INDUSTRY SPOTLIGHT
SPOTLIGHT ON HEALTHCARE IN KENYA An overview of Kenya’s Healthcare System and the need for greater collaboration between public and private healthcare providers Writer: Phoebe Harper | Project Manager: Krisha Canlas
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n Kenya, health care is a country-wide priority. Since pre-independence, the country’s health situation has been carried on a promising upwards trajectory, with continually declining mortality rates. In spite of this, with 70 percent of Kenya’s population living in rural areas, the country continues to be plagued by high levels of malaria, gastroenteritis, diarrhoea and dysentery, showcasing the familiar continental struggle of providing a clean water supply and combatting the level of mosquitoes. This particularly applies to what are often considered marginalised rural counties, such as West Pokot and Wajir. In these areas, health care provision is reliant on community health volunteers, and rudimentary health facilities that are staffed by nurses equipped with the means to provide basic services such as immunisation. The country faces an inadequate drug supply, whilst many health centres and dispensaries are lacking in critical facilities, resources and personnel with adequate training. Nevertheless, these facilities are essential in delivering outpatient treatment, diagnostic services and obstetric care in remote areas. The system is split between the Public, Private and Faith Based healthcare providers. Public providers supply the majority of the country’s health care, as the 47 individual county governments handle service provision on a local level. Each county is equipped with an individual hospital. On a countrywide level, the Public Sector is concerned with matters of policy and the country’s National Referral Hospitals, which include Nairobi’s Kenyatta National Hospital and the Moi Referral and Teaching Hospital in Eldoret. Within the country’s public hospitals, healthcare for the majority of services is free, whereas the fees within private facilities can be a significant deterrent for patients seeking care.
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It is estimated that approximately 20 percent of Kenyans are covered by health insurance, although this figure varies dependent on region, with a higher number reported in urban areas. For those with national health insurance coverage, in-patient treatment in public hospitals is free. For the uninsured contingent of the population, there is a perceived risk behind accessing healthcare, since this can result in poverty-inducing exorbitant fees. Overall, there exists a prevailing imbalance between the level of need, and the care that is readily available. This applies on both an economic and a geographical level. Most recently, COVID-19 truly exposed the weaknesses and vulnerabilities of the healthcare system, and the disjuncture that can arise between public and private providers. This lack of resiliency has been tried and tested before, as evidenced by the 2017 national strike of health care workers. Similar to the pandemic, these events triggered nationwide service disruption that highlighted the need for coordination both nationally and locally, and across all systems. Fortunately, in recent years, the health sector has been steadily ascending in terms of taking political priority, thanks to an increasingly interlinked and
KENYA’S HEALTHCARE SYSTEM – AT A GLANCE • 48 percent – Public systems operating under the Ministry of Health • 41 percent – Private sector • Eight percent – Faith-based health services • Three percent – Run by NGOs
KENYA HEALTHCARE FEDERATION (KHF)
Dr. Kanyenje Karangaita Gakombe, Chair KHF collaborative relationship between government and the private sector. This has resulted in an increase in health expenditure within the national budget. In 2021, this figure amounted to Ksh83 billion ($771 million), compared to Ksh73 billion ($678 million) the previous year. The fact that COVID-19 treatment in government hospitals is currently free, is a positive reflection of this improvement. In a bid to combat these shortcomings, the Government of Kenya (GoK) has also prioritised the accelerated implementation of UHC, with a roadmap in place to lay the foundations of an improved health system at both a community and facility level. Thanks to the invaluable assessments included within this roadmap through the Kenya Harmonised Health Facility Assessment (KHFA), the NoK can easily identify the areas for critical investment. This presents a key step towards securing sustainability across the system, thereby furthering Kenya’s reputation as a globally competitive nation.
