Kenya Healthcare Students Summit
Kenya Healthcare Students summit (KEHSS) held it’s annual conference themed “Towards a Multidisciplinary Approach for the achievement of Universal Health Coverage (UHC) in Kenya and Africa” on 8 – 9 February 2019 at United States International University, Nairobi. The Kenya Healthcare Students Summit is a conference that brings together healthcare students and interested professionals from all over Africa. The conference aims at building capacity of Kenyan and African healthcare students on matters pertaining to UHC as well as equip them with the necessary soft skills needed in their future profession as healthcare practitioners.
In his opening remarks Dr. Githinji Gitahi, CEO Amref Health Africa and UHC 2030 co-chair emphasized that UHC is a social justice concept, a philosophy founded on equity where everyone receives quality healthcare. The panel was focusing on “What it takes to be the correct health worker for UHC” and Kenya Healthcare Federation (KHF) was well represented therein. Dr. Robert Nyarango, CEO, Gertrudes Children’s Hospital responding to the question on why medical professional graduates find themselves unemployed, emphasized that healthcare organizations are looking for human resource that is highly skilled, visionary, emotionally intelligent and with a focus on problem solving.
Dr. Daniella Munene, CEO, Pharmaceutical Society of Kenya, addressing the pharmacy students encouraged them to establish a relationship with patients during their practice and ask the right questions to enhance compliance with medications. She further added that every encounter with a patient is an opportunity to educate them about their right to the highest attainable standards of healthcare, as an informed public will be the driver for UHC. Professor Gilbert Kokwaro, Strathmore University, encouraged the students to be open-minded big picture oriented. “Identify the areas that have leadership gaps and work on adding value to them”. He indicated that teaching institutions need to train job creators and leaders not job seekers,.” Professor Njeri Wamae, USIU Africa, encouraged lecturers to train youths that are fit for purpose, keeping in mind that the vision of UHC is ensuring that no one is left behind. “Think of what is needed in healthcare today and in the future” Professor Njeri Wamae, United States International University(USIU)Africa.
Sharing experience in healthcare leadership, Dr. Jacqueline Kitulu, President, Kenya Medical Association highlighted that the lag in prioritizing healthcare stems from being too inward facing in health practice. She encouraged the student to explore other value adding skills like management and leadership to enable them effectively articulate the needs of the health sector. “Through knowledge and skills acquired while pursuing my MBA, I learned how to articulate healthcare needs in a language that the economist can understand” she continued. Dr. Kitulu further encouraged the students to join professional associations for mentorship, which she explained is one sure way of leapfrogging young professionals to effective leadership.Dr. Amit N. Thakker, Chairman, KHF, encouraged the students to identify mentors in their area of passion and interest, who can walk with them towards pursuing their career. In addition, he encouraged the students to focus on being job creators and not job seekers. The healthcare students summit was a success and the students expressed their gratitude to the panelists for the impactful session.
What is the true cost of Healthcare? and what does it entail?
Amref Health Africa in partnership with Kenya Healthcare Federation (KHF) held a forum on cost of healthcare on 12th February 2019, at Sarova Pan-Afric Hotel. In order to unpack the areas where costs lie in healthcare, the following guiding questions were asked: What is the true cost of care? How can healthcare be made affordable to all? The forum was well attended by the private sector, civil society organizations, health regulatory bodies, insurance providers and representatives from the Ministry of Health. In his opening remarks, Dr. Amit N. Thakker, chairman, KHF, emphasized on the need for Universal Health Coverage (UHC) and its linkage to preventing catastrophic health expenses leading Kenyans into poverty. He encouraged frank and open dialogue on: commercialisation of medicine, remuneration of human resources for health, understanding public perceptions of cost in the private sector, specifically, the perception of providers (doctors and facilities), insurers and manufacturers and governance of practice.
