The Center for Health Market Innovations (CHMI) traveled to Umoja, Kenya in April to meet with Penda Health, a for-profit social enterprise that aims to provide high-quality primary healthcare services for hard-to-reach populations in Kenya, with a slight focus on women’s health.
We had a chance to chat with Therese Kagwe, Penda’s Happiness Officer, who was able to shed some light onto Penda Health’s mission, operations, and patient experience.
RN: Patient experience is core to the Penda model, and your job is a big part of that. What does it mean to be a Happiness Officer?
TK: My job is to ensure we find ways to ensure the best patient experience. Whether it’s giving children balloons or asking for client feedback, we want to make sure patients come back to receive our services, and we are always looking for new ways of doing that. The other thing I do is find ways to make sure our staff is happy, because everyone needs to be happy with Penda. When you are happy at work, you will be happier with the client!
RN: How can you ensure that everyone, from patients to staff members, are happy?
TK: The most recent thing we did was work with our receptionists, who we call clinical coordinators. I developed a module on how the clinical coordinator can work with the client from the moment they walk in the door—ensure that they have some water, see what their needs are and find ways to support them. If our client comes in with a cough, we will give them some honey or make them some tea to help soothe their sore throat. If the client is very sick, we will allow them to lie down while they wait for the doctor and then the provider will come to them directly.
RN: How does Penda work with providers to ensure quality and boost job satisfaction?
TK: On the provider side, we are always trying to figure out how we can make them happier. Can we give them more training? What about salaries and benefits? We want them to be happy [about the services they provide for their clients] The most amazing thing you find is that when you ask providers what they like most about their job, they like the client feedback calls. Every provider calls the client after three days to find out how they are doing. If they are not doing well…or if they went to another facility, we try to find out why. When [providers] hear that their clients are better, they realize they have such power over the clients and power over what they do, and that they are really helping the clients. It’s very motivating.
RN: Can you describe the relationship between providers and clients? Are they able to build a sense of trust and camaraderie together?
TK: Our providers have their loyal clients; we have one provider in Kitengela who gets his clients from very far away! They always travel to Penda and ask for him. That is amazing—and it’s all because of that relationship they build with the clients. One thing about Penda that is really important is teamwork. It doesn’t matter what you do in the clinic, even if you are a cleaner, your job is recognized. Everyone knows what everyone does and helps support one another for the wellbeing of the organization and our clients.
RN: Can you tell me about the average patient, or average family that you serve at Penda? What is the target client base for your services?
TK: Because of our location, we see a lot of small children and young families. The people who seek healthcare are antenatal mothers, their children, and also quite a few men, particularly the husbands. Women are the major decision makers when it comes to the health of the family, and that’s why Penda decided we cannot just see the women. We also need to see their children and their husbands. Now, we even see men bringing their children to Penda on their own!
RN: What are the “competitors” in the two markets (Kitengela and Umoja) that you serve? If Penda wasn’t there, what options would those families have (i.e. public facility, pharmacy)?
TK: A lot of people will end up in pharmacies when they get sick. A new client will come in and say, ‘I’ve been treated for Typhoid 3-4 times and it’s not getting better!’ That happens a lot—clients will go somewhere else first. For example, they get a fever, so they go buy malaria medicine because to them, a fever is indicative of malaria alone. There are a lot of other facilities in Umoja of varying quality. One of the ways we work is that we don’t push drugs or lab tests on our clients. We will tell you how much it costs, and you have a choice. A lot of facilities around don’t do this with patients because they are not accountable—they charge the patient 3000 Ksh for something, and for our clients, that can be very hard to pay. Our consultations are between 100--300 Ksh, which is much lower than the average market cost in this area. We rely heavily on our volumes to support that lower cost, so repeat customers and quality is key. When a patient comes to Penda, spends less than 500 Ksh, and gets better - that is our patient for life.
RN: Can you share some stories of patient feedback you receive?
TK: A woman I met the other day told me that she came to Penda on her own at first, and now she brings her entire family. She said, “I brought my mom, I brought my dad, I brought my children—everyone comes to Penda, we all have files here now!” We have another patient who moved three hours away and still comes to Penda because they are so happy with the services.
RN: Penda recently participated in CHMI’s primary care leanring collaborative and helped co-write the Innovator’s Handbook. How has the Handbook shaped the work of Penda’s staff at the clinics?
TK: I’ll share an example. Just the other day, we had a meeting at Penda to discuss our plans to open a third clinic. Having read the Handbook, I recognized how to choose a new location. For example, it should be facing a road in an area where young families, similar to our current location in Umoja. Reading the Handbook made me feel like we can collaborate—there are other clinics similar to Penda doing what we do, and they are so creative! It was really eye opening for me to learn that.
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