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.
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.
‘Health regulations will be key focus in the Universal Health Coverage’
The health regulation and quality standards committee, of Kenya Healthcare Federation, held it’s first quarterly meeting for the year 2019, on 16th March 2019, at KHF offices, to outline 2019 focus areas. The meeting was chaired by Dr. Elizabeth Wala, federation vice chair, and the director representative for the committee. In her opening remarks, Dr. Wala reiterated that 2019 focus areas on regulations to be key in the Universal Healthcare Coverage (UHC)agenda. She noted that the Health Act and its implementation process was very slow in 2018, because it was overtaken by the UHC agenda and the supply chain concerns. In addition, she noted that efforts towards quality in 2018 focused more on the Kenya Quality Model for Health (KQMH) as a framework, yet other existing models that could be applicable in the health sector. She concluded by saying that this year this committee must set three achievable focus areas.
It was agreed that given that the Ministry of Health (MOH) is substantially mandated with the regulatory role, the committee should seek the ministerial input through the Ministerial Stakeholder Forum (MSF) meetings. Through the Business Advocacy Fund () grant, the committee agreed that prevailing challenges on quality and accreditation would be added to the BAF fund as key focus areas in advocacy. The committee’s key focus areas in 2019 include:Drafting a position paper on private sector’s position on Universal Healthcare Coverage (UHC)(This will ensure that the quality component is well defined implemented in UHC), rolling out of the KQMH, advocating on Kenya Accreditation Service (KENAS) accreditation process and spread the communication on Health Act Implementation.
Kenya Healthcare Federation holds the first members meeting for the year 2019
Kenya Healthcare Federation held the first members meeting on 28th February 2019 at Movenpick Hotel, Nairobi. The meeting was sponsored by Malaria no More. The theme of the meeting was ‘’End malaria to unleash Kenya’s economic growth’’ according to research and analysis, Malaria was the leading cause of death in the year 2017.The government has since made efforts to bring this under control. During the panel discussion, a major question asked was what is the private sector’s major role in malaria control and elimination . “100% of the supplies are produced from the private sector and a major concentration is on malaria treatment “.Dr. Amit N. Thakker, Chairman Kenya Healthcare federation. Dr. Thakker further informed the attendees that the private sector ensures that there is a malaria treatment are readily available at all facilities. How do we control malaria? by applying preventive and curative measures, carryout community sensitization and create awareness on the spread and prevention of malaria.
During the members meeting, a major focus was paid to the 10th ministerial stakeholder forum and the inauguration of the NHIF reforms expert panel. Dr. Thakker updated the attendees that the Independent Panel of Experts will be required to skilfully develop an action plan that will see the transformation of NHIF into a strategic purchaser of health services, in the context of UHC. Inadditional, the KHF chair, reiterated Hon Sicily Kariuki’s stand on the continuously engagement between and the ministry of health to keep the public informed. The Panel of experts will focus primarily on; Legal and Regulatory Reforms towards transforming the NHIF to be a strategic purchaser of health services, in the context of UHC, Organisational and Business process Re-engineering reforms towards repositioning NHIF as a National social Health Insurance provider,Fiscal and Social Accountability -Strengthening Financial and Social Accountability and Financial Sustainability-which will include the analysis of the sustainability of the NHIF under different financial and service coverage scenarios.
During the 10th Multistakeholder Forum, the CS reiterated that the ministry will continue working together with the private sector, especially in strategizing towards achieving the Universal Health Coverage. She however, challenged the private sector to ensure more discussed action points are implemented with time sensitivity. Dr. Amit N. Thakker, Chairman Kenya Healthcare Federation, congratulated the CS for inaugurating the NHIF reforms expert panel. He however, applauded her for the
the steps she has taken towards the reforms. He however promised the CS that the private sector will be working with the pilot counties on three key areas; supply chain, to make sure the medicines are available, affordable and of good quality, both locally produced and imported, Healthcare Financing, the expanded private sector insurance coverage and those in the counties will allow UHC in this counties to provide more coverage and better care and referral systems, he informed the ministry that KHF is ready to support the county referral instead of having many referral cases taken to Kenyatta National Hospital and Moi and Teaching referral hospital. Dr. Thakker and the entire KHF fraternity congratulates one of the directors, Ms. Joyce Wanderi, who was appointed into the expert panel, by the Cabinet Secretary.
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.