Mr. Nathaniel Otoo, Executive Director, Strategic Purchasing Africa Resource Centre (SPARC) reiterated that achieving UHC calls for the right capacity and collaboration between public and private sector to fill in the gaps. He took the forum through the Ghana UHC journey focusing on financing strategies. Ghana moved from passive to strategic purchasing with monitoring of quality, performance, and pricing. The National Health Insurance Scheme in Ghana moved from a price taker to a price setter. Along their journey they noted that private sector is not always a marker of efficiency. Mr. Otoo offered to support KHF in its move to tackle the cost of healthcare through capacity building in strategic purchasing, and improving of efficiency and quality of services.
The panel discussions revolved around fraud, supply chain, human resources for health and lack of robust health information systems. As a summary of the meeting, the following priority focus areas were outlined: supply chain management – regulation, distribution, purchasing, prescription; local manufacturing of key products, methods to determine true cost of healthcare at provider, distributor, manufacturing and payer levels; operational efficiencies – equipment sharing, centralised ambulance services, utility costs, models of healthcare worker remuneration; enforcement of professional standards; governance including guidelines or protocols on management of costs; self regulation; patient behaviour change and right of choice; data generation, analysis, and governance; and finally healthcare financing including increasing the risk pool which calls innovative insurance models and social health insurance to capture a larger population, and incorporation of the prevention aspects of healthcare into our current insurance models
10TH Ministerial Stakeholder Forum
The 10th Ministerial Stakeholder Forum took place on 26th February 2019 at the PanAfric Hotel, Nairobi. The Cabinet Secretary Health Hon. Sicily Kariuki chaired the meeting with the Chairman of Kenya Healthcare Federation, Dr. Amit N. Thakker as the co-chair. The forum took place immediately after Hon. Sicily Kariuki inaugurated the NHIF Reforms Expert Panel. In her opening remarks, the Cabinet Secretary (CS) welcomed the attendees emphasizing that the government still holds the vision of a more efficient, socially accountable and a transparent NHIF. The CS said, “As you are all aware, to kick-start the Universal Health Coverage Program, the President launched the UHC Pilot Programs on 13th December, 2018. Further to the pilot program and as part of the UHC agenda, His Excellency Uhuru Kenyatta directed the strengthening and reform of the National Hospital Insurance Fund (NHIF) and the Kenya Medical Supplies Authority (KEMSA).”
The CS informed the attendees that through intensive stakeholder engagement and expert review, the independent panel of experts would be required to develop an action plan for the key objectives of the panel. The panel of experts will focus on legal and regulatory reforms towards transforming NHIF to be a strategic purchaser of health services in the context of UHC, organisational and business process re-engineering reforms aiming at repositioning NHIF as a national social health insurance provider and strengthening fiscal and social accountability and sustainability. The Ministry of Health (MOH) will continuously engage the media to keep stakeholders updated. During the forum, the CS reiterated that MOH would continue working together with the private sector especially in strategizing towards achieving the UHC. She challenged the private sector to ensure implementation of action points discussed while being sensitive to timelines.
Dr. Amit N. Thakker congratulated the CS for inaugurating the NHIF Reforms Expert Panel noting the steps the MOH is taking toward reforms under the leadership of the CS. The KHF Chairman said, “The steps you have taken shows the public that you are serious about reforms. The 90 days timeline [for recommendations from the NHIF Reforms Expert Panel] will give good time to NHIF to make progress towards taking it the next level. It’s also great to hear that the same reforms process will be done for KEMSA”. Dr. Thakker advised the CS that the private sector would continue working with the pilot counties on three key focus areas. The first is the supply chain of medicines and non-medical health commodities where private sector will collaborate in ensuring that the supplies are available, affordable and of good quality. The products will include both locally produced and imported products. Secondly, the private sector will support in healthcare financing by expanding private medical insurance coverage to the pilot counties to complement UHC thereby enabling provision of wider coverage and higher quality of care. Lastly, on the matter of strengthening local referral systems, he informed the ministry that the private sector could help build local clinical capacity in the county referral hospitals effectively reducing the cases referred to Kenyatta National Hospital, Moi and Teaching Referral Hospital and other national referral hospitals. The KHF Chairman, Dr. Thakker, and the entire KHF fraternity congratulates our KHF director, Ms. Joyce Wanderi on her appointment into the NHIF Reforms Expert Panel by the Cabinet Secretary Health Hon. Sicily Kariuki.
