HealthX Africa is a Kenya-based primary healthcare service provider built on the vision of a doctor for every Kenyan. HealthX exists to ensure that every Kenyan has easy access to the most affordable medical services anywhere and anytime. By doing so, the company seeks to put the power of healthcare decision-making back in the hands of every countryman. Through its affordable subscription model, HealthX patients have unlimited access to a full-time team of HealthX doctors, nutritionists/ wellness advisors, and mental health professionals. HealthX is not a specialist or niche medical service – rather, the company is focusing on preventive and early care that helps to stem huge healthcare costs that come with late-stage and complicated illnesses. HealthX uses a variety of digital solutions with telemedicine being the initial priority to ensure that all the services are of high quality, affordable, and accessible through video and voice consultations, live chat, in-person care, virtual clinics, and home-based primary care (coming soon) 24 hours a day- 365 days a year.
Dr. Radha Karnad is the Chief Medical Officer at HealthX Africa and one of the members of the founding team. She is a physician who completed her pre-med training at Bryn Mawr College (PA, USA), medical school at the University of Southampton (UK), and a Masters’s in Public Health (Health Services Management) at the London School of Hygiene and Tropical Medicine. She started studying Obstetrics and Gynaecology in the Oxford Deanery, UK National Health Service before undertaking her Masters in Public Health. In 2013, she moved to Kenya and worked for Jacaranda Health, an affordable and high-quality maternal and child hospital where she established clinical programs for quality care. Subsequently, she worked at Jhpiego, an affiliate of Johns Hopkins University, in a variety of roles culminating in leading their global Primary Health Care portfolio.
Dr. Radha says that she grew up being aware of the huge seemingly insurmountable challenges that people face in accessing healthcare (and quality healthcare) around the world. Whether it is a high or lower-income country, engaging with the health system often fills people with fear and dread. Since childhood, she had clarity in her desire to be part of making a difference in the health system somehow, and medicine felt a natural way to achieve that. She states, “My most formative lesson was during my residency when I realized that ‘medicine’ as I had imagined it was possibly not going to help me deliver the change I wanted to be part of. I could continue to care for one patient at a time for my entire career without really making any tangible difference in the health of women in terms of numbers and scale. This realization has shaped all the choices I have made subsequently.”
While she was in the NHS, she got to learn what a functioning health system actually should look like. Dr. Radha recalls that it was an extraordinary privilege to train, work, and learn in that health system. At Jacaranda Health, she became aware of the power of the huge (and growing) middle economic class in Kenya – a population that is educated, aware, and willing to pay, including for healthcare. She adds that they know what they want from healthcare, and they understand what quality healthcare means to them but their options are extremely limited. They may not want to utilize public hospitals that are overburdened, poorly resourced, and understaffed, but many cannot afford the high-end private health care that exists seemingly to serve only the wealthiest Kenyans. Adding to this, she said that at Jacaranda, she was able to reinforce her belief that quality and cost of healthcare do not have to go hand in hand, and that quality care could be provided consistently and affordably through innovation, efficiency, and creativity. Jhpiego was the place from where she learned about putting programs together, a sustainable health system, and how important it is to be engaged in advocacy, policy, regulation-building, and standardization from the outset. Further, she expressed how she traveled widely across Africa and got clarity about the nuances of different health systems.
Dr. Radha states that she has been very lucky not to have faced too many practical obstacles or challenges in the initial phases of her career. As someone who never says no, she found opportunities arose whenever she was ready to step in to do something.
One of the primal challenges, as mentioned by Dr. Radha, is that she has always been racked with a sense of self-doubt and uncertainty. She believes that this challenge is something that many leaders try to figure out to continuously thrive in both work and families. She was worried about the continuous switching of roles as this would make her a jack of all trades, and master of none. In earlier years, Dr. Radha reveals that she witnessed such cases with colleagues who were more focused and experienced on one track moving forward faster because they stayed on that path. However, she mentions that in this role as CMO especially, she found the breadth of experience, knowledge, and networks that have truly benefited her work with quite a different perspective and credibility. It is in this role that she learned being a jack of all trades was not a bad thing – in fact, that the whole quote is “a jack of all trades is a master of none, but oftentimes better than a master of one” (Shakespeare).
According to Dr. Radha, every CMO should have a keen focus on doing the right thing clinically, legally, and ethically, keeping patient at the center of those decisions. She believes that the CMO is the compass of healthcare organizations and sets the direction for how patients are managed medically as well as how they are treated as users of the service – both are equally important. Dr. Radha continues that telemedicine and digital health is very new in Kenya and still relatively unregulated. So as the CMO, she has found it important to focus on ensuring that HealthX is built to meet the highest standards of local and global guidance and best practice in telemedicine.
Further, the CMO should have the ability to evaluate information, make quick and thoughtful decisions, and stand by them. She opines that this is an attribute that all those who work in medical professions develop quite early, and it is really important because unusual circumstances and complex situations come up all the time, especially in the start-up world. Adding to this, she mentions that as CMO, her team looks for her to make important and difficult decisions, and thus, consistently and confidently asserting those decisions is a really important attribute for the position.
“It is important to be a good leader. This is something I am still learning and I have not always done well. In this role as CMO, I am, for the first time, leading a large group of professionals. I tend to be someone who is quite confident in their own decisions, likes to get things done, and wants to execute, and it has been a real learning curve for me to slow down, listen more (and truly listen), admit my own mistakes, and delegate. As I learn to do this, I see a lot of positivity and productivity in our workplace,” she adds.
Dr. Radha feels that healthcare is already so disrupted and fragmented in much of the world, and she is not out to disrupt further, but rather to fill the gaps in the existing system so patients have an easier time. She accepts that there are some really fascinating opportunities for technologies like AI and big data in Kenya and across Africa. Importantly, as there is very little research and data from African countries that are used in shaping global practices or even global technologies, these technologies have the potential to bring those discrepancies to light and allow a more representative view to shaping the direction of global healthcare in the future.
She claims that the role of the leader has changed enormously. She elaborates, “Earlier it was perhaps more didactic in leading the direction yourself and having your team follow, now it is more about creating an environment within which your team is best able to thrive themselves, and being the person they can rely on in times of uncertainty”.
This is an extremely exciting time for HealthX Africa and the industry. In Kenya, there are currently over 64 million active SIM card subscriptions for a population of 50 million people. This means most adults have one, if not two or three active sim cards. Millions of Kenyans use their phones multiple times daily to communicate, access financial services, work from home, shop online, study and socialize. So for her, healthcare remains the last bastion of services delivered very traditionally and only face-to-face with little use of technology beyond diagnostics. She references Kenya being known as the “Silicon Savannah” of the continent – and how quickly things are changing. “It is exciting to be a part of that changing tide to help develop and set the regulations and standards that will guide the profession to move forward and start to explore what HealthX’s services could look like in neighbouring countries,” remarks Dr. Radha.
Dr. Radha advises emerging CMOs not to worry if they don’t know everything – they can’t! In her experience, leaders do best to focus on their strong suits (for her these are understanding of health systems, accessing the right networks for strategic partnerships, and putting in operational systems for quality) and to show humility in acknowledging their gaps and hiring the right people to fill those gaps. “Keeping a track of all commitments from the outset and notes on every decision is important – as you get busy things may start to slip and putting everything in writing will mean you don’t miss important things, and also is a reference resource to go back to later,” she concludes.
– Radha Karnad, Chief Medical Officer, HealthX Africa