In Nigeria, the primary focus of the government and donors is on communicable diseases, maternal health and HIV/AIDS. Instead, Nneka Mobisson is focusing on the main threat to global health which is not on the radar of the government, mainly the non-communicable diseases (cardiovascular diseases, diabetes, cancer etc). She is decreasing the mortality level by empowering communities to prevent such diseases and is doing this through an accessible platform. She is also introducing a system of groups and coaches who help risk groups to cope with these diseases through behavior change.
The New Idea
In the absence of a management system for non-communicable diseases, Nneka has created a system for communicating and connecting doctors and patients together to disseminate knowledge in the communities and villages. She also understood that access to coaches and to peer to peer learning would position patients to achieve behavior change, she developed an individual coaching system as well as a platform for sharing and learning. Moreover, she had seen that there is no database for those disease in Nigeria, so she decided to develop a national database for NCDs.
She understood that knowledge and education formed the core of early prevention of non-communicable diseases, she mapped the scope of the problem and interviewing people on the ground she understood that there is no knowledge whatsoever of NCDs, there was lack of physical activity etc.
For patients who have non-communicable diseases Nneka created an easy to operate directory which distributes information and knowledge of early prevention and lifestyle adjustment, she launched community-based groups that operate blood pressure and other devices, so tests are conducted on the ground and shared with coaches.
Mortality from non-communicable diseases have surpassed that of communicable disease in recent times. Africa has been experiencing an increase in the prevalence of non-communicable diseases, and the World Health organization estimates that NCDs will cause around 3.9 million deaths by 2020. The World Bank has stated that in 2008, deaths from NCDs were 28% but will rise to 46% by 2030. Non-communicable diseases will likely cost the world economy $47 trillion over the next 20 years according to a joint study by Harvard University and the World Economic Forum. According to the National Nigerian Bureau of statistics, in 2012 Nigeria has a population of 166.2 Million people. Of this population, the World Health Organization has stated that non -communicable diseases account for 24% of deaths and the likelihood of dying prematurely is 20%.
NCDs are now a global health and economic issue as they affect the health of a number of young people in their prime and has an impact in the economy. The number of people diagnosed with NCDs are on the rise, further straining the already overburdened health care system, and the loss of young adults from the workforce will have huge effects of families and communities. The health care system in Nigeria is already very strained from managing communicable diseases and is not well equipped to manage the number of NCD cases that are on the rise. Patients barely receive the right treatment and the ratio of doctors to patients is 1 to 1000, making it difficult to develop patient-centred care for people suffering from NCDs.
The increase in NCDs is attributable to lifestyle factors: the Nigerian sociocultural construct promotes weight gain and consumption of alcohol and tobacco as a sign of affluence, so more people are inclined to move from eating traditional nutritious foods to unhealthy diets. There is also the lack of physical activities and people do not go for regular medical check ups to ascertain their health status.
Additionally, healthcare facilities are not adequate, so patients who are ill need to wait long hours in the hospitals to get tested for their ailments before they can access treatment, hence people who are not critically ill find it very inconvenient visiting the health centres.
After years of working in the medical profession, Nneka retired as a doctor in 2013 to launch her own practice after witnessing first-hand the challenges in managing non-communicable diseases in the African healthcare system. Nneka started out by mapping the scope of non-communicable diseases by interviewing people on the ground.
Nneka talked to over 1,000 people across all strata of the society to understand their pain points in terms of chronic diseases in Nigeria: about half of the people who took part in the research had no knowledge of non-communicable disease and how to manage them but they were desperate for education. She also discovered through research that there was no specific activity targeted at empowering people with non-communicable diseases to manage their illnesses and live quality lives.
Nneka knew that for her to target people with non-communicable diseases she had to go into peri-Urban as well as highly densely populated communities in Nigeria. She targeted communities who already had structures such as village groups that bring people together. She leverages these groups, builds them and then provides support towards NCDs. She builds the knowledge of these groups on chronic disease prevention and management. She started health talks in the community meetings to create awareness about NCDs, which led to an activated thirst for knowledge. This helped her recruit volunteers in the communities to do door to door outreach and mapping of health facilities.
Nneka realized that people did not know where to check their health status, so she created health hubs where patients can get tested and also get information about disease management. She also created groups where individuals are connected to navigate the management of their diseases together, sharing insights and best practices as well as supporting each other and sharing goals while working with one coach. The groups come together to purchase the testing machine so each person can have access to the machines and maintenance is done by the entire group. She also teaches them how to use the blood pressure and other testing devices. The community groups are done online and offline to help the patients support each other. In addition to that, Nneka organizes media talks on radio and television and this adds to the general public knowledge on NCDs and early prevention.
Realizing that the government lacked information about health care service providers, Nneka created a national database of health care providers, pulled information from google maps and the disease management platform as well as her researchers to develop a national directory of health care providers for NCD management in Nigeria. She also created the ‘’Find a facility care’’ to help individuals easily find a facility close to them to get treatment for their chronic diseases. This app serves both individuals and doctors in the sense that doctors who did not have the information about health facilities now use the app to identify hospitals close to patients and can refer cases to those health facilities that offer services related to NCDs. Understanding that access is crucial, she started the peer to peer learning and the individual coaching system as well as a platform for sharing and learning. She designed a disease management platform which addresses the tools individuals need to manage their disease. The platform contains information about the patients, and patients are connected to a virtual coach to help them navigate their treatment information and plan. There are information and incentives to support behavior change to help patients achieve their health target, and patients get more instant support from the platform to help them manage their diseases.
In 2018 Nneka is operating in 3 States in Nigeria linking local groups with peer to peer support and coaches, and she is training healthcare providers on how to provide the right care and education to patients with NCDs. So far She has trained 5000 people In 2018, she has over 2500 active people on her platform and has spread across 5 countries in Africa. She is already in South Africa, Rwanda, Kenya, Zambia and is adding Ghana in January 2019. She partners with international organizations which helps spread the information and organized information system, she wants to contribute to significant decrease of mortality or bad effects of NCDs (for example amputation) She wants to expand to the whole Nigeria in 2020. She plans to also create clients demand for quality health service and accountability.
By 2024 Nneka plans to spread to 13 countries in Africa.
Nneka grew up in Nigeria but went to the United States for her university education. While studying engineering, she began volunteering in local communities. She stumbled upon an article on volunteering in Tanzania,and became interested in going for the program despite not having funds. Determined to attend the program, Nneka sent a request for funds to all the department heads but all the responses came back negative. However, that did not deter her, and she decided to write to the President of the institution and finally got a positive response. While in Tanzania during her internship, Nneka discovered the failing healthcare system in Africa and decided she wanted to help in that regard. This helped her decide she would study medicine and master's in public health to become better equipped to help turn around the health system in Africa.
As a medical doctor, Nneka could reach a comfort zone but she decided to postpone her career and totally commit to improving medical care system. This was especially because her father, who was 53 at the time, had died of complications from a massive stroke that he suffered simply because he didn't have access to knowledgeable providers to help him manage his uncontrolled high blood pressure. He sought the help of traditional medicine to help him with his blood pressure because he didn’t like the side effects he was experiencing, and a few weeks after discontinuing his medication, he had a massive stroke that debilitated his life. Complications from the stroke ultimately led to his demise. Nneka became angry because she constantly asked herself how many lives is Nigeria losing and what impact is it having on the productivity of the country and the continent? She decided to start mDoc using technology to address the very same health problems her father had so that ultimately, Nigeria can be a happier, healthier, more productive country in Africa.