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Achieving Universal Health Coverage in Africa

Achieving Universal Health Coverage in Africa

 

Annual Africa Health Business Symposium 2018 focuses on achieving Universal Health Coverage (UHC) in Africa

Africa has recorded a high increase in health expenditure over the last two decades with an associated increase in out-of-pocket expenditure for primary healthcare services. Access to quality healthcare plays a key role in achieving sustainable development goals (SDGs) and boosting economic growth. Integration of UHC as a goal in the national health strategies of African countries is becoming increasingly critical as the continent continues to bear the highest disease burden, an increasing population and lack of a strong health workforce to meet healthcare demands.

Africa Health Business Limited held the 3rd Africa Health Business Symposium dubbed AHBSIII at Hyatt Regency Hotel in Johannesburg , South Africa from  8th  – 9th October 2018. The two day conference was themed “Achieving UHC in Africa: Stronger Together.” The conference brought together more than 300 delegates from over 50 countries, majority being African. A major expectation for the attendees was learning from various countries’ experiences in implementing UHC and the various policies and financing mechanisms required for UHC to be achieved.

The South Africa minister for health Dr. Pakishe Aaron Motsoaledi opened the conference by welcoming the attendees to South Africa. He further thanked the AHBS team for choosing South Africa to be the host country for the third annual Africa Health Business Symposium. In his opening remarks, he said “The concept of achieving Universal Health Coverage by 2022 is important. We should aim at reducing the burden on health systems in Africa”.

Dr. Pakishe Aaron Motsoaledi, Minister of Health South Africa speaking during the opening ceremony of the third Africa Health Business Symposium in South Africa

H.E. Amira Elfadil Commissioner for Social Affairs, African Union, said the public sector must work in unity with the private sector and commit to improving health outcomes for all, not just the middle, upper – middle and elite classes that the private sector mainly serves. “Universal Health Coverage, will help us narrow gross inequalities among people who require access to quality healthcare and affordable medicines.”

Her Excellency Amira Elfadil Mohammed, Commissioner for Social Affairs African Union speaking during the third Africa Health Business Symposium

“Implementing Universal Health Coverage is only possible when we train local skills and bring in the right medical equipment. The private sector is well positioned to launch such initiatives through Public – Private Partnerships or tailored agreements” Dr. Mohamed El Sahili, CEO Medland Health Services.

 

Dr. Amit N. Thakker, emphasised that quality should be the foundation and basis of UHC. “Quality is the right treatment for the right person at the right time. The private sector has the opportunity to provide care more cost- effectively”, said Dr. Thakker, the chairman of Kenya Healthcare Federation (KHF).

Dr. Amit N. Thakker, chairman Kenya Healthcare Federation addressing the attendees at AHBSIII Conference in South Africa

 

 

 

There was an emphasis on strengthening public-private partnerships for achieving UHC. Intra Health CEO, Mr.  Pape Gaye, emphasised that leveraging PPP in Africa can help achieve UHC especially establishing the right human resource capacity.

Key pointers discussed as a way forward were: PPPs, human resources for health, as well as quality and affordable medicines. There was unanimous agreement that African governments should consider working through PPPs to strengthen health literacy and health systems to increase access to quality health services and improve on financial protection schemes.

 

UHC can be achieved through learning from experiences of countries that have successfully implemented or are in the processes of successful implementation of UHC. Learning and adopting evolving innovations will give better ideas of effective healthcare models that are tailored to each country’s needs. Diversified approaches will create the road map to significantly expand the number of people covered by risk pooling arrangements, with substantial benefits to health care, optimizing resource use, maximizing results and “leaving no one behind.”

Dr. Toda Takao, Vice President, human security and global health – Japan International Cooperation Agency (JICA) – spoke of his own country’s post-World War II experience in implementing UHC. He said that it was the key economic driver to the country’s recovery from devastation by the conflict. Takao emphasized these three points: UHC is a nation-building issue, UHC is a pre-condition to economic growth and UHC must involve all stakeholders in the process or it will neither be achieved nor sustained.

Kenya Healthcare Federation was proud to partner with Africa Health Business Limited (a KHF Member) in making the event a success. KHF was represented the chairman Dr. Amit Thakker and two directors namely: Dr. Daniella Munene and Dr. Anastacia Nyalita. There were other KHF members who attended and exhibited at the event, including Corvus Health, IntraHealth International, Amref Health, General Electric and PharmaAccess Foundation. In his closing remarks, Dr. Thakker applauded the conference as remarkable, fruitful and very informative.  “We celebrate three key successes borne out of the symposium: Meaningful interaction and engagement with dignitaries, tangible progress on unification of the private sector in South Africa under a federation with good will from the Department of Health, and a commitment from the private health sector to support African Union to achieve Agenda 63.