The African Leadership Meeting
The African Leadership Meeting was held in Ethiopia on 9th February 2019.The main agenda was “commitments for investments in the health sector across the continent with an emphasy on the importance of partnerships in order to grow the healthsector. The leadership meeting was co-organized by Africa Health Business.” Dr. Amit N. Thakker, Chairman Africa Healthcare Federation, emphasized that deepening private sector integration within the African health system is non-negotiable. He urged the government leaders to embrace the private sector and improve both Public-Private Dialogue and engagement in the respective African countries through the Ministries of Health. Countries that practice this openly have already shown positive results Dr. Thakker said this while moderating a panel session themed “Domestic Financing for Health, Effective Partnerships and Private Sector Engagement”
H.E President Uhuru Kenyatta, President of Kenya, acknowledged that investments in health were integral to achieving the social economic agenda and that it was necessary to build partnerships to achieve Universal Health Coverage. The Kenyan President urged other leaders to create an enabling environment for the private sector in order to build confidence and attract investments into health systems.
It was stressed that the health sector is a viable investment area where the return on investment is substantial such that investors can expect between 9 – 20 times the level of investment. The meeting led to increased commitments of US$200 million from both public and private health sector and donor governments (Higherlife Foundation, The Government of Ireland and the Government of France), to end epidemics and achieve Universal Health Coverage.H.E. President Sahle-Work Zewde, President of Ethiopia, called on the African leaders to bring hope and opportunities to the people of Africa through transformational leadership Investments in healthcare would improve the quality of life across the continent and allow African populations to lead full, productive and prosperous lives. She emphasized that investments in healthcare underpin national development. Mr. Bill Gates, Co-Chair of the Bill and Melinda Gates Foundation, urged immediate action in order to end epidemics and meet health targets.
It was suggested that African Ministers of Health should meet more frequently to work together on the health status in the continent and report their progress to the AU Heads of State and Government Summit. In this way, African governments can learn from initiatives across the continent, identify synergies that unlock efficiencies and collaborate in relation to continental priorities. African leaders urged their counterparts to focus on improved efficiency in order to strengthen national health systems. For the private health sector, the meeting was received as a key step towards acknowledging sustainability and private sector efforts towards health outcomes. The meeting was an important platform to build on Public Private Dialogue, create awareness and commitments in relation to investments in healthcare in Africa and urge the African leadership to create an enabling environment for business. This shall lead to a stronger private health sector which can further contribute to economic development and goals towards achieving Universal Health Coverage in an efficient and affordable manner.
TERUMO BCT opens a branch office in Kenya
TERUMO BCT a global leader in blood management, blood safety, therapeutic apheresis, cell therapy and cell collections. Terumo, opened its first office in Sub-Saharan Africa in Gigiri, Kenya on 7th February 2019. This happened after the company was recently listed in a recent industry report as among the world’s top players in the blood bank market. Dr. Jackson Kioko, Director for Medical Services (DMS), Ministry of Health, who also officially opened the new company, graced the ceremony. The Cabinet Secretary, Ministry of Health (Kenya) Mrs. Sicily Kariuki in her speech that was read by the DMS, Dr. Kioko, applauded TERUMO BCT for the great achievement and for choosing Kenya as their base in Sub-Saharan Africa. She further said that the partnership is very timely as Kenya is working on making Universal Health Coverage a reality and blood and blood products are key.
