In Kilifi County, along Kenya’s coast, deliveries are increasing but sadly so are maternal and neo-natal deaths, partly attributable to poor access to affordable skilled assistance before, during, or after delivery. The Kilifi County Health Office is determined to address this and has committed to increasing skilled delivery from the current sixty-nine percent (69%) to seventy-five percent (75%) by March 2017.
Relying on credit or borrowing money from family or friends to pay for healthcare treatment is all too common for many of Kenya’s 8 million informal sector workers, known as the Jua Kali sector. They are further affected by the ‘poverty penalty’, having to pay multiple times for healthcare from progressively more expensive and formal service providers as the initial lower-cost services from informal operators did not properly diagnose and/or treat the illness. That is all changing thanks to the introduction of Afya Poa.
“The first thing I saw was the Doctor’s white shirt and her black jumper,” explained 23 year old Ruth Wangari. “I just could not believe it I was so, very happy that my mother and I danced together to celebrate,” she added with a beaming smile.
PSP4H is partnering with GlaxoSmithKline (GSK) to facilitate marketing an innovative low-cost medicine to low-income asthma sufferers in Kenya. Launched as part of GSK’s year 2020 vision to increase access by ensuring affordability, the new medicine targets Kenya’s underserved low-income mass market. PSP4H research is enabling GSK to better reach and serve the needs of this target market.
Pharmacies are the first point of contact for the majority of Kenyans seeking healthcare. Yet, consumers cannot be confident in the quality, authenticity and value of the medicines they purchase. To combat the problem, Pharmnet, a network of quality-assured pharmacies owned by members of the Kenya Pharmaceutical Association, is piloting an innovative franchise and group purchasing business model developed with technical assistance from PSP4H.
Poor customer care means lost wages for patients through long waiting times; in the worst-case scenario, patients avoid seeking healthcare altogether. Already recognising that these factors were reducing the efficiency and quality of healthcare service delivery at Kisii Teaching and Referral Hospital, County Health Minister Dr Sarah Omache was keen to implement change by bringing a private sector customer service model to the public sector.
AfyaPoa (Cool Health) is an innovative mobile money-enabled micro health insurance and health savings product offered by local company Jawabu Empowering Services and designed to meet the needs of Kenya’s 8 million informal sector workers. With little daily disposable income to cover the cost of essential items such food, transport and mobile phone airtime, the majority of Kenya’s Jua Kali workers do not carry health insurance.
Maternal mortality in Kenya remains high, whilst over 38% of deliveries take place at home. This is because there is a lack of access to affordable, skilled delivery services appropriate to social and cultural needs of low-income communities. Fountain Africa’s network of private community midwives in Bungoma County fills this gap, offering affordable pre-natal and maternal healthcare.
City Eye Hospital, Nairobi, is pioneering a unique model to deliver eye care for low-income patients, the first of its kind in Kenya and possibly the whole of sub-Saharan Africa. PSP4H is facilitating City Eye Hospital to pioneer an assembly-line style of eye care delivery for Kenya’s low-income communities, complemented by a cross-subsidy business model.
In Kenya it is common knowledge that private medical clinicians often lack business skills. This knowledge gap has come about because medical training institutions in Kenya do not offer business management as part of the curriculum. It is this systemic issue that PSP4H is addressing, through development and facilitation of an innovative business skills training programme piloted through Population Services Kenya and their for-profit Tunza Family Health Network.
Successful market systems pilot programs are relatively common whereas those that reach scale, the acid test of systemic change, are rare. Theoretical literature explains what scaling up means, how it should take place and the underlying changes it can lead to in bringing about a better-functioning market system. However, documentation is sparse on how scaling up actually occurs in practice as a result of market systems interventions. This brief case study documents one such case from the healthcare sector in Kenya.