Center for Health Market Innovations (CHMI)

Programs

K-MET Post Abortion Care Network

last updated Jul 9, 2012

Overview

Implementing organization: 
Kisumu Medical and Education Trust (K-MET)
Legal Status: 
Year Launched: 
1996
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Out-of-pocket payments
Additional Source(s) of Funding: 
Donor, Membership/subscription fees

Scale

Personnel Employed: 
100<
Number of Clients Served: 
15,000 (2011)
Number of Facilities Operated/Networked: 
350 (2011)
Summary: 

Kisumu Medical and Education Trust (K-MET) provides post-abortion care through a network of over 300 reproductive health providers (clinicians and nurses) in western Kenya. The initiative, titled PACNET, operates in five of the eight Kenyan provinces and aims to integrate health care, especially reproductive health services, into the core community development activities.

Program goals/rationale: 

K-MET aims to promote development of under served communities through innovative health and education programs.

Key program components: 

The post-abortion care network (PACNET) actively recruits and trains providers, both physicians and mid-level providers (clinical officers, nurses), in 5 of the 8 provinces in Kenya: Nyanza, Western, Eastern, Rift Valley and Coast. KMET pioneered training in use of manual vacuum aspiration (MVA) in 1995 as a safer, effective, and more accessible alternative to the traditional surgical dilation and curettage (D&C) procedure. Training providers in MVA, has increased the accessibility, affordability, availability and acceptability of PAC for thousands of Kenyan women and has saved countless lives. K-MET currently has over 300 providers enrolled in its PAC network (PACNET) which is still growing.

Members in the network must meet facility standards for cleanliness and privacy, and must pay membership fee of US$116. In exchange, they receive training, some clinical equipment, regular delivery of contraceptive supplies, and low-interest loans for facility improvements.

K-MET launched RLF (Revolving Loan Fund) to improve its value proposition to members and to help sustain its core activities in four provinces by becoming the only medical-based social franchise in Kenya with a microfinance component. The model makes small loans available to network members, enabling them to improve their clinics (purchase beds, drugs, lab equipment, and other medical equipment; paint and renovate; and purchase furniture and fittings) and services to meet K-MET quality standards. The RLF has disbursed $294,538 to 31 formal service providers and 441 community-based service providers. To cope with increased demand from members, strategies are in place to widen the financial capacity of RLF through fundraising.

  • Microfinancing mechanism. K-MET obtains a primary loan at a subsidized rate of 5%, which the central coordinating agency disburses as secondary loans (ranging from $2,000 to $10,000) at a marked-up rate of 10%–20% to each primary care service provider. Interest payments cover 90% of administrative costs.
  • Self-financing mechanism. The central coordinating agency has a vested interest in the economic viability of each primary care provider and in collecting payment from providers, so that it can pay off the primary loan.
  • Cost-sharing. New network providers are responsible for their own transport, accommodation, and half of training tuition; K-MET covers all other expenses.
  • Quality assurance measures. K-MET leverages the financial relationship between network members and the central coordinating agency to enforce provider compliance with agreed quality assurance measures and required outreach to the poor.
Program history: 

Created in 1995, and driven by a vision of communities with accessible, quality reproductive health services where every child is wanted. KMET hopes to promote development in under served communities through innovative health and education programs. In addition to post-abortion care, K-MET's programs offer clinical services, home-based care, nutrition, microfinance, and youth-for-youth programs. KMET staff act as reproductive health consultants in several sub-Saharan African countries.

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