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Our customer research process, part II

The details about our process:

  1. A quantitative survey  for chemists and private clinics

Much of this was developed with support on format from Jessica (a pro from her IPA and research days) and Amy Lockwood (a huge supporter and advisor for us). The questions cover demographic basics, information of interest to me with inventory / financial, clinical for Jess, and chronic diseases for Margaret. The survey is entered in afterwards by using ODK Collect on a tablet for clean, electronic results. While we are not asking a large enough sample to be running large analyses, this could eventually form the basis for a wider-scale market sizing survey. For now, it helps to ensure that we collect some key basic details for all stakeholders.


  1. Interview summary sheets

Long open-ended questions, often driven by asking about this form or that object that we see in a chemist shop, can lead to long and unwieldy notes that we would not have time to properly analyze. As a result, I developed a shorter summary template that we could use to quickly share highlights from each interview – from key interesting facts (e.g. the Kilgoros chemist who spent 30,000/- on a POS system) to key challenges that we could try to address. This idea of “pains” and “gains” was drawn from a class on the value proposition canvas this past semester, which I’ll elaborate on in another post someday.

Finally, these interviews are always done with an eye to product / service, and what we can offer. As a result, observations on what features we are prototyping would or would not be useful, and ideas for new features that we think of during a conversation are jotted down at the very bottom.  As one advising expert rightfully pointed out, this […]

By |July 28th, 2013|Innovation, Market Perspectives|Comments Off on Our customer research process, part II
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Our customer research process, part I

Tammy’s Highlights from Week #4 –

Taking a moment to stop, think, and rest.


This week was remarkably meeting and site visit free – an important time to reflect on what we are seeing and learning, and let things settle in our minds. Last weekend we went to Ethiopia to visit an old friend, who is in Addis for the summer working with a chicken farm and a PE firm based in Nairobi, looking into investments in East Africa. It was an interesting crowd we don’t encounter in Nairobi – from chicken farmers (okay, business guys focused on a traditional, but high-potential agro-business) to McKinsey PE folks to investment folks. This also exists in Nairobi, but because there is such a strong social enterprise community, it often feels like there is little need to look beyond it. The scale (both in dollar size and in actual business sizes) and different types of backgrounds were an interesting and inspiring jolt, something which we were talking about well into this week.

Some customer research context

Spring semester, I took an “Innovation in Services and Business Models” course (Professor Henry Chesbrough’s book, Open Services Innovation, covers many if not all of his course’s points). One concept of particular interest to me was the Value Proposition Canvas, introduced to the class over Skype by Alexander Osterwalder, the inventor of the business model canvas (explanation of the canvas is here). A key takeaway for me from Osterwalder’s presentation was how the success of a business model often hinged on finding a truly relevant value proposition, and often organizations and business models will fail because they don’t understand their customer, and come up with a not-so-valuable-value-proposition. The rest of the business model stuff is important too, of course. In our situation though (as is true […]

By |July 28th, 2013|Innovation, Market Perspectives|Comments Off on Our customer research process, part I
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Figuring out our impact

Tammy’s Highlights from Week #3 –

  1. Meeting with our technology team and seeing the first steps towards an inventory prototype
  1. Hearing Ciiru’s report on her two additional days in the Transmara – a private facility in Llogorian and a full day shadowing a chemist in Kilogoros
  1. Meeting with Sunny, and our advisors Josh Cohen and Eran, in Kenya for meetings related to their project
  1. Putting together my first wireframe mockups for the inventory and financial systems
  1. Informal meetings with friends and friends of friends, learning about different health projects around Kenya such as Changamka. It’s great to learn what others in this space are thinking, what their challenges are, and where they’re heading

Advisors and people we talk to often express the most excitement over the potential for impact through clinical decision support. Unfortunately, this sentiment is not as strongly expressed by the healthcare providers or pharmacists we talk to, who – much like providers in the United States – are often either confident in their own abilities, the “art” of medicine, or are pressed for time and reluctant to include new systems. As we build our technology, we need to be able to build it with an eye towards both improving health impact but also making it usable, with enough of a “hook” to ensure adoption.

In contrast to clinical decision support, we have a reverse problem with chemists. Here, we see more active interest by chemists for the technology we are building – but wariness by advisors in ensuring this improves health outcomes. We believe chemists play an important role in supplying drugs stocked out at other facilities, and have been impressed by the patched-together network of suppliers, couriers, and informal mobile payments to get drugs out to remote areas. However, we take seriously the […]

By |July 21st, 2013|Impact, Market Perspectives|Comments Off on Figuring out our impact
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A visit to rural Transmara

Tammy’s Highlights for Week #2 –

  1. Seeing the customized inventory tracking software used by an importer / wholesaler / distributor, to track stock and sales across branches around Kenya
  1. Meeting MEDS, importer and distributor for faith-based hospitals and other organizations
  1. Having Margaret work in our “office” for an afternoon – she has been spending nights on chronic disease systems for Miti and days with Moi University on tablet education so checking in was great
  1. Speaking with the nurse at a small, one-room public facility, an hour outside of Kilogoros town by dirt road, and watching him use VECNA’s tablet-based electronic medical record system
  2. Learning about the chemist in town and her retail POS software and computer purchased for 30,000/-

I’m writing this a week later and already it is hard to separate out what we learned this week and what we have learned after. I spent the two days with Ciiru visiting  wholesalers of drugs and non-medical equipment to better understand the supply chain ecosystem, from identifying overseas suppliers to imports to distribution and retail. Then Jess joined us to travel out to the Transmara to see where VECNA has partnered with public facilities and implemented an electronic medical record system on tablets.

In one chemist shop, the manager had spent 30,000/ for a large desktop computer with a retail POS system (designed for groceries) to print receipts for her customers and better manage inventory. A traveling salesman from Nakuru had come through her town to sell the system, and convinced her it was worth the investment. Ultimately though, it was too large to sit on her counter, she had yet to invest in a printer, and her frontline pharmacists found the system too complex so they continued to work in paper and someone entered the data into her […]

By |July 20th, 2013|Market Perspectives|Comments Off on A visit to rural Transmara
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Only a week in Kenya and already a pivot?

After months of talking and thinking about Miti Health and working with the exceptional developers at Mindflow Associates, our team has converged in Kenya, ready to learn as much as possible about the pain points that people have as they move through the health system and prototype around this.

Our first site visit was to a public health facility near Nairobi that was well run, with friendly and efficient staff.  We moved from room to room, getting a sense for patient flow and understanding the services they provide.  We were also especially keen to understand the various pieces of paperwork that the nurses fill out for each patient, since this seems to take up an unexpectedly large portion of their time.

We were surprised to find that Kenya has recently implemented a policy making medication free at all public health facilities.  While the clinicians were enthused about this policy in theory, in practice they found that it had exacerbated existing issues around stockouts.  As a general rule, they found that the government supplier was able to fill only 25% of their medication orders, and that they anticipated that if the drug orders were filled every 3 months, they could expect that 2 of these months, they would be lacking many essential medications.  In these cases, they wrote a prescription for the meds to be filled elsewhere, but found that because of high medication prices in the area, people did not fill the prescription.  They also noticed that people would often travel all the way to Nairobi to fill medication orders because prices were significantly higher in this semi-rural area.

As we wandered around the grounds, we noticed a private health facility that had set up shop at the entrance of the public facility.  The nurse who ran this center did a […]

By |July 6th, 2013|Market Perspectives|Comments Off on Only a week in Kenya and already a pivot?