Country of Operation
Target income level
- Lower-middle income (20-40%)
- Middle-income (40-60%)
- Primary care
SummaryUnjani Clinic is designed to provide primary health care services at an affordable price to under-served communities in South Africa. The fee-based service model enables sustainability and the empowerment of black women through the use of a franchised business model.
Unjani’s clinics are made in South Africa from converted second hand shipping containers and have a basic design which means a site can be created, from order to commission, in just four weeks. Each unit is made and fitted out so that once it is delivered, it can be up and running within one day. All units have toilets, electricity and running water.
Key program components
The 12 meter clinic provides consultations at a cost of between R100 and R150 per patient – Imperial Health Services (HIS) sets a maximum price for their franchisees but not a minimum. The number of patients seen per month varies between the network of 7 clinics, with the largest clinic seeing 400 to 500 patients per month. Each Unjani Clinic has an outside reception area, examination room, toilet and a dispensary for medicines at a local community center. In addition, each Unjani clinic has a registered nurse practitioner (who is licensed to diagnose and dispense schedule 1-4 medicines) and an administrative assistant.
IHS and partners support franchisees for a period of 5 years by providing initial and growth capital, establishing infrastructure (12m converted shipping container) with all medical equipment and other furnishings required to operate, and providing business skills training (specifically financial management and marketing training). The set-up costs for a container are R300,000. Over a 5 year period the franchisee (nurse practitioner) pays back 50% of this R300,000 and the ownership of the unit transfers by 20% each year. (i.e. 20% ownership in year 1, 40% ownership in year 2, etc.).
Expansion in Size and Services Unjani now has a total of seven fully functioning clinics, having launched four in February 2013. Furthermore, starting in March 2013, Unjani has collaborated with VisionSpring for a six month trial to provide affordable high-quality eye care to their patients. As of Spring 2013, each clinic is providing vision screenings at R50 per patient and sells prescription glasses and non-prescription sunglasses to be purchased at R50 and R100 respectively. Other services provided by Unjani include HIV/AIDS, diabetes and hypertension management.
Sustainability As of April 2013, sustainability of the business model is being proved based on the 7 pilot models. By this time, all clinics have been able to achieve an average patient volume of 180 patients per month, or 8 patient consultations per day (although they are in varying stages of year 1). Patient volumes have indicated that there will be incremental growth as increased awareness around the clinic is built within communities. All clinics have been able to maintain a cash flow positive status, and pay salaries and critical suppliers (drug wholesaler, medical waste collection and laboratories) on a monthly basis. None of the franchisees have defaulted on their franchise payments. It has been observed that clinics actively pursuing additional revenue streams, such as over-the-counter sales, have further strengthened their positive cash flow status.
A variety of quality assurance and performance monitoring methods are implemented throughout the year.
From implementing a National Health Insurance scheme to battling the HIV epidemic, South African policy
- Imperial Health Sciences (Pty) Ltd (IHS)For-profit