Establishing standard coding for medicine in Kenya
The ICT and Data exchange sub committee had an engagement with Prof. Francis Ndemo of University of Nairobi (UoN) and Pharmacy and Poisons Board (PPB), on 4th April 2019, at Kenya Healthcare Federation (KHF) offices, to discuss and understand the development of standard codes for medicines. In his opening remarks, Prof. Ndemo informed the meeting that the Ministry of Health is interested in monitoring usage of drugs in the country through a track and trace solution from point of entry to patient.
In addition, Prof. Ndemo indicated that Medication Therapy Management (MTM) is a needed process in optimizing benefits of medicines. MTM ensures that drugs prescribed are the most appropriate, most effective, are safe and that the patient is compliant. “This can only be done when one has the proper documentation. The good thing is that there is a collaborative effort between the physicians and the pharmacist and this has improved clinical and economic outcomes” he added. Prof Ndemo emphasized that the uniform coding is key. “We should try and learn from the American coding system which has proven to reduce errors.” Prof Ndemo. The data exchange committee shall continuously engage Prof. Ndemo and other players inorder to come up with a standard medical classification position.
Reshaping Health Workforce Mentorship
Medixus are excited to join the KHF community. Medixus is an app that aims to revolutionise the way medical expertise is shared and developed across the continent by providing a digital platform for pan-African peer support and collaboration. It provides a tool for sharing best practice between individuals, hospitals and regions. In addition, it allows healthcare workers to connect with specialists across all fields for support and advice on specific cases, empowering them to make the best clinical decisions in the field. Lack of support and mentorship is one of the most-cited reasons for healthcare professionals leaving our continent, contributing to a growing deficit of 2.4 million workers in the field across the continent. Often the distance between doctors and their peers means that their physical support networks can be limited. Medixus provides a community focused on disease burdens and treatment pathways relevant to those in the field, reducing professional isolation and improving quality of care through ongoing professional development.
The sparsity of specialists means that sending patients for consultation is costly, time consuming and can be simply inaccessible to most. Medixus provides access to a database of consultants and mentors, as well as secure uploading and sharing of case notes. This will improve local access to specialist knowledge and has the potential to save lives. Medixus is a team of medical professionals and software developers based in Nairobi and London, who firmly believe that the most pressing issue facing African healthcare is not a lack of skills and knowledge, but a lack of enough healthcare workers remaining on the continent. The team is headed by founding team Nicole Kayode, Rita Mantler & Dr. Jean Kyula.
Nicole recently was interviewed by the Daily Nation and Business Africa Online We are looking to connect with healthcare providers and individual doctors, feel free to reach out if you would like to learn more – email@example.com So far doctors using the platform have said: “A fantastic site to share information and exchange ideas and knowledge.” and “It is a good platform for networking with good clinical cases and will only get better as the following grows”
KHF Supply chain committee to engage KEMSA on UHC pilot supply chain
The supply chain committee of Kenya Healthcare Federation met on 19th March 2019 at KHF offices to outline the 2019 focus areas. The meeting was chaired the committee vice chair, Dr. Chris Masila and the committee director Dr. Anastacia Nyalita. In her opening remarks, Dr. Nyalita updated the committee that the Pharmacy and Poisons Board (PPB) has submitted the draft rules on regulation of parallel importation to the Ministry of Health (MoH) The Supply Chain Committee through Ministerial Stakeholder Forum has been advocating for the promotion of local manufacturers. This discussion has been taken up by Dr. Fred Matiangi’s team working under Kenya Private Sector Alliance (KEPSA) and together with Kenya Association of Manufacturers (KAM), there has been much progress made although the outcome of the discussions have not been released.
During the supply chain committee discussions, it emerged that the exact role of supply chain in the Universal Health Coverage (UHC) pilot counties was not clear, therefore the committee agreed to schedule a meeting with Kenya Medical Supply Authority (KEMSA) to gain insights into KEMSA’s role. Dr Nyalita updated the committee of the move by National Quality Control Laboratory This move will create monopoly in analysis leading to lack of efficiencies and cost effectiveness.
Mr. Kevin Saola from Nestle Kenya informed the meeting that international trade has been experiencing barriers especially in the East Africa. “an example of current trade barrier between Kenya and Tanzania where locally manufactured products must undergo bureaucratic, Tanzania Bureau of Standards (TBS) regulations. This has marked an increase in costs leading to poor competition.” Mr. Kevin Saola, Nestle.The committee’s focus areas for the year 2019 include: engaging KEMSA on UHC pilot counties’ supply chain, engage the NCQL board and the Ministry of Health on regulation and importation and engage the Ministry of Trade and EAC on export restrictions of Kenyan products Tanzania Bureau of standards.
Enhancing safety in the working environment
Kenya Healthcare Federation held the second members meeting at ParkInn hotel in Westlands, on 21st March 2019.The meeting was sponsored by Global Fund/Kenya Coordinating Mechanism(KCM).The goal of Global Fund/KCM is to dramatically increase resources to fight three of the world’s most devastating diseases(Tuberculosis, HIV &AIDS and Malaria)and to direct those resources to areas of greatest need The themes for the Global Fund strategy are: Innovative approaches to meet diverse country needs, strengthening systems for health is critical to attain universal health coverage and to accelerate the end of the epidemics, Increased programmatic and financial resources from diverse sources are needed to accelerate the end of the epidemics and Promoting and protecting human rights and gender equality is required to accelerate the end of the epidemics
The Key goal of KCM is to mobilize funds from The Global Fund for HIV/AIDS, Tuberculosis and Malaria programmes and to coordinate and evaluate implementation of the Global Fund grants. With the support of the Global Fund and other Partners, the MoH initiated and sustained over 1million adults and children living with HIV on ARVs. Global fund prides itself in the remarkable achievements including: Over 15 million Long Lasting Insecticide Treated Bed Nets distributed & Malaria Case Management supported, Reduction in malaria prevalence from 11% in 2010 to 8% in 2015, TB Medicines provided to over 900,000 Patients and Services for HIV, TB and Malaria are provided to all Kenyans at no cost in all Public Health Facilities.