STRUCTURE – KENYA’S HEALTHCARE SYSTEM The system works based on the following structure, with the more complicated health cases being referred to the higher levels: • Dispensaries and private clinics • Health centres • Sub-county hospitals and nursing homes • County hospital and private hospitals • National hospitals
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Africa Outlook (AO): What are some of the key Public Health related challenges you think Africa is currently facing or might face in the coming years? Meshack Ndolo, Account Manager (MN): Africa has the fastest-growing middle-class in the world. The number of middle-class Africans has tripled over the last 30 years. (AfDB defines the middle-class as persons with a per-capita expenditure of $2 to $20 a day, including a ‘floating class’ with daily consumption of $2-$4). This growth is expected to accelerate; by 2050, Africa’s GDP will double to USD 5.5 trillion while consumer spending will increase by more than three times to USD 4.75 trillion.1 Yet, as population expands and the consumption indicators move northward, we think the region shall face a critical health challenge of creating the foundations for long-term inclusive and sustainable growth. I think Africa might need to brace itself for a surge in non-communicable diseases (NCDs), in particular. AO: Why do you think non-communicable diseases (NCDs) pose a big threat? MN: Urbanisation is a key driver in Africa’s growth. Of the 2.4 billion people expected to inhabit the continent in 2050, 60 percent will live in urban areas.2 A growing middle class, coupled with urbanisation, is leading to amplified lifestyle risk factors. This demographic transition within Africa is rapidly translating into rampant unhealthy diets, increased tobacco and alcohol intake (especially among the young economically productive), and extended periods of physical inactivity, thereby causing a spike in noncommunicable diseases.
We must consider this shift in disease burden from communicable diseases (CDs) to NCDs. The yearly cost of treatment for NCDs far outweighs such costs for CDs. For instance, in Ivory Coast, the annual cost of treatment for typhoid fever with Clamoxyl is $1, while the annual cost of treatment for diabetes with Mixtard HMGE is $297 and for cancer with Taxotere is $1,764. Since access to health care in Africa is mainly financed by households through direct or indirect out-of-pocket payments, a typical middle-class patient in Africa suffering from diabetes can expect to spend more than 10 percent of their monthly income on a biologic treatment such as insulin. Therefore, access to NCDs treatments is increasingly becoming a challenge for urban middle class. By 2030, the deaths from NCDs in Africa are projected to exceed deaths caused due to communicable, maternal, perinatal, and nutritional diseases combined.³ AO: Could you help expand on the current landscape of drug availability and access? MN: Unfortunately, we are witnessing a lack of both accessibility and affordability. There is a shortage of NCD drugs and those in the market are beyond reach of the majority because of the prohibitive prices. Africa has a highly fragmented, complex private sector supply chain that limits availability and accessibility to medicines leading to a vicious cycle of complications, high morbidity and mortality with devastating socio-economic consequences to households. It is worth noting that 50-60 percent of the ‘price to patient’ is due to the accumulation of costs and charges incurred in the endto-end supply chain from port of entry to
dispensing of medicines to patients. We conducted a study across five therapeutic areas (antibiotics, anti-diabetics, anti-epileptics, anti-hypertensives and respiratory agents) and found that net manufacturer selling price was just ~25 percent of end user price in Kenya, while this was ~60 percent in India and Netherlands and ~50 percent in Russia and South Africa. So clearly, it’s crucial to fix the gaps in service delivery and streamline the supply chains to ensure better access and availability. AO: What role has IQVIA played in such scenarios? How do you help your clients overcome these challenges? MN: We have a dedicated “Public Health Practice” with offerings to strengthen health systems with resilience, targeted towards LMICs including African countries. IQVIA has worked with governments, regulators, institutional donors, large international agencies, multilaterals and NGOs. We mobilise governments and public health partners and facilitate setting the agenda for public discussions of healthcare topics — ranging from population health management, service delivery augmentation, digitisation of healthcare systems, supply chain assessments and improvement to Universal Health Coverage programme design and implementation — with regular publications of original, independent reports. We support policy and decision makers with appropriately packaged and sensitive analytics in ways that shape public opinion and influence disease prevention, positive healthcare seeking behaviour towards better health and economic development indicators.
