This paper discusses the role of dietetics services in value creation in the healthcare industry,  particularly as relates to addressing the growing issue of non-communicable diseases (NCDs).  Leveraging on value chains through dietetics and healthcare services and programs is crucial to  prevent and manage NCDs and improve population health outcomes and quality of life. 

The increased prevalence of NCDs such as type 2 diabetes, high blood pressure, obesity and  chronic kidney disease is a growing concern for health care systems across Africa. The World  Health Organization (WHO) estimates that deaths from NCDs are likely to increase by 27% in  Africa over the next ten years. That is 28 million additional deaths from these conditions which  are projected to exceed deaths due to communicable diseases, maternal, perinatal, and nutritional diseases combined by 2030.1 NCDs will soon be a leading cause of ill health, disability, and  premature death in Africa, and will have an adverse impact on socio-economic development. In  other words, the overwhelming prevalence of NCDs in Africa will have a devastating impact on  individual lives and will pose an enormous burden to the countries’ health care systems.  

A value chain is defined as a set of activities through which goods or services are developed. A value chain comprises all the activities, from the input of raw materials through to distribution,  that add value to the end-product. For any organization, the purpose of a value chain is to make  profit, and the final value of a product or service must exceed the cost of creating it.  

KUISHI SMART is a global organization with operations in Canada, Rwanda, and the  Democratic Republic of Congo (DRC). The organization aims to provide an integrated,  culturally appropriate, and client-centered dietetics care and program as a multidisciplinary team. It focuses on community empowerment, health promotion, disease prevention, advocacy and  improving self-care management of chronic conditions through dietetics and nutrition. 

For KUISHI SMART it is important to identify clients/customers and suppliers to define and  establish the willingness to pay (WTP) and opportunity cost of resources (OCR) to meet the  demand and supply of the dietetics and healthcare service market. Research suggests that a value  chain analysis involves breaking down an operation into smaller parts so that it is easy to see what  is happening at each stage of the process, and how different stages are connected. For KUISHI  SMART, the value-add activities are divided in two groups: primary and support activities.  Primary activities for KUISHI SMART include logistics (infrastructures, equipment) and  marketing (strategies for raising awareness and selling services) which are used to create dietetics  and healthcare services. Support activities such as human resources and financial management are  used alongside of the primary activities to enable KUISHI SMART’s operations and activities to  run smoothy. Below, we look at how KUISHI SMART’s supply network operates by using units  

1 World Health Organization https://www.who.int/nmh/ncd-tools/who-regions-african/en/

of resources as inputs and considering how they are transformed into outputs to fulfill the  organization’s vision, mission, and strategies to deliver value to the healthcare system: 

• Operation’s inputs include clinician providers, computer systems, Electronical Medical  Records System, patients, medical supplies, and devices.
• Operation’s processes include booking patient appointment and referrals, checking  patients in, providing medical nutrition therapy and medical care, gathering, and analyzing information, and delivering illness treatment and prevention plans.  
• Operation’s outputs include dietetics and healthcare provision, patients, and communities with satisfaction and feeling of receiving safe and high-quality care. 

The next step that the organization uses to add value to the value chain is to identify cost drivers.  For KUISHI SMART, this includes anything that affects the cost of the organization’s activities or processes, such as the hourly labour cost for the healthcare team. The question is whether these  costs can be reduced without adverse effects on the dietetics and healthcare services provided by  the organization? Identifying differentiation activities plays an important role as an element of the  value chain. Identifying differentiation activities for KUISHI SMART’s dietetics and healthcare  services helps to improve service quality, innovation and marketing strategies which all add value  to the service and give it a competitive edge. Using analysis such as Blue Ocean and SWOT can  show how each activity for KUISHI SMART can be enhanced (or eliminated, if necessary) to add  value to its dietetics and healthcare services. This analysis provides vital data and information to  the organization for decision-making to maintain or create add value to the chain. 

The first analysis tool we will use is the Strength, Weakness, Opportunity, and Threat (SWOT). It is a very simple but powerful tool that management can use to identify internal and external factors  likely to affect an organization’s performance, across every sector of its operations. KUISHI  SMART has been using SWOT as tool for day-to- day business operation and to examine long term market opportunities, or how to engage the healthcare team in formulating the organization’s  strategy for value chain. 

To inform the usage of SWOT, KUISHI SMART has been asking the following questions based  on each element of the SWOT tool: 

Strength - What do patients or clients love about the service or product? What do we do better  than other organizations in the industry of dietetics and healthcare? 

Weakness - What could we do better? Why do patients or clients dislike our services/products or  not buy from us? 

Opportunities - What changes in trends or weakness in the environment and/or our competitors can we exploit? 

Threats - What could our competitors do that would affect us? What social and nutrition/health  trends might threaten us?

STRENGTHS 

• Delivery of high-quality dietetics and  healthcare services 
• Differentiated services and programs • Specialist evidence-based medical  nutrition therapy and behavioral interventions 
• Competent and skilled healthcare team

WEAKNESSES 

• High price due to lack of health insurance coverage 
• Premium services limit market 
• Unavailability of competent local  healthcare staff specialized in dietetics

OPPORTUNITIES 

• Growing trend in healthy eating and  lifestyle changes to prevent and manage NCDs 
• Growing appreciation and understanding of patient/client centered care approach and evidence based services 
• Growing needs for telehealth dietetics  and healthcare services using multidisciplinary healthcare team 

THREATS 

• Policy and regulations that are complicated to provide documents on time 
• COVID-19 pandemic which has caused disruptions in services due to  lockdowns and general anxiety re: face-to-face engagement
• Political influences

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The second tool we will use is the Blue Ocean business strategy which focuses on creating demand  through an impressive improvement in value for buyers, at an affordable price. KUISHI SMART  uses this tool to identify and assess its value chain, particularly with respect to factors around  which organizations in the industry currently compete, e.g., products, services, and interactions.  In additions what patients receive for a standard market offering. The Blue Ocean analysis will  enable KUISHI SMART to have clarity re: where competitors are investing today and how patients  receive (or do not receive) value from other healthcare providers. Therefore, the Blue Ocean  analysis will provide the following information about how to focus on patients or clients’ satisfaction: 

• Increase value of NCDs prevention and management through affordable and successful dietetics and healthcare services and behavioral interventions 
• Discovering uncontested markets due to the increased prevalence of NCDs and the  resulting health, social and economic burden on individuals which the country does not have qualified and competent providers in dietetics care and behavioral interventions 
• Unblocking new demand (increase the market size demand) for affordable dietetics care  and behavioral interventions that decrease the usage and cost of drugs
• Making the competition irrelevant by the organization’s ability to hold unique expertise  in delivering evidence-based and safe dietetics care and behavioral interventions at  affordable costs. 

I will argue that KUISHI SMART is an organization that is creating a Blue Ocean strategy for  dietetics and healthcare will be less about what patients or clients need and more about what  patients or client do not need. It will be about eliminating waste and removing what is not necessary  or required for a dietetics and healthcare interaction. 

Value is “created by a business operating together with its consumers and suppliers”. In the context  of KUISHI SMART, the value creation is to address NCDs related to unhealthy food, behaviour  and lifestyle that has occurred because of the population’s health and nutrition status changes.  Therefore, value add that KUISHI SMART adds to the healthcare and foodservice sector value  chain is dietetics and healthcare services that address the risk factors and underlining root causes  of NCDs.