Working in Kenya: Agility, Diversity, Empathy
Eduardo Lioy is a Manager with a rich experience in global pharma industry and a scientific education. Access Afya is a social entrepreneur that runs a series of low-cost micro-clinics in the informal settlements of Nairobi. The small clinics are located in close proximity to their patients and are designed to provide their services as affordably as possible. Their staffs are appropriately educated to provide health care services. Each such clinic has a size ranging from just one to three rooms. The single room of the smallest clinic is separated by curtains into a small reception, a consulting room and a laboratory. Their customers are people with an income of 10,000 Kenyan Shillings (approximately 100 Euro) or less per month per family who are unable to afford health insurance.
Entrepreneur in Kenya
Initially, Lioy’s task was to develop a launch strategy for a mobile-based micro-insurance programme with Changamka – another social entrepreneur with a programme aimed at providing a mobile based health insurance for low-income populations. “On my very first day in Kenya the original partner of Changamka cancelled the cooperation”, Lioy recalls his arrival. He had to act quickly and decisively to save the initiative. “I had to go back to the drawing board and create a new concept”, he explains. “For me this was the opportunity to manage everything from the beginning to the launch” he says. “Unlike Europe with its very structured and regulated business environment, there are few rules for enterprising in Kenya and few structures to provide help – Entrepreneurs must come up with new ideas quickly”. Things could change overnight and Lioy had to be very agile for the programme to survive.
This gave him the opportunity to hone his own leadership skills: “In my opinion, empathy is not always very developed among leaders’ personality traits which are usually more facts and results oriented. I wanted to develop my skills in leading with empathy, both for my own benefit and that of my team”, Lioy explains his motivation to become an Executive in Residence (EIR).
New Partners and Agile Solutions
There is little access to doctors for the poorest Nairobians and people have little awareness on diseases and the proper use of medications. However, Kenya has a well-developed mobile phone network and a highly advanced mobile wallet (mobile payments) digital platform, called M-PESA. Lioy therefore approached two partners: M-TIBA, the developer of a mobile health wallet that functions on smart and non-smart mobile devices and allows depositing money to pay for medical expenses. The other is Intellecap, a market researcher in development countries who aided evaluating the success chances of the new micro-insurance model.
The programme’s concept aimed to address four main barriers to healthcare: affordability, availability, awareness and adherence. The result is Akiba Ya Roho, a health care management program for non-communicable diseases that functions like a savings wallet for patients. It allows patients to save money and receive financial incentives they can spend on subsequent visits. The micro-clinics provide field screenings and patients additionally receive money for routine blood pressure and blood sugar tests on their Akiba Ya Roho accounts. The platform in turn allows monitoring patient healthcare seeking behavior and allows to incentive future “good behavior” through financial incentives.
The field screenings and first year follow-ups are subsidized by Boehringer Ingelheim with 75,000 Euros. The individuals that are tested positive for condition are intended to become returning patients of the clinics – which in turn should help make them profitable in the long term without further financial support. “Akyba ya Roho was launched in early July and interest among the people has been great, there were long queues of people wanting to get tested”, Lioy describes the successful work. “By now, the programme has screened more than 11,000 persons, many of which became long term patients of the clinic”.
In the end, Lioy spent seven months in Kenya – originally, he had planned for only three. The diversity he brought into the project in Africa made the success of Akiba Ya Roho possible. The great agility on part of his supervisor and team at Boehringer Ingelheim allowed him to succeed. In turn, his team at home had much opportunity to work independently during his absence and learned to take smart risks without always asking him for permission. “In the end, one of my employees became a colleague as a leader, in part also because of the responsibilities he assumed while I was gone”, he explains.
Diversity and inclusion is about building the right team composition and balance, creating an inclusive environment where diverse thinking is valued. “In Kenya, I learned how to build a new business as an entrepreneur”, Lioy says. But partnering with Access Afya and experiencing the development of a new company not only gave him entrepreneurial insights: Working in healthcare on a much smaller scale than in Ingelheim also broadened Lioy’s perspective on his work at Boehringer Ingelheim and the goals of the company: “Experiencing the reality of life in Kenya allowed me to more fully understand why we, as a pharmaceutical company, are here”, he says and explains that “despite the difficult situations they are in, the people in the Nairobi slums impressed me with their kindness and smiles. In Germany, many problems we perceive as such are easy to solve. We live in a protected environment and I learned to be more grateful for it.”
"Experiencing the reality of life in Kenya allowed me to more fully understand why we, as a pharmaceutical company, are here, says Eduardo Lioy. "