By: Asim Nawaz Abbasi
Potential in YOUTH is huge if provided the right direction Dr.Sara Saeed Khurram CEO Sehat Kahani
Sara is the CEO and Co-Founder of SehatKahani which is an all female health provider network including that is working to create quality health care solutions for communities where health access, quality, affordability of health care is still a dream, using cost effective ICT enabled solutions.
Dr. Sara Saeed Khurram has won notable awards such as CRDF Global, Ashoka Changemakers, ISIF Asia, the Unilever Sustainable living Young EntrepreneursAwards and the Unicef- Global Goal Campaigner Award 2016 for her role formerly with doctHERs. She has been recently awarded with Arpatech young entrepreneurs award 2017. She is a regional Acumen fellow 2016and has been part of a well-known accelerator in Pakistan; Invest2 Innovate and Dr. Sara Saeed Khurram has been born and bred in Karachi. She has done her MBBS from DOW University of Health Sciences. Currently, she is enrolled in the Health Policy Management Programme at The Aga Khan University of Health sciences.
Dr. Sara Saeed Khurram loves turns ideas into reality on ground, she is an implementer and doer who loves Travel, Music, poetry but majority of her personal time is dedicated towards her 4-year-old daughter!
Q1). Would you like tell something about Sehat Kahani? What is your motive to initiate this startup?
Pakistan has a total workforce of 170,000 doctors. Nearly 60% of this total workforce consists of female doctors. However, only one third of these female doctors register them selves to work after graduation. How many are formally working in the Pakistani medical work force is still an unsolved mystery due to lack of proper data. On the other hand, almost 50% of the total Pakistani population do not have access to basic primary healthcare with women and children being effected the worst.
They fall in the hands of various socio- cultural barriers that makes it very prestigious of women in Pakistan to obtain a medical degree but that same culture forbids or looks down upon females to work after marriages or having children as for the majority of Pakistan the main role of a female is still in the house taking care of her husband and children tending to their every need. Female doctor who choose to work after marriage face a lack of support system for their children or lack of sharing of responsibilities when it comes to household chores and majority succumb to the pressure giving up their careers.
My story resonates with these female doctors- I was a graduate of one of the finest medical universities in Pakistan, youngest of 3 children, belonging to a traditional middle class family where girls were wed by the age of 23 and so I was too- After one year of my marriage, I conceived my daughter and found myself at similar cross roads, being forced to use between my family and my career.
It was then that I felt the pain of a woman who gives 23 years of her life living a dream, a dream to provide service to those in need, who learns and spends the key years of her life giving exams and practicing in hospital wards, giving up on her sleep that she has to choose between her career and her family.
After a long struggle of overcoming post partum depression with the help of family and friends, I realized that my purpose in life was to find a path to serve the marginalized to whom I had taken an oath to serve and also my fellow female doctors in a way that not only empowered me as a female but also millions of females out there who need a helping hand – a hand which can guide them and allow them to fully avail their basic right. Thus starts the journey of Sehat Kahani which in Urdu means the “story of health
Sehat Kahani is a health tech social enterprise that connects an all female health provider network to underserved beneficiaries’ providing access, outreach and efficiency of health care using technology. We have 3 distinct health verticals:
Access: By using trusted intermediaries in the communities and dormant health infrastructure, we create Sehat Kahani E- Health Hubs where a front line worker is trained via a 5 step training on medical knowledge, leadership and soft skills to connects patients in these Hubs to qualified home based female physicians and skills.
Impact: We currently have 21 e- hubs under this vertical in Sindh, Punjab and KPK. We have employed 21 nurses and 44 community health workers (male and female) in 3 provinces. We have impacted over 75,000 lives directly and indirectly via these services. We have a network of over 1200 female doctors ready to serve the low income communities.
Prevention: Sehat Kahani through its preventive health care portfolio creates innovative preventive health care messaging activities in target communities to bring out a long term change in behaviors and health patterns.
