Background on Jacaranda
Walking into the Jacaranda’s Kahawa facility each morning, I was always greeted by a hospital staff diligently working to prepare for the day ahead. Before long, the facility would be humming with activity and the waiting room would be packed to the brim, with those waiting overflowed onto every inch of the benches outside – a testament to the vital care Jacaranda Health provides to the community.
The organization, which currently operates two hospitals, provides affordable, world-class maternal care to low-income families outside of Nairobi. Jacaranda is not only providing direct medical care, however; it is attempting to transform the way care is delivered across Kenya and beyond.
A cornerstone of Jacaranda achieving its vision is creating a model that delivers quality care in a way that is financially sustainable. The organization has made great strides in this regards, but was still far from where it needed to be and my primary directive over the summer was to build a 12 to 18-month roadmap that would get Jacaranda to 100% cost recovery – where hospital revenue fully covers expenses.
Pulling from the knowledge and skills I have received in the MBA/MPH program, I worked with the Jacaranda team understand the key opportunities and challenges that would allow us to improve its financial health. With the hospitals not operating at full capacity, a major area of focus was to increase the number of patients served.
To do this, we built on existing outreach efforts and explored the further use of community mobilizers to actively engage with expecting and new mothers in the area. In addition to increasing volume, it was important for Jacaranda to identify opportunities to reduce costs.
After working with the team to investigate major cost-drivers however, we realized the current systems, while adequate to allow for key management decisions, could be improved to better capture the stock and accounting detail. I worked with finance team to put in place an accounting system and processes that more clearly reflect the activity of the organization.
A final dimension of our roadmap was price revisions. Surveying nearby facilities that serve similar communities and realizing our prices were well below average, we determined that moderate price increases could also be a part of the solution. This decision wasn’t taken lightly — any price increase would be at odds with the organization’s core mission, which was to serve low-income families. It was only after several lengthy debates that we agreed upon moderate price increases as this would provide an immediate financial boost.
In the two months since my time ended in Nairobi, Jacaranda has put several elements of the roadmap into action. The accounting system was overhauled, allowing the staff and management to better understand the overall financial health of the organization. Furthermore it opened them up to take timely, measured action as needed.
In addition, moderate pricing changes were made and implemented. To our surprise, these changes did not come with any reduction in patient volume, a major concern that arose while deliberating price changes. The results of all of the efforts won’t be realized immediately, but early indications show that Jacaranda is on track to reach its goal of being financially sustainable. Doing so will help prove that the model works and is a stepping stone on the way to achieving its broader vision.
My time in Nairobi not only benefitted Jacaranda and the countless families it serves, it also provided a tremendous amount of personal insight as I explore various career paths. The summer with Jacaranda not only reinforced my desire to work in the field of global health, but also helped me become a better change agent as I now better understand the unique challenges faced by organizations on the ground. My summer was truly transformative, both personally and professionally, and I would not have been able to do this without the Rashell Young Fellowship. I am honored to be a fellow and am tremendously grateful for its support.