Officials from the Japanese Government and TERUMO BCT emphasized that their decision on choosing Kenya was informed by Kenya being a high recipient of Official Development Assistance (ODA), an agreement that was signed during Sixth Tokyo International Conference on African Development (TICAD6). The conference focused on “Advancing Africa’s Sustainable Development Agenda – with a major theme as promoting resilient health system for quality of life.” Kenya’s prioritization of healthcare by driving the health agenda as reflected in the BIG 4 Agenda further incentivized their move.
As a company, TERUMO BCT will apply three strategies through it’s partnership in Kenya: Create awareness, Capacity building and training of blood bank technologists and professionals and Use of advanced technology & systems. The company officials emphasize that they will proudly share their knowledge and experience in blood safety and blood bank.
Through sharing of knowledge and expertise, the company will contribute towards saving lives especially mother and child, achieving Universal Health Coverage and achieving Sustainable Development Goals (SDG).
Kenya Healthcare Federation engagement with Meru County
Kenya Healthcare Federation held the initial county stakeholder engagement with Meru County Health Officials to discuss the establishment of Meru Medical Care. The meeting was held on 10th January 2019 at KHF offices. The engagement with the county was very timely because KHF has set a goal to establish county stakeholder engagements. The Governor, Meru County, has laid a plan to establish Meru Care that will ensure all households have medical cover. The cost of Meru Care is proposed to be ksh. 2,000 per household annually.
Meru County has a population of 1.56million people with 2000 health workers, which gives a ratio of health workers to population at 1:780. Meru Level 5 Hospital is the main teaching and referral hospital and has specialists. The county has one Level 5 hospital, 15 Level 4 hospitals, 25 Health Centres, 157 Dispensaries and 76 Pharmacies.
Dr.Githu Wachira from the Ministry of Health-Non-Communicable Disease Unit, Meru County, said that Meru County is leading in the burden of NCDs with Gastrointestinal Tract (GIT) cancer being very common. He further said that research is ongoing to determine the trigger factors for the GIT cancers. Trauma is the second leading cause of NCD morbidity with a major cause being assaults. Dr Lillian Karoki, Director of Medical Services, Meru County informed the meeting that the total county health budget received from treasury is Ksh. 3.2 billion. She further said that 85% of the total population can afford to pay National Hospital Insurance Fund (NHIF) subscription; the challenge is they do not keep up with the monthly contributions thus bringing the current active NHIF membership to as low as 7%.
KHF was pleased with the vision of Meru County as regards their health agenda. KHF advised that the County should explore ways to increase revenue for the health facilities to make them self-sustaining. Commodity management is important in ensuring that limited resources are used appropriately and loss through pilferage is minimized. Given that 85% of the population can afford NHIF, the County could establish the Meru Care to target the medical needs for the needy. KHF further advised the County to consider licensing Meru Care as an official scheme with transparency in revenue collection, revenue allocation, benefits, beneficiaries and provider management. This would enable the scheme to purchase healthcare services and products competitively. It was also proposed that the County share their proposal for Meru Care with KHF who can assess the benefits package for validity and sustainability. KHF expressed willingness to assist Meru County with advocacy and lobbying to justify the budget for Meru Care and to bring the vision into fruition.
Challenges facing the Healthcare Facilities in Kenya
Crescent Tech Limited held a breakfast meeting at Parkinn Hotel in Westlands on 22nd November 2018, to discuss key challenges facing the healthcare facilities in Kenya. Some of the key issues highlighted were: Limited access to health care facilities, lack of adequate personnel and expertise to address the medical needs, poor Infrastructure where most facilities do not have the proper facilities to handle the medical challenges, ironically the facilities that are highly equipped with specialized equipment do not have effective processes and personnel in place to execute the tasks, access to medical records and Healthcare Financing.
The breakfast meeting was organized by Crescent Tech Limited and Napier Healthcare who partnered so as to address these issues of access to healthcare services and also to offer solutions that will provide a seamless access to records and efficient delivery of services to even the most rural area in the country.