Impact: Via this Vertical, we launched more than 12 preventive health campaigns with leading corporates and organizations such as Unilever, GSK, Engro, Legal Aid office, and Lifebuoy impacting more than 800,000 lives via these initiatives.
Efficiency: Through our unique and specialized tele-health platform we have designed digital health solutions to reduce the disease load of tertiary care hospitals by treating primary and secondary diseases via virtual home base female doctors part of Sehat Kahani network in less than 3 clicks. This vertical allows any female doctor to create a virtual clinic and see patients at her ease. This solution can be used globally by Corporate, Insurers, bankers and any third party organization to provide cost effective, automated virtual Out patient solutions
Impact: Portal has already been launched as a pilot in a leading corporate of Pakistan (Unilever) as a health and wellness portal for its corporate employees.
Q2). How is the response of Sehat Kahani so far?
The response has been phenomenal! Sehat Kahani has managed to establish itself as one of the key players in the tele-health industry of Pakistan and has managed to find its niche in all market segments it caters too. Our collective impact of providing quality health care services to almost 900,000 people shows effort on ground. Our growing network of female doctors, partnerships with the government, non government, private sectors and leading Telco’s has enabled to scale rapidly in 3 provinces. Our effort has been recognized by national and international media and many reputed health sector organizations which humbles and motivates us to keep pacing forward to reach our mission and vision!
Q3). How Sehat Kahani is supporting health sector of Pakistan? What steps you have you taken for the development and sustainability of health sector?
Pakistan, a population of almost 200 million and one of the fastest growing economies in the world still struggles to provide basic healthcare to 51% of its total population. Around 40 million people live below the poverty line. Almost 30% of the population lack access to even primary health care facilities. The total GDP spent on healthcare in 0.9% and there is a recorded 30% penetration of counterfeit medicines. One child in ten dies before their 5th birthday.
Sehat Kahani aims to become a gate keeper for the government by managing primary health care segment of the health sector using technology and dormant government infrastructure. The use of EMR data recording enables us to capture health data of patients whom health data is not available anywhere. It also enables the patient to get referred at the right time and stage to tertiary care hospitals making disease management more efficient. Via our preventive health care service, we impart valuable health care educative practises in communities which can help decrease disease burden load from health deprived communities. We also work to bring un used female medical workforce back into the formal health care system giving them a chance to not only create financial avenues for themselves but also serve the economy. We empower nurses and community health workers using refresher training increasing quality of care provided by these front line workers Ultimately we have proved that private providers such as Sehat Kahani have the ability to create quality processes and system along with an agile team that can help government fill gaps in this fragmented health care delivery system.
Q4). How Sehat Kahani is facilitating the people in terms of quick accessibility, availability and affordability of good quality health services?
As mentioned above, Sehat Kahani has 3 distant health verticals that work on providing affordability, availability and affordability of health care services.
Our E- hubs in the low income communities’ focuses on providing health care access to patients who have never seen a qualified health care provider in their community and provide online consultations, access to labs, ultrasound and tertiary care referral services by charging between 50 to 500 PKR.
Our preventive health care vertical educates people in communities on preventive health care messaging using simple and interactive digital and non digital tools designed according to their level of understanding, community culture and needs
Our efficiency verticals aim to provide out patient health services to patient making such health care is available at any point of time and is accessible from their mobile phones. We have surpassed physical barriers that often delays seeking treatment for many people who are working hard to make ends meet.
Q5). Many people in our country are unaware about health issues. Have you taken any initiative to educate and aware people about health problems?
We have created an entire vertical called “Prevention “that helps educate people in low income communities on the importance of health care issues and how to treat them at a primary level so that they do not progress to complicated tertiary care diseases. We work key issues such as Maternal and child health care, WASH. Mental health, nutrition and disease awareness. Through our community friendly teaching techniques and use of community health workers, we make sure that message Is communicated in the language and mode easiest to understand. We work with many corporate, pharmaceutical and non government partners to bring this sustainable change.
