Dr. Yetunde Ayo-Oyalowo is founder/CEO of Market Doctors, a social enterprise that brings affordable healthcare to underserved communities in Nigeria. With a team of 18 permanent staff and 40 ad-hoc employees, she has served more than 500, 000 people in 2000 communities across 18 states in Nigeria. Her social impact-driven organisation has also worked with seven mobile clinics to reach people in more places delivering health care, aside providing hundreds of antenatal care kits to help women and babies stay healthy after birth. The healthcare professional is working to help close the gaps in Nigeria’s healthcare system. Assistant Editor CHIKODI OKEREOCHA reports with materials sourced from Africa’s Business Heroes (ABH) newsletter.
Even though she earned a Bachelor of Medicine and a Master of Public Health (MPH), she turned her back on anything conventional; she did not want to work in the hospital or specialize in clinical work. Instead, the founder/CEO of Market Doctors, a social enterprise that brings affordable healthcare to underserved Nigerians, Dr. Yetunde Ayo-Oyalowo, opted for a different career path, venturing into the health insurance world.
While in the health insurance industry, Dr. Yetunde worked for different departments and her work ranged from working with customers, hospitals, and in marketing. She also started another company called Preventive Health Managers- a company that did a combination of consulting and training. It was while working in the health insurance industry that she noticed that a lot of people did not have access to health insurance.
“I started asking myself how I can create access to healthcare for the common Nigerian,” Dr. Yetunde said, adding, “I knew if I wanted to prevent deaths like my grandmother’s and to do that successfully, I needed to meet people where they were. So, I focused on a place that many people, especially women visit daily- the market.” And this was how Market Doctors was birthed, shaped of course, by the tragedy of the loss of Yetunde’s grandmother.
Narrating how it all started, she said: “Months before I was born, my grandmother got ill and my dad went to her remote village to assist her. She lived about an hour’s drive to the nearest hospital and she died within a few hours of reaching that hospital. She was diagnosed with simple diarrhea which is something that simple salt and water solution would have solved, had she lived close enough to care.
“This tragedy shaped my life in many ways. My father encouraged me to go to medical school, in part to make sure that nothing like that ever happened to our family again. So, I carried not just my grandmother’s name but a story and that of millions of Nigerians like her who died because they could not get a doctor in time.”
Putting the founding of Market Doctors in context, Dr. Yetunde said Nigerians get everything at the market- food, clothing, furniture, etc., including find connections and friends there. “So, I had the idea of having people add preventive healthcare to their shopping bags. I knew from my training that preventive care like blood pressure readings and diabetes screenings would make a huge difference for people. It could even save lives,” she said.
Dr. Yetunde recalled that one day, underneath a canopy, sitting on a folded chair, she and her team welcomed their first patient and “We called ourselves Market Doctors.” I remember on that first day, shoppers walking by with trays full of fresh tomatoes, and grains on their hips were curious to see us in our white coats holding simple medical devices like stethoscopes, and blood pressure readers which they had never seen.
“The first questions to us were the expected ones. Are you a doctor or a nurse? How much will this cost? I would tell them that I was a doctor, and I was proud to say that healthcare was accessible and affordable right in the market,” she said, pointing out that many Nigerians live so far away from health centres that they would have to forgo days of wages just to afford transportation costs alone.
Giving more insight into the state of access to healthcare in Nigeria and the huge gaps in the system, Dr. Yetunde said when she became a doctor, less than five per cent of Nigerians had health insurance, and today, more than 70 per cent of the population work in the informal sector where health insurance is even more out of reach. “Often, people are turned away at hospital doors or leave the hospital before they recover because they cannot pay,” she said.
She, however, described her work with Market Doctors for the past seven years as an eye-opener. According to her, it made her realize the sad truth that money really keeps people alive. Her words: “In Nigeria, and I believe this is the case in many other African countries, you get to the hospital, and if you do not have money to pay, you cannot be treated.
“Sometimes you are not even touched despite how dire your situation is. In another case, you are in the hospital and you have been spending money, but if you need more treatment that is above your means, then the treatment stops. Sometimes, this goes so deep that people do not even attempt to seek care because they already know they cannot afford it.”
Dr. Yetunde added that the disparities Market Doctors was already seeing in accessing care were exacerbated by recent crises such as COVID-19, the hike in fuel prices, and high cost of living, as several people who were already poor became poorer. She, however, said Market Doctors has, in the past seven years, tried to change the healthcare access narrative by bringing healthcare to a location many Nigerians visit almost daily—the market—as well as to people’s homes.
