Health Solutions International, a social impact organization dedicated to advancing healthcare standards to save lives in East Africa

Isabella Epiu is the founder of Health Solutions International, an organisation founded in 2015 in Uganda and dedicated to Advancing Health Care Standards To Save Lives by sourcing new approaches to emerging global health challenges through research and implementation science. She is an Anaesthesiologist with a PhD from the University of New South Wales - UNSW School of Medicine in Sydney, Australia, which is among the top 50 medical schools in the world. Isabella’s recent research focused on neural-respiratory physiology, to design targeted cost-effective management plans and improve the quality of life in people with pulmonary diseases. Previously she performed multi-national research across the East African Community aimed at improving maternal and neonatal outcomes through safe anaesthesia. Isabella is passionate about quality improvement in healthcare, and particularly safety in medicine with experience in research, leadership and management, global health, economic modelling, policy analysis. She currently has 20+ publications with up to 220+ citations already.

In Uganda, Isabella is the first anaesthesiologist to attain a PhD, and the first Female in East Africa. This achievement was recently celebrated at a State Auction by H. E. Yoweri K. Museveni the President of Uganda at the National Independence Grounds in Kololo, Kampala, Uganda on 5th December 2023. She has been recognised with several awards, a recent one being the 2018 PhD Scholarship at UNSW; 2016 Media Award from a USA based Society of Obstetric Anaesthesia and Perinatology, and 2013 World Federation of Societies of Anaesthesiologists (WFSA) Research Award for her significant contribution in advancing safe anaesthesia and safe surgery. This led to a 2014 award by the USA National Institutes of Health as a Postdoctoral Clinical Research Fellow, a collaboration with University of California Global Health Institute (UCGHI), and department of anaesthesia at Makerere University, where she conducted a countrywide multi-center study in 64 hospitals in Uganda and also performed the cost-effectiveness analysis for obstetric fistula surgery.

Previously, Isabella performed multi-national health systems research particularly to improve maternal and neonatal outcomes through improving access to safe surgery and safe anaesthesia in East Africa. She has presented this work in several local and international meetings and published in high-impact peer-reviewed journals. She received a top 10% presenter award for the first Cost-Effectiveness Analysis in Obstetric Fistula repair in East Africa. The Health Policy and Planning Journal ranked her cost-effectiveness analysis as the top 5th paper from 2018 https://blogs.lshtm.ac.uk/hppdebated/2019/01/21/health-policy-and-plannings-top-10-articles-in-2018-have-a-browse/. This work was also recognised by the World Economic Forum https://www.weforum.org/agenda/2019/01/why-improving-access-to-surgery-in-childbirth-makes-economic-sense.

Lioness Weekender spoke to Isabella Epiu about her entrepreneurial journey, and her dedication to achieving equity in health for vulnerable people.

What does your company do?

Health Solutions International is an organisation that is dedicated to Advancing Health Care Standards To Save Lives by sourcing new approaches to emerging global health challenges through research and implementation science. It is a multinational platform for fostering and providing improved standards of health care, patient safety, mentoring, and empowerment for vulnerable groups.

The mission of the Health Solutions International is “to build a healthy generation, and improve health by supporting various global health solutions, maternal and child health initiatives and empowering of vulnerable groups achieving equity in health for all people worldwide.”

What inspired you to start your company?

From my multi-national trial in ~70 hospitals in the East African Region which included national, and regional referral hospitals, district (general) hospitals, private for profit and private not for profit hospital, I identified significant shortages of both the personnel, equipment, drugs, and protocols needed to provide safe anaesthetic care for obstetric surgical cases. https://pubmed.ncbi.nlm.nih.gov/?term=Epiu%20I%5BAuthor%5D.

I therefore developed this platform to advocate and implement several programs that'll bridge the gaps identified. Now is the time to re-configure the global health target to specifically address these health disparities in low-income countries for achievement of SDG 3.