Q6). Would you like to share some achievements of your venture Sehat Kahani?
Sehat Kahani has managed to create impact both quantitative and qualitatively. We have impacted more than 900,000 lives in our journey and spread our geographical foot print across 3 provinces. We have ensured enhanced quality services at all our e- Hubs with better educated and skilled staff in the communities that has been appreciated by positive feedback of the patients. We have learned from experience in the field to provide better services with the passage of time.
Along with Impact, we have managed to create key partnerships with national and international stakeholders including corporates, pharmaceutical, government etc which has helped us magnify our impact. Our work has been recognized by organizations such UNICEF, WORLD BANK. DIFID, DFAD, AUSAID, UN etc. in the form of awards and certifications. We have been covered by media world wide. However, My most important achievement is to create team of motivated and passionate individuals who love their work and want to create a change in the society
Q7). Can you share us the challenges you are facing? How it could be overwhelm?
There were many challenges in the journey- but for me- the challenge is an opportunity to find solutions. Hence at SK- we deploy multiple mitigation strategies to eliminate the risks.
- Challenge: Failure of partnerships. Mitigation: Develop multiple partnerships to avoid any detrimental effect on the aimed impact.
- Challenge: Affordability of Community Beneficiaries to access health services. Mitigation: (1) Devise cost effective services for community beneficiaries to ensure maximum community participation and involvement. (2) Subsidization on health services availed by community beneficiaries. (3) Collaboration with local and international partners to support/sponsor tele-health services for beneficiaries.
- Challenge: Technical Failure Risk [software risks] in remote areas of Pakistan. Mitigation: (1) Technical assessment performed during need survey of target communities. (2) Placement of Internet boosters or back up internet devices. (3) Usage of portable internet dongles to avoid internet disruptions in power failures. (4) Integration of work offline mode in the system to restore last data saved. (5) Flexibility of switching from video to audio mode in case of low internet bandwidth. (6) Soft launch of system in community to asses any loopholes in the system. (7) Master training of software by technical respective to the project staff. (8) Collaboration with technological partners and National and International level.
- Challenge: Community Uptake for tele-health services in rural Pakistan. Mitigation: (1) Weekly mahaulla [cohort] meetings and elder session to induce awareness and increase acceptability. (2) Live demo sessions with women cohorts. (3) Health awareness videos. (4) Confidence building measures to avail tele-health services.
- Challenge: Political risks- Many political parties can influence the clinical activities in the targeted region to justify their political mandate. Mitigation: (1) Sehat Kahani strives to sustain a neutral relationship with political parties. (2) Sehat Kahani ensures that no endorsement of any political parties is being made at any beneficiary communities. (3) Sehat Kahani develops a steering committee including community leaders and political influencers to avoid any conflicts with the political culture of the targeted communities.
- Challenge: Legal risk- No legal regulations or frameworks available in Pakistan for tele-health service delivery model. Mitigation: (1) Sehat Kahani reviews all health legal acts to ensure transparency in the procedures. (2) Legal consultancy to mitigate any regulation issue. (3) Sehat Kahani before deploying any services in target communities seeks an approval from a local District Health Office [DHO] approval. (4) Sehat Kahani formulates partnerships with Governmental agencies to ensure compliance to regulations. For instance, currently Sehat Kahani has collaborated with Maternal and Child Health Pakistan [MNCH] – a government agency that monitors and ensures the quality of health services delivered by local community health workers and midwives.
Q8). Women are the integral part of the society. What initiative you have taken for women empowerment?
Our company focuses on using an untapped force of female doctors to help impart quality health care to patients especially women and children in need of health care. We work with female health workers as front line intermediaries in our clinics educating them and providing financial incentives to work with us in e- hubs. We make sure that we use female community mobilizers from within the area to create outreach for our services. 80% of our total work force and key leaderships is female. We are a women led startup by 2 female co- founders who are mothers, wives and daughters making sure they balance work and home with equal passion and grit. The central vision of our company is based on the fact that women are a force capable to achieve any dream they aspire to and our hardworking enough to achieve that dream.