For a healthcare facility to deliver quality healthcare, it should be well equipped with the right equipment and tools, quality medications, should be accredited, should have qualified and experienced staffs. In Kenya, the healthcare sector is facing some setbacks in: supply chain, the facilities are understaffed, healthcare financing and innovations & technology. Once this set backs are looked into, the delivery of quality healthcare will go a notch higher.
In his opening statement, Dr. Percy narrated a direct experience of how the above mentioned challenges impacted and eventually led to the loss of their C.E.O, the late Mr. Kennedy Mbwaya, who was in urgent need of medical attention while in Eldoret for a business meeting. Thereafter, the ambulances services arrived late, and it was a challenge identifying a center that could perform an endoscopy. When that was established, an appointment was required to be made so as to access the services of a specialist. This whole process greatly affected the speed at which his life could have been saved.
According to Dr. Amit N. Thakker, Chairman Kenya Healthcare Federation, the new constitution that brought forth the two arms of government, National and devolved governments gave capital to projects aimed towards the BIG 4 agenda, healthcare being one of them, through the Constituency Development Fund(CDF).Under financing of the health sector, our government has reduced its funding and this has posed as a challenge in the health sector. Over 80% of the country’s population is dependent on this funding for their healthcare needs. A very small percentage of Kenyans have access to private insurance and can afford to pay for their own healthcare expenses. This is less than 20% of the Kenyan population.
“Kenya has undergone quite some positive disruptive changes in governance and through the devolution of some services from the national government to the county government. As expected, this transition has encountered its challenges. In as much as we consider our country as having highly skilled specialized staff, we still do not have available workers to provide for healthcare services to the larger population. The people who mostly need these services, still have challenges accessing the services of specialized health workers to assist them. There is an urgent need to address this human resource and staffing issue through a proper policy in place that will boost the public health sector.” Dr. Amit N. Thakker, Chairman Kenya Healthcare Federation.
Recommendations towards solving the challenges as discussed in the meeting were: The general challenge of leadership and governance has trickled down to the health care sector. Allocation of resources has been hampered by poor governance and the lack of accountability in the use of the resources allocated to the healthcare sector therefore, the Government should accelerate discussions and implementation of public-private partnership initiatives for creation of sustainable models for healthcare financing to achieve Universal Health Coverage.
“Since Africa is emerging as an economic hub, it is notable that there is a great need to embrace technology in the key sectors like health care. Napier healthcare comes in handy with relevant solutions for the healthcare sector as it has technology that was designed by a team of doctors based in Singapore. Singapore is a proper case study for Kenya as both countries were colonies of Britain and in 1979 both economies were at par. Bloomberg ranked Singapore’s healthcare system the most efficient in the world in 2014. The Economist Intelligence Unit placed Singapore second out of 166 countries for health-care outcomes.” Enrico Lim, Regional Alliance Director, Napier Healthcare
New plans on achieving Universal Health Coverage
Kenya Healthcare Federation(KHF) Healthcare Financing committee held it’s last quarterly meeting at KHF offices on 7th December 2018 the meeting was chaired by the committee chair Dr. Njoki Fernandes. The key agenda for the discussions were: Universal Health Coverage, Doctor’s price guidelines and NHIF amendment Bill. Dr. Walter Obita, director representative for the committee updated the committee on the discussion around Universal Health Coverage that has been going on at the ministerial level and the last engagement between the Ministry of Health led by the cabinet secretary Mrs. Sicily Kariuki and the private Health Sector.
Healthcare Financing Committee has been leading all the discussions around Universal Health Coverage where the committee has also been engaging with the government at the technical working committees(TWCs) set by the national government. Dr. Obita has been representing KHF healthcare financing committee in the TWCs.