Discussing access to NCD drugs specifically, we recently undertook a project on Improving Cold Chain in Sub-Saharan Africa. We helped build an analytical framework to help our client identify the binding constraints in the supply chain in Sub-Saharan Africa. Our team provided a recommendation for an industry-wide, collaborative, marketshaping approach outlining its goals, structure, implementation plan, and KPIs. This is how we have been assisting our clients building their way towards better access to NCD drugs.
AO: What are your thoughts on the quality of Africa’s current health systems? MN: While we see many countries in Africa have started to take steps towards universal health coverage for their respective populations, still much work lies ahead to truly build a sustainable health care strategy. The challenge of a frail and inadequate health care system in Africa has been exacerbated by the COVID-19 pandemic. Since the emergence of the pandemic, Africa depended heavily on other countries for supplies including testing kits, personal protective equipment
(PPE) and more recently vaccine needs – 99 percent of the continent’s vaccines are imported. This dependence on imports has made the population vulnerable to shortages of these commodities, thereby causing health security challenges to health workers, providers of health care and the citizens. The vaccine shortage indeed triggered a continent-wide crisis that evolved into discourse on the potential for Africa to accelerate local manufacturing of vaccines. Africa’s health systems have to-date largely focused on tackling communicable diseases and maternal, neonatal and child related illnesses, albeit with resource constraints. There is a lack of experience in managing NCDs and the accompanying shifts in healthcare priorities. The pandemic has drastically exposed the soft underbelly of the fragile healthcare delivery system across Africa including the poor healthcare financing infrastructure. Inadequate human resources for health, inadequate budgetary allocations to healthcare, and poor leadership and management in healthcare have led to the underdeveloped healthcare systems in Africa. Over the next decade, Africa will need over half a million additional hospital beds, better production facilities and distribution/retail systems for pharmaceuticals and medical supplies, and about 90,000 physicians, 500,000 nurses, and 300,000 community health workers.4 Those are big targets to meet.
AO: What kind of role has IQVIA played in the public health systems and service delivery space? MN: In service delivery, we bring a patient/beneficiary centric approach to all the public health projects we undertake and have a wide range of experience from healthcare surveys to technology to transformational insights. While we have worked on several projects in Africa, especially related to COVID management, I will highlight the Vaccine Manufacturing and Distribution Sector Diagnostic work we did very recently. We conducted an analysis of the vaccines market in North Africa and Frenchspeaking West Africa to aid an international development bank in better understanding the opportunity and feasibility of vaccines manufacturing in a country in North Africa. We recommend that for Africa to achieve vaccine security, it must promote regional vaccine manufacturing hubs on the continent through public-private partnerships with global manufacturers, following a backward integration strategy to develop capabilities. Another key project is the Healthplug (EMR) Platform Implementation. We used our proprietary Healthplug suite to streamline the government managed healthcare coverage in Egypt. Our solution seamlessly integrates with the insurance system,
enabling real-time eligibility checks for individuals at the point of care, minimising misuse and errors. Not only has our inhouse solution helped doctors with rapid documentation via machine learning driven smart consultation capabilities, but it has also enabled direct booking with specialists at hospitals which helped eliminate long queues at hospitals and minimised callcentre traffic. AO: Any closing thoughts you’d like to share with us? MN: Investment in Africa’s health systems is key to inclusive and sustainable growth. We need innovative solutions to break the current impasse in service delivery. In order to make any gains on global and regional sustainable development and health agenda – including the Sustainable Development Goals (SDGs), Universal Health Coverage (UHC), and Africa Agenda 2063 – a system approach to improving urban health and addressing urban justice in Africa should be prioritised.There is a need to create and sustain momentum for the design and implementation of renewed public health in Africa through advocacy targeted at different audiences and stakeholders. Essential objectives should be how to change mindsets of key stakeholders to see the need for change toward a more relevant and effective
public health framework and practice, to enable critical investment with high yields for improving the quality of life and economic development targeting: national health departments, regional bodies, global development partners, faith-based organisations, professional associations, academic and research institutions, and regulatory bodies. At IQVIA, our goal is to work with our clients to strengthen the health systems by working across health system building blocks. I would like to close with a very impactful assignment we did for a premier international development agency. Our data and benchmarking services helped them to better understand the procurement and management of contraceptive, malaria and maternal child health commodities in East African countries such as Kenya. Our objective was to minimise negative outcomes — particularly in vulnerable and underserved populations. After implementing the project, two-thirds of all family planning commodities were supplied free of charge.
