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.
Recognition and strengthening of neglected and specialized health cadres
The human resource for health (HRH) committee of Kenya Healthcare Federation (KHF) held it’s first quarterly committee meeting on 14th March 2019, at KHF offices, to set the 2019 focus areas. The meeting was chaired by Mr. Kennedy Auma, Committee Chair. The director representative for the committee, Dr. Elizabeth Wala, called upon the committee members to be meeting on a bi-monthly basis so as to ensure the focus areas are achieved. There was a unanimous agreement by the committee that there is need to address HRH issues proactively.
The first focus area for the committee in 2019 will be the establishment of a framework with the Ministry of Health (MOH) for the three specialized cadres: Community Health Volunteers (CHV), Health Record Information Officers (HRIOs) and Emergency Medical Technicians (EMT). The second focus area is the management and development of the HRH. This focus area will be implemented through stakeholder engagement through professional associations and unions, collection of data on the distribution of HRH in both public and private sector, performance management, innovative ways to overcome HRH gaps and strong leadership and governance structures. The third focus area will be on specialized cadres specifically recognition, regulation and establishment of a framework for their work with the MOH thereby enabling referral processes and availability of equipment to enable their work. Some examples of specialized cadres are Physiotherapy, Occupational Health, Oral health, specialized nurses and other medical specialties available in the diaspora.
The committee noted that HRH is a key pillar in Universal Health Coverage (UHC) and the Health Act 2017 therefore it is important to understand the legal framework therein and to monitor the implementation of the recommendations.From the three focus areas, three committees were formed to concentrate on their allocated focus areas to ensure that the committee achieves all focus areas by the close of the year.
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
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.
Finland explores business opportunities in the Kenya Health Sector
Kenya Healthcare Federation (KHF) held the 5th Bi-Monthly members meeting at the Fairmont Norfolk hotel in Nairobi. The meeting which was held in 2 parts – networking forum with Team Finland, and members meeting, was sponsored by Team Finland who had visited Kenya to discuss business opportunities. Team Finland is a network of public service providers providing internationalization services for companies. The network seeks to provide companies with a smooth service chain from counseling to finance. The main sectors of business focus for the Team Finland delegation were; Education, Energy and Health. The Finland business delegation on health and health education included Perkinelmer Wallac, Vamed Company, Logonet Group, Oulu University of applied sciences and Tampere University of applied science. They were open for partnerships that would help address issues of access and quality of healthcare.
In his opening remarks at the networking forum, Dr. Amit Thakker, KEPSA health sector board and KHF chair stated that the private sector provides 50% of medical services in Kenya. He further added that KHF provides a platform to examine Kenya’s health landscape and identify the type of partnerships that will promote trade and investment in Kenya. Affordable Healthcare for all being one of H.E. President Uhuru Kenyatta’s BIG 4 Agenda, the socio-economic agenda comes at an opportune time in Kenya where the county and national governments are appreciating the inclusion of the private sector. The key opportunities that will require beneficial, cross-cutting resolutions and partnerships include supply chain, local manufacturing and technology These areas offer opportunities for innovations to increase quality and reduce cost of health care.
Dr. Thakker then chaired the members meeting that brought together 50 members. Dr. Elizabeth Wala, KHF Vice Chair, took the members through the KHF strategic plan 2018-2020 which focuses on an increased level of advocacy, public-private partnerships, networking and regional integration. Reflecting on the previous term 2015 – 2017, she noted that there has been remarkable achievements in the membership growth (96%), that KHF has managed to hold fruitful engagements with county health stakeholders, and that through the regular ministerial stakeholders forum (MSF) KHF has managed to get a favorable ruling on the importation of medical equipment and commodities. KHF through the same forum is advocating for policy decisions to promote local pharmaceutical and medical devices manufacturing with the aim of reducing cost of healthcare.
In the strategic plan 2018-2020, the federation through it’s advocacy role will ensure that the under privileged, elderly and marginalized are considered in the national health insurance. KHF will continue to play an advisory role to the Ministry of Health on better health financing models. In line with the BIG 4 Agenda, KHF will ensure that it’s communication and publications will provide expertise on issues affecting the health sector especially where affordability, accessibility and quality of care is concerned. KHF will strengthen it’s partnership with the counties through county health stakeholders engagements to ensure quality is enhanced in health facilities.
Dr. Thakker took the members through the discussion points of the upcoming presidential round table (PRT) which will be focusing on “Closing the gap to the BIG 4 Agenda for Universal Health Coverage.” He informed the members that the private health sector will participate in the following areas: provision of health services, supply chain, technology, innovations and healthcare financing. Some of the key pain points that will be discussed include; high input cost of providing medical care, inefficient use of health infrastructure, shortage of human resources for health, multiple fees, charges and taxes, high cost of medical products and supplies, counterfeits, tax burden, irregular parallel imports, fragmentation of the health sector, poor information sharing, lack of enabling regulation to support innovation in health, delayed NHIF accreditation/ reimbursements, legislated NHIF monopoly, unfavorable laws, lack of overarching regulations for health insurance, sustainability for UHC and ensuring coverage for the poor.
