The Unjani Clinics NPC model was developed out of a need to address:
- Urgent transformation in the healthcare system in South Africa,
- The triple affliction of HIV, AIDS and TB, and
- Disease prevention and health promotion versus a costly curative care-based model.
Unjani Clinic ORGANISATIONAL STRUCTURE & GOVERNANCE
The Unjani Clinic initiative is delivered through a Non-profit Company, registered as Unjani Clinics NPC, which acts as the support structure in the relationship. The legal structure is based on a Non-profit Company, without members. In addition, Unjani Clinics NPC is a SARS registered Public Benefit Organisation (PBO #930047735).
This structure was put in place to provide maximum funding benefit to the stakeholders of Unjani Clinics NPC, namely the professional nurses who join the network, and the funders or donors to Unjani Clinics NPC (who receive the necessary legal and tax exemption certificates). All the clinics are Exempted Micro Enterprises (100% Black women-owned with turnover levels below R10 million annually) thus the relevant Broad-Based Black Economic Empowerment (B-BBEE) affidavits are provided to all funders to ensure that they meet the Department of Trade Industry and Competition’s (the dtic) Scorecard requirements. Unjani Clinics NPC is classified as a Qualifying Specialised Entity.
Different governance structures are in place for voluntary associations, trusts and Section 21 companies, now non-profit companies under the Companies Act of 2008. One of the requirements for registration under the Companies Act and Income Tax Act is that an organisation must set out in its founding documents or memorandum of incorporation, the organisational structures and mechanisms for its governance. Section 30 of the Income Tax Act imposes further conditions on the governance and operations of Public Benefit Organisations. Unjani Clinics NPC is compliant to these requirements.
There are currently 111 clinics in the Unjani Clinic Network
Founded on an owner-operator model, our clinics serve the “bottom of the pyramid” , missing middle and under-served markets; ensuring an affordable, quality primary healthcare service and the supply of quality medicines to the people of South Africa. The clinics are based in the communities of our Country ensuring that the service is delivered at the point of need.
SOURCES of INCOME
Unjani Clinics NPC is reliant on funding from donors or funders (through loans: Enterprise Development or Debt) to fund the expansion of the Network. The monthly Network Fee charged to each Facility in the Network covers some of the operational expenses of Unjani Clinics NPC.
The initial relationship with the empowered Professional Nurse is governed by a 5 year Enterprise Development Agreement (EDA), whereafter, once the Professional Nurse graduates the Enterprise Development Program as an owner of her Clinic, she may be invited to remain in the Unjani Clinic Network and a Network Agreement (NA) is signed. Both the EDA and NA require the payment of a Network Fee which covers the various support and operational costs of Unjani Clinics NPC.
The main costs associated with the project include:
- Clinic Infrastructure (converted shipping containers);
- Clinic Equipment, Initial Stock & Internals (furniture, clinic equipment, computer equipment);
- Operational Donations paid to the Professional Nurse for the first 24 months of trade (in order to assist with working capital requirements until the patient numbers reach break even).
Unjani Clinics INVESTMENT COST
When looking at the investment required in a Clinic, we look at it as an investment in the Professional Nurse over the 5-year Enterprise Development period.
Depending on the infrastructure format required (semi-rural or peri-urban) the investment cost is between R1.1 million and R1.2 million per Professional Nurse and the breakdown of this cost is approximately:
- Clinic Infrastructure & Equipment R850 000 to R900 000
- Operational Donations R192 000
- Unjani Clinics NPC Support Costs R50 000