To succeed, understand your business first

What, exactly, does it take to set up a hospital? And not just get it off the ground, but grow it and keep it running for 15 years?

A lot of hard work, foresight and innovation, says Dr Michael Mutua, the CEO of Bristol Park Hospital. The hospital’s first branch opened in late 2008 at Tassia Estate, Embakasi, and has since expanded to have five branches. Every day, he says, they serve about four hundred clients.

Reflecting on his entrepreneurship journey, Dr Mutua explains that his desire to venture into the healthcare business started back in his undergraduate years, when he met his wife, Winnie Mbithi, who was studying medicine at the University of Nairobi.

“I studied Economics and Statistics at the University of Nairobi, graduating in 2001. Between 2001 and 2005, I worked with several organisations, mostly in teaching and market research. I also tried several small businesses, such as stationery supplies, running restaurants and retail shops. In 2005, I went back to the University of Nairobi for a Masters degree in Social Statistics, where I graduated in 2007. After my wife completed her internship, we felt the need to set up a hospital, and started searching for a good location.”

By the time he was graduating with his Masters Degree in 2007, Dr Mutua had gotten a job as a Statistician with African Population and Health Research Centre (APHRC), where he would work until his early retirement in 2019.

“By mid-2008, we had identified an ideal location in Tassia Estate, Embakasi, and with my little savings, a small loan from a bank and some more from a SACCO, we were able to start off the first branch. Back in 2008, there were no major hospitals in Embakasi, especially offering inpatient services, therefore most patients had to travel to the city center or to Buruburu for healthcare services,” he recalls.

This is what informed their first location, making them the first hospital in the area offering outpatient and inpatient services.

Soon after opening the first branch, Mutua’s wife, Dr Mbithi, resigned from employment to support the new business while he continued working to provide the much-needed capital input into the business and also supporting his young family’s needs.

“By then, the family had expanded to include two children, with one already in school. At APHRC, I worked in health research, a skill that I needed to continue managing our start-up. I would step in in the evenings, during weekends and off-duty days at a managerial level as my wife focused on clinical service delivery.”

To cut down on costs and to raise more capital, he moved his family into the upper floor of the building that housed the hospital, though they had to move after six months since it demanded more space for additional services.

He would, later in 2019, apply for early retirement to focus more energy on the business.

It was the same year that he graduated with a PhD in Public Health from the University of the Witwatersrand in South Africa.

“I had enrolled for the PhD program facilitated by the Consortium for Advanced Research Training in Africa (CARTA) while still at APHRC. My study focused on Quality of Healthcare Services in Kenyan health facilities – I have published over 20 articles in peer-reviewed journals touching on related topics,” says the father of three.

On his leadership skills, Dr Mutua says he is often a mix and match kind of a leader. Often consulting with his leadership team for decision-making, but also relying more on evidence given his data background. He also admits to sometimes inviting teams to vote on an agenda, especially those that have a direct impact on staff and their livelihoods.

The 45-year-old is especially proud of two main achievements: seeing a growing number of staff that have worked with his hospital over the years, who move on to greater responsibilities and succeed thanks to the experience gained at his facilities, and secondly, every time he meets someone and learns that they are clients at his hospital.

“Just as any other business, challenges are an everyday experience and hospitals are no exception. Setting up and starting off was extremely challenging, since very few organisations are willing to invest in start-ups whose prospects are indeterminate and unpredictable,” he says, and adds,

“Unfair and unethical business practices such as fraud between insurers and some healthcare providers cannot be overlooked. These often make insurance more expensive, further diminishing the medical insurance penetration and generally exposing families and households to catastrophic health expenditures.”

He adds, “Last, but not least, the cost of doing business in Kenya is high, mainly driven by high cost of pharmaceuticals, medical and non-medical consumable products, electricity, water, business permits on top of business permits and licenses. For a hospital, like any other business, these costs are often passed on to the clients, who often find health services unaffordable, resulting to poor health care seeking behaviour, including home management and backstreet service providers, whose outcomes are unpredictable,” he further notes.

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