Second Universal Health Coverage Conference in Nyeri
Kenya Vision 2030 delivery secretariat in partnership with Ministry of Health (MoH), Kenya Healthcare Federation (KHF), Amref Health Africa, Kenya Cardiac Society, Council of Governors, NCD Alliance Kenya, Kenyatta University and Nyeri county health department organized the second Universal Health Coverage Conference held at Green Hills Hotel, Nyeri County from 11th – 12th September 2018. The conference sought to address the non – communicable disease (NCD) challenge to the country and was appropriately themed “Universal Health Coverage for Sustainable Development – Transformative Solutions to Halt and Reverse the Non-Communicable Disease Epidemic”
The conference was graced by several dignitaries: Her Excellency Dr. Carol Karugu, Deputy Governor, Nyeri County; His Excellency Prof. Peter Anyang’ Nyong’o, Governor, Kisumu County; His Excellency Prof. Kivutha Kibwana, Governor, Makueni County; Dr. Julius Muia EBS, Principal Secretary, State Department for Planning; Dr. Racheal Kamau, CEC Health, Nyeri County.
Rev. Samuel Njenga of the Presbyterian Church of East Africa opened the conference with prayer and thereafter giving a brief address. He said that the church has a vital role to play in advocating for and sensitizing the people about good health.
Dr. Kamau welcomed participants and thanked the organizers for choosing Nyeri County to host the conference, adding that she looked forward to fruitful deliberations. “Nyeri County is facing a high burden of NCDs. We need to change our ways of practice and take up the challenge” she remarked. Thereafter Dr. Kibachio Mwangi, the Head of NCD unit at MoH highlighted the key objectives of the conference which were: Understand the NCDs challenge; outline the role of private sector in addressing NCDs; outline the role of consumer organizations in protecting the public from sale of harmful products; and outline the role of government, civil society and the youth in addressing NCDs. Dr. Mwangi emphamphised that NCDs are not purely a health agenda, but require a multi-sectoral approach incorporating sectors such as transport, education and agriculture particularly in prevention measures.
“We should put health first; unfortunately what are addressing is a result of our choices such as what we eat. Good health plays an important role in boosting the economy, reducing poverty, increasing education and boosting investment” Dr. Julius Muia said in his address to the conference.Preventive measures against NCDs took center stage in the deliberations. It was appreciated that more focus needs to move to prevention as we continue in disease management interventions.
The consensus on the way forward included creating awareness, education of the public and preventive measures against NCDs, adoption of a multi-sectoral approach, utilizing Public- Private Partnerships and supporting local pharmaceutical manufacturers to make medicines affordable and strengthening the supply chain. “Managing NCDs is very expensive. If we truly want to make UHC achievable, we need to address the issue of cost. If we reduce costs we’ll be able to expand the care. The biggest PPP opportunity in cost reduction is in supply chain”, said Dr. Peter Kamunyo, Director, Kenya Healthcare Federation.
Further, there was consensus that community health volunteers (CHVs) should be officially entrenched in the health system. It was recognized that CHVs play a very critical role in NCD public sensitization. It was agreed that NHIF be strengthened, that it should cover preventive health checks and that it should ensure that the poor and vulnerable are covered. The country should strategize on addressing the poor availability, lack of affordability and inadequate resources as barriers to UHC. Young people should be informed and sensitized on NCDs so they can act as role models to their peers in NCDs prevention. NCD education should be incorporated in the school curriculum.
A patient representative at the conference made an appeal to the health sector to address survivorship of NCDs, a phase of management that insurance doesn’t cover. She highlighted that cancer patients are usually deserted by friends and family after diagnosis due to the burden of their disease on their loved ones. “We are left alone. It’s time for medics to inform us how we can survive after diagnosis of an NCD like cancer. This way trauma can reduce and a patient can accept the situation, love on themselves and even achieve their goals. The price of medications is usually very high and almost unaffordable. Patients get financially drained while trying to get medication”, said Elizabeth, a cancer survivor of nine years.
Professor Nyong’o called on stakeholders to identify areas of inequity in health care, and strategize on how to fill the gaps. “Counties don’t have a strong primary healthcare system, the aim of UHC is to strengthen primary healthcare” said Dr. Karugu, while Prof. Kibwana called upon all pilot counties to learn from each other as a way achieving UHC uniformly, further adding that CHVs will play a big role in rolling out UHC, particularly in educating communities.
The conference was well attended attracting 400 delegates drawn from both public and private health sectors. There was representation from national government, county governments, World Bank, the United Nations office in Kenya, Non-governmental organizations and youth organizations. KHF was represented by the chairman, Dr. Amit Thakker, directors Dr. Peter Kamunyo and Dr. Daniella Munene, Dr. Joy Mugambi, deputy Secretary General, Kenya Medical Association (all panelists), as well as several KHF members who attended as delegates. A number of KHF member organizations sponsored the event.