From the UHC discussions in the ministry of health ,the current position shows that the government is not going to use the social insurance schemes to roll out UHC. Hence it plans on directly procuring or paying for commodities through Kenya Medical Supplies Authority( KEMSA).The counties will therefore have to roll down the payments made to KEMSA by directly making orders to KEMSA where KEMSA will make the deliveries. Inadditional,the government is going to allocate some resources to the public health activities,community health activities and 80% will be used for commodities and supplies to KEMSA.
The counties have been tasked with a role in ensuring that all other health systems are built through allocation of finances to each of the activities which include:Human Resource recruitment, deployment and management, Strengthening of governance structures and management of data, information and technologies .
Dr. Fernandes brought to the attention of members the NHIF amendement Bill with a major focus on section 2a) part II which states that there shall be paid into the fund the employer contributions matching employee’s contribution, Part III. such monies as may be appropriated by the National Assembly out of the Consolidated Fund, for persons certified by the Board to be unable to pay the contributions, Part iv. Gifts, grants or donations, Part v. Funds from the National Government, County Governments or employers for the administration of employee benefits and section five ,Part vi ,to administer employee benefits on behalf of the national government, the county governments and employers in respect of their employees. KHF’s recommendations included: should discuss this bill with the parliamentary Health Committee, Lobby in, Federation of Kenya Employer(FKE) and KEPSA and Healthcare Financing Committee to be involved in all the discussions.
There was a parliamentary directive that the Doctor’s rate should be taken back to 2006 price guidelines that were abandoned two years ago with the adoption of the current rates. The National Assembly’s Health committee further requested the Cabinet Secretary, Ministry of Health, Mrs. Sicily Kariuki to replace the existing Medical Practitioners and Dentists Rules 2016 with the second edition of the Professional Fees Rules and Guidelines of 2006, which prescribe cheaper rates for various medical services and procedures.
KHF’s recommendations as a way forward for the doctor’s price guidelines include: KHF should get more involved in costing and also learn from the successes of other countries and professionals, KHF should engage more health experts especially health economist to join in the discussion to guide in making more sound decision, Healthcare Financing should be more engaged in the discussions so as to deter NHIF from charging high rates ,the medical board should consider setting up maximum rates instead of minimum and there should be maximum margins set for pharmaceuticals and supplies which will also bring about price regulations.
Other issue as discussed was the quality of care which has been compromised and the public is not well informed on where to seek care from. Therefore the committee suggested that there should be edu-information and sensitization done to the public on who to go for care. There should also be regulations on healthcare providers at all levels in which they should have the right qualifications and experience.
The committee agreed on the focus areas for the year 2019 as: NHIF Amendment Bill, Doctor’s Price Regulations, Pricing Quality and Regulations ( this will focus on care services and medications) and engaging the media in Agenda setting.
Medical Exellence Japan(MEJ) prepares for the first Public –Private Mission(PPM)
The Medical Exellence Japan(MEJ) team visited Kenya from 26th November to 1st December 2018 in preparation for the first Public –Private Mission that will be held in Nairobi, in the month of February 2019.The MEJ shall conduct the mission in partnership with Kenya Healthcare Federation.The main aim of the pre-visit by the MEJ team was to invite Kenya to participate in their programs and collaborations. Some of the companies and organizations that were visited include: Ministry of Health, Kenyatta National Hospital, The Nairobi Hospital, M P Shah Hospital, Council of Governors, Moi Teaching and Referral Hospital, Fountain Healthcare Eldoret Hospital and Mediheal Hospital & Fertility Center. In preparation to the PPM, one of the areas the team was focusing on was getting to know the impression or specific opinions on Japanese products and services and the impression on PPM.in an interview with Dr. Joan Osoro, AD, Medical Services & Research ,Nairobi Hospital she applauded the Japanese brands in medical equipment and products “ Quality-wise, we know Japan and its brand reputations. Japan should consider what would be the strong/appealing points to introduce their equipment or services to our hospital. This is a good idea. We would like to hear more options from Japanese companies.” Dr. Joan Osoro, AD, Medical Services & Research, Nairobi Hospital.