Q9). Do you think it is still harder for a woman in our society to start and establish a career? How could we break this barrier?
Career for a woman in Pakistan is still considered secondary, a path that the woman should only take once all her responsibilities as her role defined by society has been fulfilled. This thought hinders many females to ever see themselves as something beyond the role defined by society for them. Many never muster the courage to take that first step to build something for themselves and often succumb to cultural boundaries. This barrier can only be broken if the society understands and values their role as an individual and provides them an opportunity to use their education and talent to contribute to the economy. Women themselves have to break this barrier by taking a strong step towards their career by finding ways to create work life balance. There are many opportunities that can be availed from out of home or on a part time basis. The world is using technology as a gateway to surpass many barriers. This technology can be helpful to many women to enjoy a career along with balancing all other roles.
Q10). As a woman, had you faced hurdles in establishing your venture? How was the response when you initiated Sehat Kahani?
I come from a traditional family where many females do not work after marriage or children. I started my entrepreneurship journey when my daughter was 10 months old. Convincing people around me of a concept that was unheard of was extremely challenging and mentally taxing. Often I thought about giving up as there more failures than successes to look forward to. However, I took each day as a challenge and made sure that I create mini goals every day that I could achieve. I worked extremely hard to make sure that each and every step that I take in my company was measured to perfection and every one in the team makes full effort to meet the targets and goals that we set for ourselves. Slowly as people saw our effort on ground, our strong implementation effort of the team to achieve what we have set out for, the response became extremely positive resulting in increased credibility of the company as well as trust of the partners and ultimately the beneficiaries.
Q11). What is your suggestion for young females who are passionate to enter in professional life and make their career?
My suggestion will be to find a passion in your life and make yourself strong enough to make your passion your career. Its nice to a have a support system to help but in the end you need to find the inner resilience to make sure you are leading the life the way you want to on your values.
Q12). Women often face gender discrimination and harassment at the workplace. What women should do in such situations? Would you suggest any solution for this issue?
My suggestion will be not to fear to seek help! There is help available in many forms. It can a colleague, a friend, your family, a helpline number or a professional but who ever you can reach out to, please do. Make sure your concern is heard as it is very important that such issues are highlighted so that due action is taken at the right time.
Q13). As an entrepreneur, what qualities entrepreneur should have to drive the business successfully?
Resilience, integrity, adherence to core values and passion are some qualities that every entrepreneur should have. Also here are some tips from my ends to the new entrepreneurs which might be helpful.
- Find the right team who champions your vision
- Instil loyalty for the vision in your team and stakeholders, make them buy your idea
- Create partnerships and collaborations
- Create a business model that is so unique that every one feels the urge to pilot it
- Find a great mentor to guide you
- Be gracious, not apologetic, ask and ask for more with pride
- Never regret a decision after taking it, you will fail a lot, it is okay
- Pivot if it is not working and pivot fast
- Learn everyday and change yourself every day to become better at your job
- Be humble and take that praise to heart but not to your head
Q14). Startup culture is flourishing in Pakistan. What is your opinion about it?
I believe there is a lot of potential in a lot of new ideas that are evolving today. There is a need to listen to the challenges of the existing startups and providing them technical and financial support for them to scale to a level that they can compete in the national and international market. The government and the private sector can play a pivotal role in changing the entrepreneurial landscape in Pakistan and this dialogue although it has started, should be done at a bigger scale with requires more interest and input from all relevant stakeholders.
Q15). How do you see the potential of youth in Pakistan? Any advice for the youth?
I do see a potential in the youth of Pakistan if their talents, interests and skills are gauged in the right direction. Education, skill building, technical growth, mentorship are some of the key attributes that can add value to our pool of youth to become leaders of tomorrow. My advice to them will be to learn and learn and learn. There is no better way to succeed in life!
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