Eighty five per cent of the health market innovations in Kenya rely heavily on donor funding. Six per cent rely on out-of pockets funding while government-funded projects accounted for only 1%. These findings are based on an analysis done by the Institute of Health Policy Management & Research (IHPMR) of 151 innovations in the country. The findings were released at a forum held at the Fairview Hotel in Nairobi on 27 September 2011. The forum brought together key stakeholders in the health sector, including donors and government officials, to promote efforts towards the scale up of the health market innovations in Kenya. A couple of key takeaways from the forum are below.
Sustainability of heavily donor dependent initiatives. While donor funding plays an essential role in supporting the testing of ideas, it is important to have sustainability built into the design of innovations to ensure that programs continue to run when donor funding runs out. Strategies proposed for achieving this include implementing interventions that can be executed using locally available resources and capacity.
Government has a major role to play in creating enabling environments for innovations. This can be done by developing a health innovation agenda, providing favorable platforms that allow airing of ideas, enforcing of intellectual property rights, and establishing the culture of innovation among all citizens.
Fostering strong public-private partnerships (PPPs). PPPs between health organizations with similar objectives, mission and vision could also be an effective way to create sustainable health market innovations. The adoption of Private, Public and Community Partnership (PPCP) models was also proposed. New PPCPs ensure sustainability by mobilizing local communities as active participants from the onset so that they do not ignore or sabotage the innovations.
Unlike the public sector, private sector implementers have mastered the art of engaging the market through research. Engaging the health market, evaluating its feedback and conducting implementations based on them is crucial to getting sustainable solutions that are realistic in terms of the health needs of the local people.
89% of the identified health market innovations are oriented towards behavior change and only 19% deal with regulating performance of key players in the health sector. The behavior change interventions are applied mainly in programs that focus on HIV/AIDS and maternal health. Participants expressed that while these two health areas are a priority in the Kenyan system, a paradigm shift to programs aimed at regulating performance should be embraced by implementers because this is where the greatest impact can be made. Regulating performance targets policy makers, thus increasing the likelihood sustainability.
Top of the mind health market innovations mentioned by participants include social franchising programs such as AMUA operated by Marie Stopes in Kenya, financing healthcare initiatives such as the NHIF providing services to the informal sector e.g. Matatu operators, programs operated by social/ community groups such as churches, and the Stop TB programme.
A participant noted that whereas the above mentioned examples are innovative, the health sector is yet to see a big bang innovation such as the MPESA money transaction system that is currently being used by over 6 million subscribers.
A presentation made by Dr. Allan Mulengani, an Associate Professor at Strathmore Business School, made a distinction between creativity and innovation. Creativity involves coming up with ideas and is solely displayed by individuals, innovation involves the capacity to bring those ideas to life, and happens only in an organizational environment. Innovation happens when creative ideas are transformed into activities; up-scaling is the responsibility of the beneficiary. The potential for scaling up is exploited by those who see the benefits.
The topic of health market innovations drew specific interest from funders. Funders are interested in programs that are ready for commercialization and looking for investment to facilitate this.
IHPMR indicated to participants more forums will be held in future. Topics proposed for future forums include:
- Role of Public Private Partnerships in Health Market Innovations
- Creating an enabling environment for health market innovations
- Co-opetition between the public and private sector in health market innovations
- Innovations in human resources for health