“Roaming” nurses expand access in Sierra Leone

New program expands rural services and helps nurses start small businesses with support from DKT International

By DKT International; Diane Kawa, DKT Sierra Leone Medical Detailing Manager; Frederick Humpah, DKT Sierra Leone Sales Manager; and Abdul Kamara, DKT Sierra Leone Sales Manager

Getting contraception into the hands of people that need it the most is a challenge DKT International’s sales and marketing teams take on everyday. In Sierra Leone, access is a particular problem in rural areas, but DKT Sierra Leone has come up with a way to simultaneously reach consumers, build the capacity of public health professions and possibly even turn a profit through a new program called “Roaming Partners.” The new initiative aims to empower both the consumer with knowledge and more choices and health providers with additional training and financial support.

The program, which launched in June, taps into an existing network of public health nurses who are unable to earn money while they await licensure. Roaming Partners trains and sends these new nurses deep into the field, armed with enough product and knowledge to start and sustain their own small business. It’s an innovative capacity building solution that allows DKT Sierra Leone to reach the hardest to reach consumers, while also building the financial and professional capacity of its partner nurses.

The Roaming Partners program grew out of a need to more fully develop DKT Sierra Leone’s wholesale business, said DKT Sierra Leone Country Manager Michael Enema. A few months ago, the team identified the need to expand and create a new revenue stream for its wholesale business partners, who were experiencing lagging sales. Rather than hire a whole new team, Enema drew upon existing resources in the public sector and partnered up with a network of State-Enrolled Community Health Nurses (SECHN). These nurses serve as volunteers working in public hospitals pro bono after they complete their two years of specialized training, and work without pay until the government is able to absorb them into the civil service or issue them a license to practice in the private sector. This “volunteer” period, he said, can last anywhere from six months to a year (or longer) and can be very prohibitive financially for the new graduates.

Enema’s idea was to “activate” this network, so DKT Sierra Leone soon began working with the government to organize a training for 150 graduates in Freetown to improve their knowledge of basic contraceptive methods and products. The training focuses on how to prospect for clients in their community, teaches counseling techniques and helps graduates learn how to price family planning services such as injections and pills. Nurses learn how to refer clients to Lydia Partner Clinics for more complex needs, such as the insertion of IUDs or implants, and receive support with financial management, budgeting and entrepreneurship skills.

“We felt the more trained professionals that had our products in their hands, the better for us,” Enema said. The energy in the room during the training, he said, was “inspiring.” “They saw the opportunity to make some decent margins for themselves.”

Roaming Partners:

• Provides nurses (aged 18 to 22) with an array of non-invasive DKT products (products they didn’t need more advanced insertion skills to administer)
• Trains them on how to explain the use of those products to people in the hardest to reach communities
• Provides them with entrepreneurship skills to build their own business, using revenue earned to buy more stock from DKT’s wholesale supply partners, with the aim of continuing to grow their businesses

The model is a win-win for everyone, Enema said. The nurses gain more knowledge and confidence in their professional and financial skills,  DKT is able to reach more consumers, and the consumers have more access to contraception — which is the ultimate goal of DKT Inernational’s programming.

The contraceptive “kits” DKT Sierra Leone provides can serve up to 60 individuals at a time and includes condoms, oral contraceptive pills, lubricants and injectables, as well as HIV testing kits. The specific seed stock includes Fem 3 injections, Lydia OCPs and Oraquick HIV Self-test kits. Replenishment of these stocks and other inventory they might require can be handled directly between the nurses and the wholesalers. All trainees were given a list of DKT’s wholesalers, tools on how to re-order and made sure to stay connected via What’s App so they can build their own support system and ask questions when necessary.

Enema said the WhatsApp group has been especially important as a training resource and allows DKT to maintain a close, working relationship with nurses, who are some of its most essential partners. This network of support hopes to tackle questions like: what should they do if a client tests positive for HIV? How can they encourage or counsel clients who are experiencing side effects,  and how often should they follow up with clients for their next injection, or round of birth control pills? The WhatsApp group is also a way for Enema and his team to follow sales, which have been especially strong since the program launched. The nurses, he said, are contacting the wholesalers to replenish their stocks regularly.

The next Roaming Partners training is scheduled for the second half of 2023, and the next class of 150 nurses is expected to take DKT’s products and services into even more remote regions of the country.

For more information about the Roaming Partners program please contact Michael Enema at enema@dktsierraleone.org