Sources: 1. 2. 3. 4.
AfDB – Africa Progress in Figures Africa Union Agenda 2063 The Rise and Rise of Chronic Diseases in Africa Health Care in Africa: IFC Report Sees Demand for Investment
IQVIA_MEA iqvia-middle-east-and-africa
www.iqvia.com
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INDUSTRY SPOTLIGHT
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KENYA HEALTHCARE FEDERATION (KHF)
Interview: Kenya Healthcare Federation (KHF) As Health Sector Board of the Kenya Private Sector Alliance, (KEPSA) the Kenya Healthcare Federation (KHF) champions access to quality, affordable healthcare for all. CEO, Dr. Anastasia Nyalita, discusses the organisation today
Dr. Anastasia Nyalita CEO, Kenya Healthcare Federation
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ince its foundation in 2004, the Kenya Healthcare Federation (KHF) has represented the collective voice of the country’s private healthcare sector. KHF acts as the health sector board for the Kenya Private Sector Alliance (KEPSA). Taking a pro-active role in advocating for the sector’s best interests at a governmental level, KHF champion the altruistic vision of providing quality and affordable healthcare for all – both within Kenya, and across the wider East African community. Indeed, KHF stands as one of the founding members of the East Africa Healthcare Federation (EAHF), founded in 2012 with the mission of engaging private sector health actors across the region. As a unifying voice pioneering private sector consolidation, KHF is critical in maintaining engagement with both government and stakeholders through Public-Private Partnerships and consistently voicing support and concerns on behalf of their members. By so doing, KHF is wellplaced to propose alternative solutions to the major issues confronting Kenya’s health sector. In the face of the supply chain and health service disruption from the COVID-19 pandemic,
KHF continues to lobby for the need to secure a sustainable future by continuing to strengthen an enabling business environment. As a result of this difficult time, KHF implemented a COVID-19 Response Team, designed to coordinate activities amongst private sector stakeholders in health to expedite detection and reduce transmission of the disease through an effective structure. Indeed, these efforts had a tremendous impact on the country’s overall COVID-19 response. Strategic key partnerships with the National Government of Kenya (GoK), county governments, Faith-Based Organisation (FBO) networks, and NGOs are all instrumental in driving the federation’s goals. Dr. Anastasia Nyalita, CEO of KHF, tells us more. Africa Outlook (AO): Can you talk us through the origins of the KHF; how it came about and its initial vision? Dr. Anastasia Nyalita, CEO (AN): Here in Kenya, the private sector is very well structured to engage with the government. We have an apex body called the Kenya Private Sector Alliance (KEPSA). Within KEPSA, we have Sector Boards that basically mirror the government agencies. This makes it very easy for the private sector to engage them and other partners in terms of dialogue relating to the private sector. The Kenya Healthcare Federation (KHF) represents the Health Sector Board within KEPSA. KHF was founded in 2004 and registered in 2008 as a company limited by guarantee. Our foundation Africa Outlook issue 92 | 9
Marie Stopes Kenya (MSK) is the local implementing partner of MSI Reproductive Choices in Kenya and has consistently worked on increasing access to high-quality and affordable sexual and reproductive health (SRH) services for all the women and men in Kenya since 1985. As the leading SRH provider in Kenya, MSK works in close coordination with the Government of Kenya and aligns programming to the national health priorities set by the Kenyan Ministry of Health. MSK implements a service delivery approach that is free from stigma, judgement, and discrimination of any kind. MSK provides all modern methods of contraception, comprehensive post-abortion care (CPAC), sexual health counselling, gynecological check-ups, cervical cancer screening and treatment, testing and treatment of HIV and other sexually transmitted infections, and antenatal and postnatal care.