Ms. Doris Kimbui, Nursing Officer in charge of resource mobilization and Mr. Kennedy Mbogo Liaison Officer from Kenyatta National Hospital welcomed the Japanese team by applauding the idea of PPM, From Ms. Doris and Mr. Kennedy view the Japanese equipment and products are of high and excellent quality, however they welcomed the team to the hospital in the month of February Where they requested them to have only ten delegation.
During a visit to the council of governors(COG) office, Hon. Meshack Ndolo, Senior Health System Advisor informed the MEJ team that the devolved government system in Kenya has significantly increased county level decision-space on diverse tasks. COG takes its leadership to organize and run each committees for providing solutions to diverse issues. “As for the Health committee, H.E. Mohammed Kuti; the Governor of the Isiolo County is the Chairman. Emerging issues are Human Resources and Capacity Building in the healthcare field. To get to know more about our ongoing projects, please visit our site. Quality-wise, we know Japan and its brand reputations and it has excelled.” Hon. Meshack Ndolo, Senior Health System Advisor, Council of Governors.
Mr. Reyaz Shariff, Director of Operations and Dr. Vishal R. Patel, Assistant Medical Director, In charge ICU,welcomed the MEJ team to M P Shah Hospital.During an interview,the M.P Shah officials informed the Japanese team that M P Shah hospital operates under the umbrella of the Social Service League which is a non-racial, non-religious, non-political charitable institution and cares for the patient along with it’s policy and it’s the ‘one-stop healthcare provider in East and Central Africa.’
“In terms of a patient-nurse ratio, our hospitals provides “1 patient : 1 nurse” service, while other hospitals are “3 patients : 1 nurse. We opened a new hospital in Village Market, near the trademark hotel recently. We are about to open the MRI center, too. This is a good idea. We understand that you want to enhance the presence of Japanese products in Kenya, which is significant. However, how would you do it? You should think deeply and logically about how would you enter the market and how would you set up the specific strategies. However, we also recognize Japanese companies are trying to work on providing after care services. To minimize a down time of the devices is critical. Speaking of GE and Phillips, their backup/follow up services are fairly good. Japanese (companies) should consider the reason why we need to buy your products. You must tell us your story”. Dr. Vishal R. Patel, Assistant Medical Director, M P Shah Hospital.
Prof. Lukoye Atwoli, Associate Professor of Psychiatry, Moi Teaching and Referral Hospital who welcomed the MEJ team to Moi Teaching and Referral Hospital informed them that the hospital is currently working on a new project of expanding and establishing the largest hospital in the western region. “As for the teaching side; Moi Teaching University is composed of approximately 1,200 students from not only Kenya but also many other regions, such as Tanzania, Rwanda, Somali land, and Lesotho etc. Our two facilities; University side and Hospital side are well combined as one. In terms of the care program, our counterpart is USAID. This is a five-year program, quality-wise, we know Japan and its brand reputations which score a high mark. Japanese (companies) should consider the reason why we need to buy your products. You must tell us your story”. Prof. Lukoye Atwoli, Associate Professor of Psychiatry, Moi Teaching and Referral Hospital.
Dr. Andrew Wandera, Consultant Surgeon, Fountain Healthcare welcomed the MEJ team to Fountain Healthcare, by noting that it was the very first time to welcome the people from Japan. He applauded the Japanese products as excellent “Speaking of quality, the Japanese and its products are good, but we hardly see the Japanese products here. This is a good idea. We understand that you want to enhance the presence of Japanese products in Kenya, which is significant. We don’t think Japan’s presence is strong here in Kenya except TOYOTA, We would like to know how to use a simple device more effectively to diagnose diseases. We maybe need high-end types of equipment in the future, but it’s not now. Acquiring more knowledge from a company who sold the device to us, and letting technicians more professional are the crucial things for us”. Dr. Andrew Wandera, Consultant Surgeon, Fountain Healthcare.
