Wharton Around the Globe: Reimagining Healthcare in Nicaragua

Contributor: Minji Kim, WG’21
To learn more about Minji, click here.

 

This past winter break, six members of the Wharton Global Health Volunteers (WGHV) traveled to Nicaragua to work with Pro Mujer on a comprehensive healthcare strategy focused on women. Founded in 1990, Pro Mujer has become one of Latin America’s leading organizations commit-ted to the empowerment of women through finance, health, and educational services. With a long history of providing financial assistance through microloans to women, Pro Mujer sought out the assistance of WGHV to assess opportunities to expand their services to cover a critical healthcare gap in Latin America.

Pro Mujer currently operates one pharmacy out of its Leon clinic, the first retail operation for the organization. Furthermore, Pro Mujer hypothesized that women, the main target audience, are less likely to seek out medical help for themselves, but much more motivated to find care when it’s for their family. The team focused on three overarching objectives to craft the final health-care strategy:

  1. Accessibility
  2. Profitability
  3. Efficiency

Accessibility
Over the course of the week, the WGHV team visited multiple Pro Mujer clinics in Managua, Leon, and Masaya to understand the current healthcare experience. Our visits included rural meetings in communities without electricity to busy urban clinics in the capital of Nicaragua. Observing the full spectrum of daily life, commute, and surroundings helped ensure the team started from a place of empathy.

The majority of Pro Mujer’s healthcare clients started as microfinance loan clients, and, as a result, the current customer journey was not suited for a healthcare-first strategy. The WGHV team crafted a three-phase roadmap to focus on serving clients beyond microfinance by enticing new clients, engaging deeper, and extending relationships beyond the first clinic visit. Some of the recommendations included free educational materials, a Pro Mujer network of external specialists, and a word of mouth referral bonus program.

Profitability
Many non-profit organizations struggle with their dependence on fundraising to finance operations. For this reason, Pro Mujer emphasized the need to provide healthcare services in a fiscally sustainable way. The WGHV team identified restructuring the current pricing scheme as one quick and effective strategy for top-line growth. Currently, Pro Mujer offers two health packages: a low cost ‘basic’ tier that includes a simple exam and consultation, and a high cost ‘premium’ tier that includes an additional predefined set of tests and services.

In order to provide a comprehensive health journey that proactively caters to the needs of women at each life stage, the WGHV team recommended health packages that aligned to the life stage of the users: Basic, Family, and Comprehensive. Each package caters to a specific age group and contains services and exams that align with the health needs of a typical woman in that life stage. For example, the redesigned Family plan targets women who are looking to start a family or already have children. On top of basic care, this plan would also include sexual health consultation and exams and pediatric services for children of the plan holder. Over 95% of Nicaraguans live in a family unit, and, for most women, providing medical care for their dependents is a higher priority than receiving medical care for themselves. Designing a plan for this specific type of user meant Pro Mujer would be better able to reach and serve this major customer base.

Efficiency
Lastly, the team identified efficiencies to improve the patient experience, reduce the cost of operations, and create more sustainable practices. To start, we captured a comprehensive list of pain points through stakeholder interviews, observations, and an analysis of existing data. Through this assessment, the team identified inefficiencies in the customer experience, such as long wait times and confusing intake processes, and the backend processes around record-keeping.

In response to these pain points, the team created a two-phased strategy focused on both immediate short-term tweaks and larger structural changes. One immediate low-cost improvement was adjusting the physical flow of the Pro Mujer centers to embed healthcare enrollment tasks with other workflows. Instead of redundant registration and verification processes, creating one patient-centric streamlined flow meant avoiding long wait times and complicated intake steps. The team also identified some long-term enhancements, including investing in digital solutions, such as self-serve patient portals and CRM systems to improve existing manual processes and reduce redundancy.

Pro Mujer believes women can become powerful agents of change for themselves and their communities if given access to the right opportunities. The WGHV team feels incredibly fortunate to have worked with Pro Mujer on furthering this mission, specifically focusing on the critical task of reimagining a better healthcare system to support women in Nicaragua.

The lessons we learned will stay with us long past this engagement, and we would like to thank the Pro Mujer team and the alumni for enabling us to play a small part in this important mission of empowering women across Latin America.

Contact Minji at: minjikh@wharton.upenn.edu