Delivering free primary healthcare in Nigeria with microclinics

The medical staff at the clinic completed their 3-hour electronic health records (EHR) training with Ajirmed in the last week of January. Here’s lead Nurse Adegbola (Nurse B), Nurse Chioma, Nursing assistant and front desk admin Blessing, with their instructor from Ajirmed.

Ajirmed’s system is very user-friendly, and the clinic’s medical team are even more excited to adopt it!

The clinic started a “soft migration” to the EHR this month (February) and plans to migrate to Ajirmed’s EHR system by March 1st fully!

Bonus pic: One of the clinic’s little patients who showed up for treatment with his mom during the training :)

In January, the micro-clinic provided free primary healthcare to 312 patients, the youngest of whom was a one-year-old girl.

You can read the report here: January report

Hi all! Excited to introduce you to David, one of our younger patients at the clinic.

David, a 5-year-old boy from Oworoshoki, presented with malaria symptoms, including a severely high fever in December. Thankfully, he was able to access healthcare through the clinic early enough - a crucial action necessary to prevent deaths from malaria, especially in young children 5 years of age and younger. David was treated promptly at the clinic by Nurse Chioma and is doing amazing now!

Some other exciting updates:

Nurse Chioma, our second registered nurse at the clinic, joined us in early December. She works alongside Nurse B. at the clinic. Nurse Chioma is highly qualified, caring, and friendly, with core experiences leading health equity initiatives and care delivery in primary health care and sexual and reproductive health. As a reminder, the clinic is manned daily by two highly qualified registered nurses, our lead Nurse B and Nurse Chioma, and occasionally supported by our network of volunteer physicians!

We secured an in-person training date with Ajirmed to train clinic staff on operating the Ajirmed electronic health record system. Once this training is complete, we will migrate to an EHR system as a fully tech-driven facility - aiding data collection, improved workflow, care delivery, and clinic & inventory management.

The first clinic committee kickoff was a success! As a reminder, the clinic is overseen by a carefully selected group of diverse community members who meet monthly to discuss the clinic's progress. This ensures that the clinic remains community-centred, with the voices of those in the Oworoshoki community at the forefront of the clinic’s ethos. The committee will meet on an ongoing basis at the start of each month to discuss the clinic operations from the previous month.

Thank you!

I've got the first report from the clinic for the launch month of December:

You can read the entire report here: Full report

Our investment in building a free healthcare clinic in Lagos is already saving lives!

Before the clinic's official opening, a medical outreach event was held where patients could pre-register and receive treatment during registration.

At the pre-opening, the nurses treated 115 people, a higher number than expected ... there's obviously a deep need for free primary healthcare.

Here's the data that was collected on the day:

70% of patients reported a monthly income of N40,000 - N45,000 ($27 - $30 per month).

The youngest beneficiaries were two 2-year-old children who were treated for malaria and common cold, respectively, and the oldest was an 80-year-old woman who was treated for unmanaged hypertension.

Malaria is a disease that is especially deadly for children when treated late; catching and preventing it early with basic care is very important, and thankfully, we did for many, including 17 children under the age of 10.

Most patients (~39%) were diagnosed and treated for malaria. The second most common diagnosis after malaria was high blood pressure (hypertension) (~15%). This is expected as malaria, and hypertension is among the leading causes of death in the country.

Two patients were found to be at risk of fatal/near-death complications from unmanaged hypertension and were immediately treated and referred to the nearest tertiary institution. Of note, a mother from the community had extremely high blood pressure and was at significant risk of a stroke if her condition wasn't revealed during the outreach. Our practitioners gave her emergency treatment, and she will be following up with a specialist at a tertiary hospital.

The rest of the patients presented with varying illnesses, including unmanaged arthritis, diarrhoea, upper respiratory tract infections, the common cold, ulcers, skin infections, and allergies. ⁠

Four patients had no symptoms of illness and came by for a regular medical checkup, an act they noted would have been a luxury if they hadn't had this opportunity.

69% of patients self-identified as female, and 31% as male.

Today, we went out into the community alongside young volunteers from Oworoshoki. In true Nigerian style, we walked the streets with a music band, sharing fliers and announcing the arrival of a free health clinic. The young volunteers were thrilled to spread the news to their friends and families.

The clinic is fully set up and equipped to begin operations! Here are some updated pics and videos of the clinic.

We have stocked the Pharmacy/Dispensary with medications from a trusted local pharmaceutical supplier. The nurses will maintain strict inventory control to ensure proper management and free distribution to patients in need.

The clinic's core facilities are now complete.

Here is the completed nursing station area where patients will have their vitals checked by the supporting nurse before their consultation.

Here is the fully equipped consulting room, complete with an examination/observation bench, drug shelf, refrigerator, and hand washing station, amongst other basic healthcare equipment

Summary update on the latest progress of the micro-clinic in Lagos:

Facility upgrades:

• Two air conditioning units are installed and functioning

• Window blinds were installed throughout the clinic

• A mini refrigerator was purchased for medication storage

• The consulting room has been equipped with a desk, chair, laptop, and phone

• The side alley/walkway was improved for better accessibility

Technology and record-keeping:

An Electronic Medical Records (EMR) system subscription secured through Ajirmed will help streamline patient records, enable impact measurement, and protect patient data.

Recycling Initiative:

Three recycling bins were purchased for the plastic collection, and a partnership with WeCyclers has been confirmed for free weekly collection. Collected plastic will be converted to cash for clinic services.

Key dates:

Attached photos:

We've hired our supervising nurse for the Oworo clinic - Nurse Bosede! She's a registered nurse from the local area with over 20 years of experience, including work with the Lagos state government, and brings a real passion for community healthcare.

She'll start on November 1st, beginning with training at our pilot clinic to learn "the AHA way" before taking charge at Oworo. Over the coming weeks, she'll help hire the supporting nurse and front desk admin while working with us to ensure the clinic meets all standards before launch.

We've established a local clinic management committee for Oworoshoki! The committee consists of 4-5 diverse community residents and partners who will meet with our team monthly to review clinic reports. We're already connected with committee members via WhatsApp and planning both virtual and in-person introductions soon.

We have purchased vinyl ceilings to be fixed.

Medical equipment has arrived! We've received all the essential supplies needed to run the clinic according to state regulations—this includes weighing scales, glucometers, stethoscopes, instrument trolleys, examination couches, and sterilising machines.

We've purchased 2 air conditioners for the clinic space and are currently getting them installed.