According to Dr. Yetunde, the organisation’s team of health workers goes from stall to stall in the market or house to house in the community, carrying medical devices to measure blood pressure, blood sugar, and cholesterol levels, as well as perform other tests depending on the patient’s needs. Health workers use mobile devices to connect by voice or video with medical doctors to confirm diagnoses and prescriptions and they can dispense drugs on the spot.
“Our doctors travel in a school bus that has been converted into a mobile clinic. We serve consumers who do not have access to primary healthcare. We also work with non-profit organisations that want to support medical services driven by non-governmental organisations,” Dr. Yetunde divulged.
The thing is that healthcare access for Nigeria’s informal sector is a huge challenge. Many people working in the informal sector earn a daily income where they cannot afford huge healthcare costs. They choose between healthcare, feeding themselves, or income loss. Also, Primary Healthcare Centres (PHC) are far from where they live or work and are only utilized 20 per cent of the time.
This, The Nation learnt, is due to poor services, prescription shortages, and lack of medical personnel for a country of an estimated 200 million people. This is where Market Doctors comes in to eliminate the journey time and waiting time of going to health centres which come at a cost to the patient and prevents them from earning income during that lost time.
Unsurprisingly, the results of Market Doctors’ novel medical outreach programme have been telling. For instance, from that first stall in the first market, Market Doctors, according to Yetunde, has served more than 500, 000 people in 2,000 communities across 18 states in Nigeria. It has also worked with seven mobile clinics to reach people in more places delivering health care on a little fitted school bus.
“We also provided hundreds of antenatal care kits to help women and babies stay healthy after birth, Dr. Yetunde added, noting that some of the things that make Market Doctors’ business, service or product special include the removal of barrier of entry, as it does not request registration cost before treatment; location of care is at the workplace or while shopping so that one can access healthcare.
That is not all. Market Doctors also boasts convenience and easy affordability. By reducing overhead of hospital buildings, it operates from stalls and back packs. Besides, quality of care is top-notch, with doctor availability. Payment is also flexible, as patients pay daily as the use service, and there is minimal no journey time. Apart from its one stop central point of care and test/consultation/drugs, Market Doctors also offers referral services to bigger health facilities.
Though a social enterprise, Dr. Yetunde has devised an ingenious way of balance the provision of affordable care and running a financially sustainable organization. “We realise that some patients are unable to pay and supporting them to access care is a big part of how we measure our access. This support costs time and money,” she said, adding, however, that part of what she does to keep the organisation sustainable is by using a sliding scale fee structure and sometimes subsidising some of the costs.
Her words: “We have a mixture of services ranging from high-margin services and low-margin services that we are able to cover for some costs with the margins from our well-paying services. We leverage strategic partnerships, collaborate with brands and apply for grants. We have a lean management team and we try to be efficient with our resources so that we can provide as much care to people as possible.”
Sharing how her entrepreneurial journey kicked in, Dr. Yetunde said the journey started way back. “I have always wanted to be in control of my time which medicine would not give me the opportunity to achieve. I wanted the flexibility of work. Also, while I was in school, I engaged in some selling activities although my parents were academicians.
“My grandparents, especially from my maternal side, were entrepreneurs who engaged in buying and selling of goods and services. Thus, being an entrepreneur has always been part of my family,” she said, pointing out that the most rewarding thing as an entrepreneur is getting to think of solutions to help the challenges faced by people in everyday life, and as a result create an enabling environment to mentor people while creating employment opportunities for people.
Having come this far, what are Dr. Yetunde’s future plans and aspirations? “I hope to have franchises in every state in Nigeria. We will have cemented partnerships with government on achieving universal health coverage. I will have a digital community health worker academy where I can train prospective health workers as the last milers. Our model will be used by other African countries to increase health coverage,” she responded.
She also has some success nuggets for aspiring women entrepreneurs. “My advice is to encourage all women out there to know that there are enough opportunities for them if they are thinking of doing something that can enact a change in the world or can make the world better for other people.
“When you start, you may think you don’t have so much. But look within you and you will see all the resources, even resources online that can help you start from somewhere. Start from where you are and you will be surprised how far you can go,” she said.
Dr. Yetunde, who is a member, Advocacy and Resource Mobilization Malaria Partnership Committee (ARMPC) and also a U.N. Secretary-General’s Special Envoy for Health in Agenda 2030 and for Malaria, spoke from her personal experience. For instance, she latched on the Africa’s Business Heroes (ABH) community as a resource to drive her mission.
The ABH shapes the future of African entrepreneurship. “Applying to ABH really gave me the clarity that I needed on what the organisation was about and what we wanted to achieve. Beyond the application process, the ABH community is a strong community of entrepreneurs who are always ready to share knowledge, resources, joy, and support and I feel privileged to belong to such a community,” Dr. Yetunde said.