Many delegates visited a General Electric (GE) medical innovation center that features the latest high-tech ultra sound scanners, infant incubators and other ultra modern medical equipment. GE considers this center as part of a solution toward African development by fostering home-grown solutions. This includes an education and training center where expert healthcare providers train rural, community-level healthcare workers who are usually mostly untrained in the use of new technological advancements. There was unanimous agreement that the next AHBS (AHBSIV) will be held in Ethiopia.

Medic East Africa Conference

Medic East Africa Conference

 

 

6th Healthcare Management Conference

The 6th annual Healthcare Management conference, organized by Medic East Africa, took place at Kenyatta International Conference Centre ,Nairobi, Kenya from 25th  to  27th September 2018.The conference had three different themes for each of the three days. The first day’s theme was “From vision to Action – Reinforcing Healthcare Systems in East Africa, the second day was “The Role of Clinical Officers in the Implementation of Universal Health Coverage” and the third day’s theme was “Quality and Access under Universal Health Coverage”. The objective of the forum was to drive the region towards a health leadership infrastructure that is focused on perfomance and is held accountable for delivering on specific health system goals.

Reinforcing Healthcare Systems in East Africa ,day one theme during Medic East Africa conference at KICC, Nairobi

The conference brought together over 150 exhibitors from 18 countries. The first day conference was moderated by Dr. Amit N. Thakker, Chairman, Kenya Healthcare Federation. In his presentation, he emphasized that the key barrier to reinforcing healthcare systems in east Africa are; geographical and financial. Dr. Thakker informed the attendees that over 85% of Kenya population do not have any form of a cover and rely on out of pocket. 50% of the population do not have an access to primary healthcare and this set back results from poverty. He called upon all healthcare workers in attendance to come out strongly in health advocacy because unfavorable health outcomes such as maternal mortality are increasingly becoming a daily occurrence. Dr. Thakker further urged the attendees to capitalize technology, which is in itself revolutionizing daily.

Dr. Amit N. Thakker, chairman Kenya Healthcare Federation, speaking at the Reinforcing Healthcare Systems in East Africa, Medic East Africa Conference at KICC,Nairobi

 

“We need to adopt auxiliary health workers and also strongly recognize community health workers for the big role they play in health. The ministry of health should have considered hiring the specialists that we don’t have instead of employing what we already have because this doesn’t help in filling the identified gaps in the workforce. The BIG 4 Agenda is supposed to ensure creation of job opportunities and 5% of the jobs are expected to come from the health sector. Therefore I call upon the public and private health sector to operate in harmony to see great job creation and ensure good service delivery.” Dr. Amit Thakker, Chairman ,Kenya Healthcare Federation.

Dr. Andrew Mulwa CEC-Health, Makueni County informed the attendees that some of the challenges in the county level towards achieving Universal Health Coverage are: lack of healthcare workers i.e. the recruitment and retention of human resources for health is very low. This is because most of the specialists that are required in the counties, are mostly concentrated in the urban areas. Finance is an important factor affecting access to quality healthcare and is challenge because most of the population does not have a formal employment therefore cannot purchase or contribute to medical cover plans. This leads to over reliance on out of pocket expenditure. He however added that recruitment and retention of the health workers should match the county’s economical abilities.

Dr. Andrew Mulwa CEC-Health, Makueni County presenting on the achievements of Makueni County, during the Medic East Africa conference ,KICC, Nairobi

Dr. Janet Muriuki, Deputy Chief of Party/ Technical Director – Intrahealth International was in attendance and said  “We need to motivate the health workers, to help in reducing immigration. Assessing the reason for immigration, creating a favorable environment for them to work and giving them a good remuneration will also help in retaining the health workers. However, there is low distribution of health workers where majority are concentrated in the urban areas. Question is, are we taking training where it is needed? Are the specialist deployed where they are needed? This should be the initial stage in gap analysis. Technology should be a vital tool in this .This is because it can display the gaps in the human resources and distribution of health workers and track the training of health workers i.e. who needs long term training and who needs short term training. Therefore it’s important to deploy specialist where there is deficiency and not where there is a surplus.” She emphasized that the health sector needs to employ workers who are fit for purpose and the health workers should ensure they are safe in their working environment. This would serve as one of the solutions for curbing immigration of health workers. According to world health organization(WHO),the ratio of health workers to the population per county should be 23:10,000 in Kenya whereas the current ratio is still low as we stand at 13:10,000. Dr. Muriuki noted that the counties with highest health workers deficiency are  Isiolo and Wajir.

