According to the World Health Organisation report, ‘Towards long-term care systems in sub-saharan Africa’, there are 46 million older people living in sub-Saharan Africa and this number is expected to more than triple (to 165 million) by 2050. A significant proportion of these people will require long-term care at some point in their lives. Currently, families provide most long-term care in sub-Saharan Africa and do so without any organized training or support. Reliance on families alone to provide this care results in inconsistent care quality and places a particularly heavy burden on women and girls. Moreover, it may be unsustainable given the rapidly increasing number of older people.
Nebiyat Demeke, who majored in clinical nursing saw the gap as an opportunity to reduce the family and hospital burden. Her personal experience taking care of their critically ill father was a great motivation for launching Rohobot Home Based Care Services.
Her sister Yeabtsega supported her once in a while during the early stages of the business before being fully employed and getting an official membership of the company as a co-founder.
Meet Rohobot Home Based Care Services
Rohobot Home Based Care Service is a nurse owned company established legally in January 2017 to provide quality home-based healthcare services to the critically ill older people in Ethiopia.
When asked why they chose the name Rohobot, Yeabtsega said,
“The name Rohobot is a bibilical word that means expansion. It was a way to show that our dad has left his footprint in the organisation and that it could expand through a vision that is greater and bigger than ourselves.”
Target market and services provided
Rohobot’s target market is families who have chronically ill patients with a focus on elderly patients. They have segmented their customers based on their level of income. However, the services they provide are at a rate that is still more affordable than what their clients would pay in hospitals.
These services include all nursing procedures that a patient is supposed to receive while in hospital including helping them shower, feeding them and administering medication based on doctor’s orders.
They also train home based care service providers, especially fresh graduates from medical school who take the free training for 6 weeks.
Building lasting relationships with clients
The major marketing strategy Rohobot Home Based Care Service uses is establishing partnerships with various hospitals especially those that have ICU’s and critically ill patients under their care. You will find their banners and other promotional materials within the hospital premises.
They have also leveraged on word of mouth marketing from satisfied clients,
“The good thing about providing a quality service is the people who have used our service end up referring us to more clients, so we always strive to provide the best quality service to all our current clients.”
Rohobot also stands out form other providers by creating a close relationship with the families they serve. They hold regular meetings with the home-based care providers, they have a doctor on call who checks in regularly with the patients and Nebiyat’s experience as a nurse has also greatly contributed to ensuring the services provided are quality.
Telegram is a major marketing tool for Rohobot. Their telegram group has over 200 members and they keep it active by sharing health tips and medical insights that add value to the members.
Rohobot’s biggest achievement has been developing a training manual for home-based care service providers which is the first of its kind in Ethiopia. They have presented the manual to the Ministry of Health who are in the process of approving the content as the set standard for such trainings. The manual trains the service providers in 13 nursing procedures including pain management.
Yeabtsega also noted that seeing their clients satisfied with the service and getting positive feedback from them has been the backbone of the company over the last 3 years.
Impact on the community
Rohobot Home Based Care has provided their services to more than 13,000 people. More than 150 trained health professionals have gotten jobs through the service, 80% of which are women.
In March 2020, they plan to start a public health community awareness programme. Ethiopia has a culture of households meeting every month for a get together so they plan to leverage on such opportunities to bring the community together and have conversations around how their lifestyle affects their health, especially for the elderly.
“We have partnered with the Ethiopian Medical Students Association which is under the International Foundation Medical Students Association to share information about certain lifestyle diseases, symptoms to look out for and how to prevent these diseases. It is going to be an open discussion with question and answer sessions just to bring more health awareness to the community,” Yeabtsega said.
After the sessions, the people in attendance will also have an opportunity to get their vital signs checked at no cost.
Major challenge faced
Yeabtsega admits that the major challenge they face providing the service is not being able to hire public health officers who are more stable. Most nurses who work with Rohobot Home Based Care are mobile but having public health workers in the team would offer stability. However, they are in the process of having discussions with the Ministry of Health to address this issue.
She also wishes that there was specialization for nurses in Ethiopia so that specific nurses can handle specific health issues.
Financial stability is an ongoing challenge that Yeabtsega and Nebiyat have to face. They currently have only one doctor on call which can be challenging especially when more than one client needs to see a doctor urgently.
Access to some vital medical equipment such as stethoscopes and vital signs equipment is limited in Ethiopia which affects their services.
Advice for entrepreneurs
“From our experience at Rohobot, we have learnt that it is important to have a structure before you set up your business. Once you have a structure, it will help you fill the gaps when the business is up and running because it is easier for everyone to fit into this structure. I would advise entrepreneurs to look beyond their passion and create that structure for your business,” she said.
Experience in the GrowthAfrica Accelerator
Since joining the GrowthAfrica Accelerator in 2019, Yeabtsega has changed her perspective on a lot of things concerning the business,
“The GrowthAfrica Accelerator made me sit back and look at what challenges are preventing the company from growing. One area we’ve had to address is creating a better relationship with the health professionals and staff since they are our brand ambassadors.”
Something else they did not really look into when starting the business was understanding their competitors,
“Having the opportunity to conduct a competitor analysis with support from GrowthAfrica gave us insight to create a packaged service which gives our clients options between a nursing service and a service inclusive of medical equipment. This has enabled us serve our clients better.”
“I believe Rohobot has a very bright future. We are looking forward to finalising on our regional office which will hopefully help us to set up in more areas around Addis Ababa,” Yeabtsega said.
She hopes that by the end of the year, they will have set up a drug store where people can be able to access vitamins and supplements.
Another major change that is in the near future is digitising Rohobot’s healthcare monitoring system so that they move from the traditional patient monitoring sheet to an app where all patient information will be safely stored and updated.
Yeabtsega is also hopeful that their training manual will receive final approval from the Ministry of Health and that they will be able to open a training centre for home-based care service providers by 2021.