MSK currently delivers services in 43 counties through various service delivery channels adapted to fit the different contexts of each county, to maximise opportunities for building sustainable service delivery platforms. With over 250 staff, MSK operates centres, a maternity obstetric hospital, Basic Emergency Obstetrics, the AMUA social franchising private clinic network, and supports government clinics as part of its Public Sector Strengthening programme. In Kenya, the current Maternal Mortality Ratio (MMR) is 362 maternal deaths per 100,000 live births, with the still birth rate standing at 23 deaths per 1000 live births, that is far below the target of 70 maternal mortality per 100,000 live births and 12 still births per 1000 live births respectively.
The major complications that account for nearly 75 percent of all maternal deaths are: • Severe bleeding (mostly bleeding after childbirth) • Infections (usually after childbirth) • High blood pressure during pregnancy (pre-eclampsia and eclampsia) • Complications from delivery
The World Health Organization (WHO) recommends that every pregnant woman should undergo at least one ultrasound scan, preferably before 24 weeks of pregnancy. The 24-week period is of vital importance to accurately estimate the gestational age, improve the detection of fetal abnormalities and to detect multiple pregnancies. In addition, the WHO recommends increased contact between pregnant women and the antenatal healthcare providers to improve communication, identification, and the management of potential complications. In response to this national health requirement, MSK offers Maternal Health Care. MSK currently has one maternity obstetric hospital and has recently expanded to having two additional Basic Emergency Obstetric (BeMOC) facilities. The centres are fully equipped with state-of-the-art equipment and trained personnel to offer quality antenatal and postnatal care services. Since January 2020 MSK has served a total of 2,521 clients with ANC services and has served 887 mothers with delivery services.
“We are very proud to offer maternity services to support the health system and the health objectives of the Kenyan Ministry of Health. We work in very close coordination with the Government of Kenya and treasure this partnership and collaboration to address issues such as maternal mortality. Every woman who goes through a successful pregnancy and delivers a healthy child is another step in the right direction for all of us. We are happy to be a part of it.” - Sophie Hodder, Country Director of MSK
WhatsApp: 0709819001 Tel: 0800720005
www.mariestopes.or.ke
INDUSTRY SPOTLIGHT
African Region, Kenya, Uganda, Tanzania, South Sudan, Ethiopia, Rwanda and Burundi, coming together to form the Healthcare Federation (EAHF), acting on a rotating chairmanship. Critically, this enables us to also shape policy on the regional level. AO: What are KHF’s organisational goals? AN: KHF’s goals are as follows: • Initiate activities and programmes that guarantee the sustainability and vitality of the Kenya Healthcare Federation. • Promote the role of the private sector as a key player in delivery of quality healthcare services in Kenya.
INTERVIEW
Health Sector Round-up meeting
was born from the need to have one voice within health to engage the government in dialogue, promote strategic public-private partnerships and champion access to quality healthcare for all. This is our mandate and it is what we continue to do. In terms of mission, this is to drive strategic publicprivate partnerships within what we call the publicprivate dialogue for better healthcare. This involves engaging, representing and networking for win-win negotiations. Our core values include compassion, inclusivity, capacity building, leadership and innovation. In terms of how we achieve our vision and mission, we do this by initiating programmes and activities that guarantee the sustainability and vitality of the federation. We were one of the first healthcare federations to be founded in the region with support from the International Finance Corporation (IFC) and World Bank through the Africa Health Initiative. There are seven organisations similar to us within the East
KHF - CORE VALUES • Compassionate • Inclusive • Consensus-building • Low-ego leadership • Innovative
