Nicole Spieker is Director Quality of PharmAccess Foundation, based in Amsterdam, the Netherlands. PharmAccess is a Dutch not-for-profit organization dedicated to the strengthening of health systems in sub-Saharan Africa. Working with local public and private partners, PharmAccess’ mission is to create access to affordable, quality healthcare for low income groups. This is achieved through the introduction of standards, the creation of health insurance systems, the provision of affordable loans to private clinics, medical and administrative capacity building, HIV/AIDS and healthcare workplace programs, and learning and analysis through operational research. She launched the SafeCare Initiative, started in 2010 by the PharmAccess (Netherlands), the Joint Commission International (JCI, U.S.A) and COHSASA (South Africa). The SafeCare approach is based on internationally acknowledged (ISqua) quality standards and dissects the improvement process of healthcare providers in survey-able, measurable steps. Currently she is leading the digital innovation agenda of PharmAccess in Kenya. At the core is the M-TIBA mobile health wallet, developed by PharmAccess, CarePay and Safaricom, which allows users to send, save and receive dedicated funds to access healthcare services using their mobile phones. It is a closed loop where these conditional funds can only be used for healthcare costs at selected providers. This is a first step in creating new digital solidarity mechanisms where people start paying for each other. The rich for the poor, the sick for the healthy, communities for an individual. M-TIBA will accelerate a transformation in the healthcare market in sub-Saharan Africa. The national roll-out of M-TIBA in Kenya is now underway, with 300,000 people already registered and 300 healthcare providers signed up in Nairobi and Central.

We envision compassionate + high-quality health systems that achieve better societal outcomes at a better cost. We are a collective that unlocks the value of compassionate + high-quality care for care-seekers, providers, and payers in Ghana, India, Kenya, South Africa, and beyond. I serve as one of six principals who lead the Leapfrog to Value collective.

Reporting to the Chief Executive OfficerResponsibilitiesAdministrative and Operational Director of the inpatient and outpatient clinics, Operating Theatres, Pathology, Radiology, Dental, Renal unit, Physiotherapy, medical records, support services and any special projects.Key tasks: to develop and foster effective collaboration between clinical support departments, medical staff leadership, faculty and other affiliated services (inside and outside of the hospital) to ensure an integrated approach to providing services, and fulfilling the hospital's diagnostic, clinical, research and educational goals and objectives.

In charge of the Clinical Pathology department responsible for daily management of 24 technicians and support staff as well as the small laboratories at the upcountry primary care centers. The laboratory provided haematology, biochemistry, microbiology, immunochemistry and histology tests. With a high number of HIV cases in the hospital HIV related tests (e.g. CD4 counts) were a key area of the laboratory. Other responsibilities:1. Setting up and maintaining SOPs for all laboratory tests according to ISO9001 standards.2. Implementing and maintaining QC standards for all laboratory tests3. Preparation of laboratory for ISO 15189 accrediation. This was a collaboration between the Aga Khan Hospitals of East Africa.4. Developing new diagnostic tools5. Setting up training courses for laboratory staff6. recruitment of new staff.

Lecturer at the faculty for Family Medicine of the Aga Khan University.

Employed as part of the IOP Genomics initiative of the dutch government. The project involved the investigation of Wnt signalling during early development and its role in tumour formation. I was responsible for managing the animal facility of the group I worked in and supervised all related administrative issues including the permits needed by the government.