Mr. Miten V. Lodhia, Finance Director and Dr. Neelesh Aggarwal Director from Eldoret Hospital Pharmaceutical limited informed the MEJ team that they run hospitals and a distributing company; Eldoret Hospital Pharmaceuticals Ltd, in Kenya where they also supply medicines to the Moi Teaching and Referral Hospital as well as the other hospitals in the regions.
“We understand that you are going to hold the PPM in Nairobi. However, you need to explain to us why we should have your companies and devices here in Kenya. Quality-wise, we know Japan and its brand reputations, but the word “Quality” is not belonging to you anymore, is belonging to any companies all over the world. You may need to consider and set up a good narrative to provide your products to us. You may need to convince us in a good way.” Dr. Neelesh Aggarwal Director, Eldoret Hospital Pharmaceutical limited.
Role of Supply Chain towards achieving Universal Health Coverage
Kenya Healthcare Federation supply chain committee held the last committee meeting of the year at Kenya Private Sector Alliance (KEPSA) offices on 22nd November 2018 to confer about Public-Private Partnership (PPP) areas in Supply Chain, Innovations in Health Product Distribution/Supply Chain, Promoting Local Manufacturing and the Role of Supply Chain towards achieving Universal Health Coverage (UHC). Dr. Chris Masila of PractHealth chaired the meeting.
Innovation in healthcare is rapidly growing and can contribute positively to healthcare accessibility. However, Mr. Rolando Satzke CEO, COSMOS Limited, raises a major concern that the patient is not put at the center of the innovations and that the quality of medicine must be maintained to the point of delivery. Further, Dr. Christine Sadia, Chair Kenya Medical Women Association, questioned whether the instructions of the prescription would be clear to the patient at point of delivery.
Dr. Nyalita backed the ideas by adding that most of the innovators focus on the commercial side which raises the question on quality. On the matter Mr. Rolando Satzke concluded by saying “I strongly suggest that all innovations should be patient centrered ensuring that all patients should be able to access quality medication without financial strain.” Dr. Anastasia Nyalita updated the committee on price regulations where she informed them that the Pharmacy and Poisons Board(PPB) is working on the price regulation strategies that was mandated by the Ministry of Health(MoH) and the final report will be ready by the beginning the year 2019. It was good to note that Kenya Healthcare Federation is well represented in the technical working group that is working together with the Pharmacy and Poisons Board.
There was a unanimous agreement by the supply chain committee that it will contribute and support UHC. However, price controls gives less opportunity for profit makers to distribute and resell drugs at a margin to typically unreachable markets, eventually resulting in less impact on patients. This argument links to the importance of patient awareness of and understanding of factors affecting commodity prices. Its important to bring this issue up now when the UHC is being strategized. Countries like Japan Switzerland, Ethiopia and Lesotho are good examples of price regulation models.
The committee has also been discussing the parallel importation Act and Dr. Nyalita updated the committee that the Act by PPB has been finalized and was presented at the Ministerial Stakeholder Forum and will be gazzetted. The Act will look into regulations of parallel importation and Illicit Trade.
On national coding of drugs, Dr. Nyalita updated the attendees on the consensus that was reached where KHF was asked to prepare and present a proposal to the Ministry of Health on coding of pharmaceutical products. In the ninth Ministerial Stakeholder Forum, it was agreed that Kenya should select a global pharmaceutical coding system such as the Anatomical Therapeutic Chemical Classification System(ATC) codes as used by PPB to register medicines. Dr. Daniella Munene was requested to work closely with PPB on this in order to propose a workable coding system for medicines. During the Ministerial Stakeholder Forum, it was agreed that the private sector should share an updated paper on the role of the Private Sector in achieving Universal Health Coverage. The presentation should include bottlenecks that should be addressed to increase coverage and access to quality, affordable healthcare for all.