Last week’s Database at a Glance: Kenya Part 2 focused on how insurance programs in Kenya are shielding the public from catastrophic health expenditures. This week, in Part 3 of our 3 part series, we’re looking at how Kenyan health service networks profiled in the CHMI database are reducing fragmentation and informality in the healthcare system.
Creating health services networks to reduce fragmentation and informality of health care delivery
As part of the devolution process, the Kenyan government is focusing on policy formulation, target setting, monitoring and evaluation, and divesting some portions of health service delivery. As a result, the opportunity for the private sector to play a role in health service delivery has increased. To compete for these opportunities, many private delivery organizations are becoming licensed and accredited to ensure consumers they are receiving quality care, and forming health service delivery networks to reduce the fragmentation among health care providers.
In Kenya, 35 of the 187 programs profiled focus on innovative ways to organize delivery of health care and reduce fragmentation.
- 19 of these programs are health service networks
- All 19 programs operate with a parent organization
- 15 of these networks are located in rural communities
- These networks are largely focused on HIV/AIDS or MNCH work.
The North Star Alliance Roadside Wellness Centers (RWCs) are public-private partnership programs that establish a network of roadside health clinics at major truck stops and border crossings in Africa, India and Asia catering to drivers, sex workers and the communities with which they interact. In Kenya, the Alliance set up its first center in Mombasa in 2009, and since then has expanded to six centers located at borders and truck stops all over the country.
The Alliance works with national and regional transport sectors and health authorities to identify HIV/AIDS hotspots along major transport corridors. Working with local partners and policymakers allows the program to leverage an even broader private sector response to HIV/AIDS programming by encouraging other private sector companies (e.g. FMCG, transport, distribution and courier companies) to support the RWCs project financially or in-kind.
Nairobi Slums TB Project is organizing community health workers to identify tuberculosis cases in the slums of Nairobi,in order to improve prevention and care. Before the program was established, TB testing sites were too far and testing too intensive for workers to afford the transportation or time off work.
The program has equipped 10 MOH health clinics across Nairobi to immediately test, diagnose, and treat TB.Maltesar Intl, the non-profit organization that runs the program, relies on a team of 60 volunteer Community Health Workers, who are given small incentives such as lunch and transport money. WhenTB patients are too ill to get out of bed and attend the clinics the CHWs care for them at home.
The project has been successful and the government has adopted the CHW model for its own clinics and projects. To date, CHWs have traced and screened 723 smear positive TB contacts, and referred and linked 800 of the TB patients with other partners to assist them with additional needs.
Devolution provides an enormous opportunity for improving access and equity in the health care sector. The challenge facing Kenya now is to capitalize on the increased role of the Kenyan counties in delivering health services and push for reductions in maternal and infant mortality, reduce the burden of non-communicable diseases, and in achieving Universal Health Coverage.
Vision 2030, the ongoing dialogue around utilizing public private partnerships, and the establishment of the Health PPP Council are strong indicators of the government’s interest in engaging with the private sector. Civil society organizations, policymakers, innovators, and funders should find a way to engage with one another to jointly address these health challenges and leverage the significant numbers of health market innovations that have surfaced in Kenya to help meet the health needs of its large and diverse population.
CHMI in Kenya
Africa Capacity Alliance (ACA) improves health outcomes by building the capacity of individuals and institutions across Africa. ACA specializes in capacity building, training, information sharing and advocacy. ACA supports capacity building for Public Private Partnerships primarily through PPP-focused trainings, knowledge sharing platforms and advocacy activities. ACA achieves exponential impact through its extensive network of 37 Member Institutions across 12 countries. ACA members include International NGOs, National and Local NGOs, Management Institutions and University Departments. ACA’s members have diverse technical expertise and recognized competencies in improving health outcomes through their capacity development programs. Each has significant reach across the health sector within its own country and throughout the region.
Image: A North Star Alliance Roadside Wellness Clinic in Emali, Kenya.