Ms. Faith Muigai, Regional Director, SafeCare, Pharm Access Foundation reiterated that there is need to need to shift attitude and create a good environment for patient care. We also have to change the narrative if we want to see good service delivery. However, she noted that there is poor or lack of infrastructure to enhance this. There is no independent body that checks the health workers performance thus there is no competition that would drive quality of service delivery. Ms. Faith said that more health facilities should be accredited and the accreditation system need not be a pass or fail model but one of incremental growth. In conclusion, Ms. Faith mentioned that data is required to drive transparency and accountability, that there is need to leverage on public private partnership so as to drive the quality agenda, and finally that there is need to invest in proactive and responsive versus reactive solutions.

Some of the major concerns that were raised from the audience were: there should be an assessment carried out on why there is poor distribution of health workers and even lots of immigration observed among the health workers and come up with a solution. There should also be a safe working environment for the health workers because some of the equipment and medication used exposes them to the dangers of contracting infections or even developing other health conditions. There was a recommendation that the health workers should be trained on disaster management even as we assess the training needs in the healthcare industry. Participants expressed unanimous consensus that there should be capacity building among the leaders to enhance accountability on financial management and on performance of healthcare workers. The policies created should also speak to each other.

The 6th annual Healthcare Management conference was a success bringing together a wide representation of stakeholders. The presenters provided key insights into the challenges and opportunities in the healthcare industry while the audience contributed engaging and thoughtful questions and remarks. If these ideas were implemented, we would expect to see the healthcare industry change for the good of all Kenyans! We look forward to the next conference

Healthcare Regulation and Quality Standards

Healthcare Regulation and Quality Standards

Private health sector advocates for quality healthcare services and patient safety

Healthcare regulations and quality standards are aimed at ensuring that health services are safe, effective and of good quality, and that they are provided in accredited healthcare facilities by duly qualified health professionals.

Health Regulations and Quality Standards committee members during the breakfast meeting

The Kenya Healthcare Federation (KHF) health regulations and quality standards committee held a breakfast meeting at KHF offices on 16th August 2018. The meeting was chaired by the committee chair, Ms. Millicent Olulo. In their previous meeting, the committee had engaged Ms. Doris Mueni, Deputy Director, Kenya Accreditation Services (KENAS), to clarify on the functions of accreditation and certification bodies. She advised that accreditation ensures an organization is competent to perform specific functions in a reliable, credible and accurate manner, while certification is provided to mark compliance with a standard or specification. There are major benefits of accreditation such as quality improvement in internal operations, safeguarding credibility of results from conformity assessment activities, and improved market image.

There has been much engagement between Ministry of Health (MoH), Kenya Bureau of Standards (KEBS) and the Kenya Accreditation Service (KENAS) to see how to adopt the Kenya Quality Model for Health (KQMH) as national standards for quality and patient safety. It was noted that KQMH has been revised and piloted in four counties and that the next steps as outlined in the tool are roll out of adequate human resources for health, definition of the private sector’s and counties’ roles, establishment of clear road maps based on the pilot and assessment, making a sustainability plan, and identifying public – private partnership (PPP) opportunities for the private sector in implementing KQMH.

It was also noted that there should be discussions with MoH on the Universal Health Coverage (UHC) agenda, particularly on the following aspects: Whether it is prudent to solely rely on the National Health Insurance Fund (NHIF) to deliver UHC for Kenyans –  would this compromise quality of care? Secondly, there needs to be a focus on quality assurance and a reliable supply chain. Ms. Faith Muigai urged KHF to have a strong position on quality of care. Ms. Muigai will develop a position statement to advocate for quality of care for UHC which will be presented to the Parliamentary health committee. There was a suggestion that Dr. Charles Kandie and Dr. Jared Nyakiba who deal with quality and safety policies at MoH be invited to the next committee meeting to enrich further discussions on accreditation of hospitals and patient safety.

The committee held elections of officials for a new term. Ms. Millicent Olulo and Mr. Antony Jaccodul were re-elected as chair and vice chair respectively. This was the first committee meeting under the directorship of the newly elected vice chair, Dr. Elizabeth Wala, and Director, Ms. Faith Muigai.

 

 

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