There is urgent need to increase the number of physician anaesthetists, to improve the training of non-physician anaesthesia providers, and to develop management protocols for obstetric patients requiring anaesthesia in LMICs. This will strengthen health systems and improve surgical outcomes in developing countries. More funding is required for training physician anaesthetists if developing countries are to reach the targeted specialist workforce density of the Lancet Commission on Global Surgery of 20 surgical, anaesthetic, and obstetric physicians per 100,000 population by 2030.

Why should anyone use your service or product?

From my research in East Africa, for a population of 142.9 million in the East African community, there were only 237 anesthesiologists with a workforce density of 0.08 in Uganda, 0.39 in Kenya, 0.05 in Tanzania, 0.13 in Rwanda, 0.02 in Burundi Anesthesiologists per 100 000 population in each country (Epiu Isabella et al A&A 124, 1, Page 290-299; 2017. LWW).

I believe that increasing access to quality cesarean sections and safe obstetric anaesthesia would improve maternal and neonatal outcomes and move closer to the goal of safe motherhood.

Tell us a little about your team:

We are a dynamic team of highly trained scientists that have competitively won several awards and dedicated to advancing health care standards to save lives.

Share a little about your entrepreneurial journey. And do you come from an entrepreneurial background?

I am a Research Scientist, a National Institutes of Health Global Health Fellow at University of California Global Health institute, with training in Quality improvement in health care, Leadership and Management in Health, and Epidemiology for Global Health. I am also an alumnus of President Obama’s Mandela Washington Fellowship program in Public Management where I gained skills in leadership, public policy analysis, modelling, simulation, and also formed networks with local and international organisations. This was a very competitive program funded by the USA Department of State and USAID where they selected the top 1% applicants across Africa.

In 2012 as part of my Master of Medicine dissertation, I assessed 5 National Referral hospitals in East Africa, specifically looking for their capacity to provide safe obstetric anaesthesia. The USA National Institutes of Health through the University of California Global Health Institute awarded me a fellowship in 2015 where I assessed 64 hospitals in Uganda, and also performed a cost effectiveness analysis for obstetric fistula surgery. This work was recognised by the World Economic Forum and ISPOR, The International Society of Pharmacoeconomics and Outcomes Research, where I received a top 10% award for the first Cost Effectiveness Analysis in Obstetric Fistula repair in East Africa.

In my interactions with the rural community following an award from the UCLA Center of Expertise on Women; apart from Obstetric Fistula, I found many women burdened with other non-communicable diseases especially COPD following exposure to biomass fuels during cooking, and I embarked on my PhD research to develop cost-effective solutions, and to improve the quality of life of such people with chronic pulmonary diseases.

To date with the Scientia PhD scholarship from UNSW, I have performed ground breaking research using several neurophysiological techniques to assess airway reflexes, airway sensation, and to test swallowing dynamics in COPD and healthy ageing. I am celebrated, not only as the first Anaesthesiologist in Uganda to be awarded a PhD, but also the First Female Anaesthesiologist in East Africa to attain a PhD from the Prince of Wales Clinical School, University of New South Wales - UNSW Sydney, AU.

What are your future plans and aspirations for your company?

Through Health Solutions International, we are dedicated to advancing healthcare standards to save lives by sourcing new approaches to emerging global health challenges (www.healthsolutionsinternational.org)

What gives you the most satisfaction being an entrepreneur?

Being a successful rising star in Science and Technology from the Pearl of Africa, Uganda! Special thanks to all my mentors, family, and friends for standing by me.

What's the biggest piece of advice you can give to other women looking to start-up?

Never give up! "Fill your brain with giant dreams so that there is no space for petty pursuits", Robin Sharma

To find out more about the work of Health Solutions International, contact Isabella Epiu via email: hsiepiu@gmail.com or visit the website and social media platforms:

Website: http://www.healthsolutionsinternational.org

Facebook: http://www.facebook.com/epiu.isabella

Twitter: http://twitter.com/isabellaepiu

YouTube or Vimeo Video: https://www.youtube.com/channel/UCB5l7bAauvjyeMAbMrIEzzw