The meeting was also graced by Mr. Antony Wahome, chairman, national gun owners association of Kenya, his major focus was to inform and sensitize the health workers on how to handle armed patients to protect themselves and the patients as well. He emphasized on internalizing the law of fire arms and how to safely handle fire arms. Dr. Amit N. Thakker, chairman, Kenya Healthcare Federation, emphasized on a call from the cabinet secretary, ministry of health, Mrs. Sicily Kariuki, for joint efforts with the private sector towards fighting corruption and fraud in the health sector especially in the supply chain, with a major focus on pharmaceuticals.
“Private health sector should have code of conduct!”
“Private Health Sector should have code of conduct that govern its operations!” This was a call by the Cabinet Secretary, Ministry of Health, Hon. Sicily Kariuki to the private health sector to come up with code of conduct that will govern the way the private sector operates. The CS said this during the 10th Ministerial Stakeholder Forum, which was held on 27th February 2019. She said this while addressing the issues of Human Resource for Health, where she noted that most of the private health sector usually employ health workers whose contract has been terminated on disciplinary grounds or irregularities from the public sector. The code of conduct should also address this and the private sector be sensitized against hiring such personnel.
The Public Private Partnership Committee of Kenya Healthcare Federation (KHF), held their first meeting at KHF offices on 20th March 2019 to discuss and outline 2019 focus areas. There was a unanimous agreement that the committee will tap into Kenya Private Sector alliance (KEPSA) Resources and work closely with KEPSA to crystalize clear requirements for drafting the code of conduct.
Other committee’s focus areas for the year 2019 include: Mapping out PPP areas in the counties through a comparison of the various studies done by stakeholders and map out gaps identified, act as the private sector’s focal point of advisory and delivery of the Global Fund, and Draft a position paper on bureaucratic challenges facing the Private Sector regarding involvement in Universal Health Coverage (UHC) implementation at the County level. The committee will also work with other committees on their findings on UHC in the 4 pilot counties. The committee will review the PPP Act document and its restrictions to the PPP at the county level.
Kenya Healthcare Federation to engage the NHIF reforms panel
The Healthcare Financing committee(HCF) of Kenya Healthcare Federation held their first meeting for the year 2019 on 12th April 2019 at KHF offices. The meeting was chaired by the committee director Dr. Walter Obita. HCF committee is mandated to oversee the UHC discussions and planning and it’s also the backbone of UHC from the private health sector. National Hospital Insurance Fund (NHIF) is currently undergoing reforms and the Cabinet Secretary, Ministry of Health, Mrs. Sicily Kariuki, appointed a panel to look into recommendations toward reforming NHIF. KHF through HCF committee needs to have proposals towards reforming NHIF.
The committee met the NHIF panel and presented recommendations from the private sector to the NHIF reforms panel in restructuring and reforming NHIF will included; NHIF recommendations should cover its structure, operations, legislation, accreditation, reimbursement framework, quality of care, its core mandate and role of other stakeholders, there should be a system that monitors the financing of health programs to avoid overlapping and thus save cost. Healthcare providers claim for the same service from NHIF, private insurers and Non- Govermental Organization(NGOs) financing these programs, In order to achieve Universal Health Coverage( UHC), NHIF need to promote cover of non-contributors who are the poorest and cannot afford to pay, there is need to track the NHIF recommendation and reforms by the panel because part of the NHIF reforms also includes how NHIF will implement UHC when it rolled out to the other 47 counties, NHIF management structure and governance needs to be competitively recruited.
The composition of the NHIF board which is in the NHIF act should be stronger with wider stakeholder representation including private sector, the private sector insurers reimburse their members based on use of their medical benefits. NHIF focus on provider payments instead of member benefits this opens a channel for corruption. KHF advocate for NHIF to change from focusing on provider payments to member benefit, NHIF should increase the efficiency, speed and transparency of processing claims as well as change their way of administration. Need to redefine the core mandate of NHIF, NHIF accreditation tool was designed for hospitals only. Different levels of care should have their own accreditation tool so that level 2 and 3 health facilities are given the chance to offer primary care, there should be a key focus on quality of care offered in health facilities Incentives on performance-based financing focusing on outcomes needs to be put in place. KQMH should be the minimum standards used across all health facilities,
the capitation rate set by NHIF is also on provider focus and not member focus. The capitation rate was poorly calculated and the annual amount 1,200/- that includes all drugs, laboratory
covers, consultation etc. has promoted provision of lower quality out patient care.
KHF directors and health care financing committee met with the NHIF panel and discussed the above recommendation. As a way forward the committee was requested to Share any accountability mechanisms for NHIF that has worked in the private health schemes e.g. fraud prevention, e-Governance, Be specific on the sources of funding for NHIF as elicited on NHIF on how to increase the resource pool, share any data on health insurance that we may have for NHIF review. Share ways of improving the ecosystems as an enabler for NHIF e.g. the Healthcare Finance Strategy, any legal reforms, how to make NHIF more prominent in the Primary Healthcare space. It was agreed that all the information collected from the private sector will be discussed by the panel and feedback shared to the private sector.