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• Engage with various government of Kenya agencies and other policy makers in the development of policies that promote delivery of quality healthcare services in Kenya. • Build the capacity of members and lobby for action in key thematic areas of health service delivery. • Facilitate, coordinate and undertake the publication and dissemination of the annual Kenya Health Index. AO: What do you find most exciting about working within Kenya’s private healthcare sector? AN: It is our mission of supporting quality and affordable healthcare for all which is achieved through strategic partnerships. In Kenya, we have what we call the public-private mix, in terms of health service delivery. If you look at our health facilities, the private sector constitutes more than 48 percent of Kenya’s total health service – so it is a key contributor. Alongside this, we have the other players which include the public sector (which is the main one) and faith-based service providers. Our role is a dynamic one in terms of how we really influence policy’s contribution to quality healthcare through engaging with the various government agencies and other policy makers in their development. We appreciate the open-door policy that we have with the Ministry of Health. I know that this also applies to other ministries in Kenya, who have very well-established public-private dialogues. As KHF, we participate in many of the government technical working groups encompassing many
KENYA HEALTHCARE E F E D RATION K ( HF)
areas - ICT, supply chains, Universal Health Coverage (UHC), and within inter-agency coordinating committees. We hold regular ministerial stakeholder forums presided over by the Cabinet Secretary for Health and co-chaired by chair of KHF to discuss health matters on a quarterly basis, concerning emerging issues and what we propose as the private sector. This also allows us to feedback on what the Ministry are doing. We brainstorm any current issues that are arising, and this creates a very strong collaboration between us and the Ministry of Health. At KHF and through KEPSA, we have the one platform through which the government can effectively engage with the private sector. As KHF, we are driving an agenda that will ensure that beyond COVID-19, we are self-sustaining from a supply chain and service delivery perspective on a similar level to India and Bangladesh. Of course, this is aspirational. I believe that this is truly a value proposition for both the country and our members. AO: On the flip side, what are its biggest challenges? AN: One of the things that healthcare players and providers are struggling with is efficiency and
healthcare financing. This is particularly difficult for private sector bodies to source financing. Another key thing that we are working on tackles the large amount of fragmentation that exists around the private sector in terms of the supply chain and service delivery. This has particularly become a major issue due to the disruption caused by COVID19, which means that most countries are now looking inwards. AO: Have you got any ongoing projects in the pipeline you wish to highlight?
INTERVIEW
KHF partnered with Stanbic Bank Kenyato donate PPEs
AN: In the discharge of its mandate, KHF conducts different projects with partners. We give our members priority to participate in projects such as Afya Elimu Fund, multi stakeholder partnership and other national, regional and global projects. Another key thing that KHF do concerns capacity building within the key thematic areas of health. We are currently working on a Payer-Provider Engagement initiative, in collaboration with World Health Organisation (WHO). The Ministry of Health is supporting this, as is ThinkWell and the Strategic Purchasing Africa Resource Centre (SPARC), basically to encourage the two sides of care providers to speak with each other and identify Africa Outlook issue 92 | 13
Africa Outlook (AO): Can you talk us through the origins of KCEMT; how it came about and its initial vision? Eunice Wanjiku Kamau (EWK): On August 8th 1998, the worst disaster on Kenyan soil was experienced. The terrorist bombing of the American Embassy in Nairobi destroyed a seven-storey building nearby. This left over 250 people dead and thousands of others injured. The injuries ranged from simple incisions to massive avulsions, numerous fractures especially from people who tried to jump from the upper floors of nearby buildings and pedestrians with all kinds of injuries caused by flying shrapnel & pieces of broken glass. The search and rescue efforts were led by the armed forces. Other rescuers included firemen from the then Nairobi City Council, volunteers from St. John Ambulance and Red Cross and search and rescue teams from Israel Defence Force. American, British and French rescue teams were also present. After the disaster, a training needs assessment of the Kenyan rescue teams was done and that led to the first training of Emergency Medical Technicians (EMTs) in East and Central Africa between November 1998 and March 1999. The classes were organised by the International Medical Corps and an instructor from the United States – Mr. Juan Garcia conducted the training. Two groups were trained in Nairobi and Mombasa with forty EMTs each. The EMTs were drawn from St John Ambulance, Kenyatta National Hospital, Nairobi City Council, Kenya Army and the Kenya Police. The second class in Nairobi had approximately twenty EMTs drawn from Nairobi Hospital, Gertrude’s Garden Children’s Hospital, AAR and AMREF.
