is already a challenge, with constrained resources, medicine stockouts and inadequate personnel and operating time for clinics. This makes it even harder for us to fully meet the needs of the hardest-to-reach populations, the ones who are the farthest distance from, but most in need of care.

How have you implemented what you learned at STICH to improve access to health care for the vulnerable populations North Star Alliance serves?

Since coming back from STICH, I’ve challenged the teams at the Blue Box Clinics across Kenya to come together and develop innovative new solutions for the current issues our clinics and the mobile populations we serve are facing. At STICH, we were constantly reminded to challenge the status quo. I’ve brought this perspective back with me to North Star, and I’ve found my teams respond very positively to this approach. For every problem we encounter, we ask: are there simpler ways to achieve even better results for our patients?

A North Star Alliance clinical staff does outreach to ensure the extended reach of services to the hotspots around the Blue Box clinics. (Photo credit: Dave Chidley)

As a result, we’ve come up with new ways to better link our clients to services and providers. For example, viral load testing for people on HIV treatment can be challenging to access in Kenya. We are currently testing two prototypes to increase our clients’ access to this service: one where a lab technician comes to our center to do the testing, and the other where we collect samples on specific days and then network with a lab that does the testing. Another opportunity we are exploring is how to increase the reach of our services to people beyond the immediate surroundings of our clinics. We’ve set up outreach sites ten to fifteen kilometers away from our clinics to get to know the people, offer them services, and identify if and how they may be at risk of HIV infection. We’re not afraid to do things differently, and we’re constantly testing and innovating to improve access to care. Instead of asking people to come to us, we’re finding new ways to meet the needs of our communities.