With a population of over 40 million people that is expected to double by 2050, providing health care to the mothers and families in Kenya is a growing challenge. Lately there has been great interest in the social enterprises in Kenya working to bring impactful change in health care and development to the poor, while also turning a profit. The Kenyan Government, meanwhile, is eager to partner with successful organizations to transfer lessons learned from private organizations to the public sector. As reported in our latest Database at a Glance: Kenya, the Kenyan government is moving towards decentralization of services, and has identified a number of partnerships that improve the quality of care. Despite a strong commitment, however, Kenya’s private sector health market remains both highly fragmented and crowded with a plethora of smaller- scale providers. This makes it challenging for the government and other stakeholders to identify promising models that are adaptable for future investment or new Public Private Partnerships (PPPs).
Within this context, CHMI’s East Africa partner, Africa Capacity Alliance (ACA) saw a need for a facilitator that could bridge the gap between the government, private sector innovators, and other stakeholders such as international donors and impact investors, that are all working towards positive MNCH outcomes in Kenya. Drawing on the 200 Kenyan programs profiled in the CHMI database (57 of which are MNCH programs) and their extensive government connections, ACA (Africa Capacity Alliance) has been pioneering work to bring these stakeholders together, aiming to form new PPPs to solve priority challenges in MNCH.
Innovator-Policy Maker Roundtables
On November 27th 2014, ACA led the first of a series of four roundtables to discuss government partnership with the theme: “Strengthening the Health Market Ecosystem in Maternal, New Born and Child Health (MNCH) through Innovations in Kenya.” This series of roundtables aims to among other things, create necessary dialogue between various private sector stakeholders (innovators, investors, development partners) and policy makers on effective strategies for integrating MNCH innovations to support achievement of the Health Policy 2012-2030 goals.
Dr. K. Gakombe, CEO of Metropolitan Hospital in Nairobi and a private health care entrepreneur, notes that “Partnerships are not easy: we will however not make meaningful outcomes to our people’s health – which is what we have all set out to do – without engaging in a structured way, albeit each of our (innovators, government, investors) has different approaches.” Participants at the first roundtable were invited to share real life experiences, challenges, and opportunities related to their work in the public and private sectors.
Speakers included ACA’s Executive Director Ms. Kristi Maasjo; World Bank’s International Finance Committee (IFC), Dr. Njeri Mwaura; ANDE, East Africa Chapter Coordinator Ms. Mary Mwangi; Acumen’s Christine Kapkusum, and representatives of the County Health Departments. Innovators and investors invited to the roundtable included Moka Lantum of Zidi MicroClinic Technologies; Faith Mungai of Jacaranda Health; Sam Agutu of Changamka; Annie Robets of Open Capital Advisors and Carrie Ngongo of Grameen Foundation.
Stakeholder Perspectives on PPP’s for MNCH
Representatives from the World Bank’s IFC, and the Kenyan County Health Departments spoke on the challenges and opportunities to partner with small and medium-size private sector organizations. Key success factors for effective PPPs in health included the need to identify common approaches to health priorities and open discussions between all stakeholders.
From an investor’s perspective, the challenge is in knowing exactly how to execute a PPP, as pointed out by ACUMEN’s Christine Kapkusum. For many investments the focus on volume is key: investors seek partnerships that can ensure delivery of high quality services and goods to the maximum amount of people at the lowest cost. At the same time, many investors want to commit higher volumes of funding, whereas many small health enterprises can only absorb lower funding envelopes.
During the breakout sessions at the roundtable event, government officials and innovators identified and prioritized the challenges of specific counties in regards to MNCH. The highest priority challenge identified was “the improvement of health seeking behavior of expectant mothers through technology,” followed by “aggregating and presenting health information on health service delivery and improving information management.” Participants identified future suggestions for improved MNCH delivery that are appropriate for PPP formation, including training programs tailored to local settings, and public-private inter-facility exchange.
One program recognized as a problem-solving PPP is Jamii Smart, a multi-stakeholder mHealth program working in partnership with government, NGOs and Safaricom, the largest telecom provider in Kenya. CHMI and ACA have recognized Jamii Smart as a “one-stop innovation shop” that is already placed to meet the priority challenges identified. This multi-phased program features data collection and health information dissemination at the clinical and community level, and is currently implemented in Bamba by World Vision and Busia by Amref. Jamii Smart’s long term goal for Kenya is to achieve national scale of mHealth initiatives for MNCH, with a target of 6 million mothers and their children.
Want to get involved?
ACA will hold three more roundtables in 2015. Discussions hosted by ACA aim not only to further the conversation on PPPs and the scale-up of innovation, but also provide active networking space for county officials, innovators, and investors. The second roundtable, to be held in February 2015 at a side event during the Sankalp Forum, will focus on the major challenges of MNCH delivery and awareness, and encourage policy makers and innovators to brainstorm creative solutions. Are you a program or stakeholder working in Kenya? For more information about participating in a roundtable or getting involved in CHMI East Africa, contact Lucy Nkirote at Lnkirote@africacapacityalliance.org.
Photo: ACA and CHMI launch the Center for Health Market Innovations in Kenya in 2011.