In 2000, the same group of EMTs were re-trained and upgraded with the assistance of IMC/USAID and once again Mr. Juan Garcia & Dough Pinder both paramedic instructors facilitated the sessions. From that initial group of EMTs, 15 of them were further trained as Emergency Medical Service Instructors (EMS-I). Through these EMS-Is two other groups of EMT-Bs were trained in Mombasa and Nairobi bringing the total of EMTBs in Kenya to 152. The EMTs were trained using the Department of Transport (DOT) curriculum as is in the Emergency Care and Transportation – 6th Edition. The EMTs further received training in search and rescue, water rescue, vehicle extrication and incident command System. After noting that there was a need for improving the EMTs skills and knowledge and training of new EMTs, it was proposed that an independent mother body to represent the EMTs interests outside the workplace be formed. That gave birth to the Kenya Council of Emergency Medical Technicians (K.C.E.M.T). KCEMT that was registered under the Registrar of Societies on March 9th, 2009. Lack of legislation caused a lull in the development of pre hospital structures. In 2008, AAR partnered with USAID to offer partial scholarship for another EMT class in an effort to increase the number of EMT’s. This was a good jump start that placed KCEMT as an oversight body for agencies that train the course. With several agencies running a class, twice every year, the number of EMT’s has steadily grown and currently exceeds 1,000. AO: What does the current state of your industry look like today? Is it an exciting space to be working in? EWK: The big four agenda was introduced to the Kenyan public by the President in 2017 as the
government’s plan to fulfil promises made during the campaign period. Affordable Universal Health Care is among the items. Pre hospital care needs began to come to the fore and the gaps laid bare especially with the Covid-19 pandemic. Pre hospital conversations have now become a policy and advocacy agenda in board rooms that saw the launch of the Emergency Medical Care Policy on July 7th, 2021 and the inauguration of the Emergency Medical Care steering committee. KCEMT is in the process of tabling in Parliament the EMT and Paramedic Bill 2020 that seeks to regulate EMTs and Paramedics for recognition as a Cadre within the healthcare sector. AO: On the flip side, what are the greatest challenges facing emergency medical care in Kenya? EWK: Despite Article 43 (a) of the Constitution of Kenya 2010 that guarantees “every person has the right to the highest attainable standard of health, which includes right to healthcare services”. Further Art. 43 (2) provides that no person shall be denied emergency medical treatment, there is currently no government funding and regulation for Emergency Medical Care. Lives are lost every day because they cannot access emergency care.
Medical Care steering committee and linkage with Africa Outlook. AO: What are the benefits of becoming a member of KCEMT? EWK: Every professional needs to have a professional body to associate with for growth, licensure, networks, opportunities and capacity development. In partnership with Malteser International, 148 EMTs received sponsorship in Basic Life Support and Advanced Cardiac Life Support training; 38 EMS-I were taken through instructor course between April and August 2021. AO: Are you optimistic about the future of emergency health care in Kenya? EWK: Very much. Emergency health care in Kenya will quickly develop especially because it now has government goodwill and there is so much that needs to be done.
AO: What can you tell us about your relationship with the Kenya Healthcare Federation? EWK: KHF has enabled access to the ministerial stakeholder forums where policy makers sit and the Multi Stakeholder Partnership. KHF has created exposure and platforms for advocacy by seconding me to represent KHF in the newly inaugurated Emergency
Eunice Wanjiku Kamau Chairperson
South Gate Centre, Mkoma Road, South B Shopping Centre, Second Floor, Suite 2 T + 254 787 77 77 70 | info@kcemt.co.ke | www.kcemt.co.ke @KCEMTKenya Africa Outlook issue 89 | 15
INDUSTRY SPOTLIGHT
the themes that they are struggling with and their aspirations in terms of what they want to see from a policy and capacity building perspective. We know for example that the payers have an advantage when it comes to healthcare financing and understanding compared to the providers – so we will try and address the matter of how do we provide a solution to address this gap. As an outcome of the Payer-Provider Engagement initiative is draw up an issue paper where there will be actions, policy aspirations, and so on in terms of the key thematic areas. Aside from the Board, KHF also has the secretariat, which I lead, alongside our technical working groups/committee and our members can participate based on their technical expertise and individual areas of interest. These are aligned with the building blocks of health systems as specified by WHO, which include Health Regulations, Quality and Standards, Healthcare Financing, Human Resources for Health,
INTERVIEW
KHF – PROJECTS AT A GLANCE • Private Sector Health Partnership Kenya (PSHP - Kenya). • The Afya Elimu Fund (AEF) - Revolving fund in Kenya towards maximising the contribution of the private health sector.
KHF Management team
“The primary benefits for our members fall into six main categories; advocacy, projects, partnerships and engagements, networking, regional integration, and access to patent events, trade missions and expos throughout the year” - Anastasia Nyalita, CEO, KHF
• Aids Free (Abt. Associates) - The APHIAplus Health Marketing Communications Programme (HCM) under the PPP SOW.
Supply Chain, ICT/Mobile Health and Public Private Partnerships.
• KHF and McKinsey - Strengthening the role of the Private Sector in treatment, diagnosis and financing for HIV/AIDS in Kenya.
AO: Tell us more about being a member of KHF?
• The Multi Stakeholders Partnership Kenya (MSP-K) - Strengthening the Specialised/ neglected Carers in Kenya. • Afya Ku Anza! Fund in partnership with Kenya Paediatric Association - The private sector children’s fund. • African Economic Research Consortium (AERC) - Strengthening East Africa Community Policy Response to COVID-19. • Wheels for Life - Providing free transport to pregnant women during curfew hours to hospitals.
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AN: Our members see the benefit of belonging to KHF because we are entirely a membership-based organisation. We promote the role of the private sector as a key player in the delivery of quality healthcare services in Kenya. The primary benefits for our members fall into six main categories; advocacy, projects, partnerships and engagements, networking, regional integration, and access to patented events, trade missions and expos throughout the year. As such, the unique benefit provided to our members is primarily advocacy since we act as the sole collective voice of the private sector. We voice our member’s issues at the technical working groups at a committee level, where they can deliberate difficulties that are then taken up by the board and presented either to the Ministry of Health, or
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KHF MEMBERSHIP – AT A GLANCE KHF’s members represent the six building blocks of health systems, as outlined by WHO. These include: • Service Delivery • Health Workforce • Information • Supply Chain • Health Financing • Governance
through its agencies. When necessary, this can then be presented at even a parliamentary or presidential level through KEPSA. In terms of who is included within our membership, this extends to all the sub-sectors. We have a total of over 160 members – on our database we have close to 200 but in terms of our most active, they number approximately 160. This includes institutional organisations, such
as cooperates, NGOs, and commercial and social enterprises. They form the majority of our membership, and they come from within healthcare, financing, supply chain, service delivery, human resources for health, advisory, governors, and health technology organisations as well. Then we also represent professional associations – healthcare professionals. We don’t have individual members; they are all either organisational or institutional associations. Finally, we have Trade Associations / Institutional Associations, such as hospital associations, local manufacturers, medical insurance providers etc. As you can see, we represent everybody across the board. Overall, we also benefit from the stronger voice that KEPSA has in advocating for the wider issues. We foster engagement and host regular events to encourage dialogue from all the players in the health sector.
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• Multidisciplinary Care
Tel: +254 (0)702 249 853 admin@khf.co.ke www.khf.co.ke Africa Outlook issue 92 | 17
KENYA HEALTHCARE FEDERATION (KHF) 2nd Floor Office No. 6, Kedong House, Lenana Road/Ralph Bunche Road Junction, P. O. BOX 37929-00100 Tel: +254 (0)702 249 853 admin@khf.co.ke www.khf.co.ke PRODUCED BY AFRICA OUTLOOK MAGAZINE