A healthy society? That begins by strengthening and improving access to primary care so that everybody can avail of it. To help make this possible, Invest International, Amref Health Africa and Royal Philips have teamed up to form the Partnership for Primary Care (P4PC). A unique public-private collaboration that lays the foundation for a financially sound healthcare system in Africa. The results of a pilot project in clinics in Kenia are promising.
Making good quality and affordable primary care available to everybody in Africa. In a lasting and innovative way that also reaches the most vulnerable people. That is the goal of the Partnership for Primary Care (P4PC), a project that, after a successful trial at three clinics in Makueni County in Kenya, can now be introduced in 200 clinics in this and other counties. A fine example of using existing infrastructure, clinics and employees, with support from public-private partners and local authorities.
“With this project Amref and Philips can increase the impact on African healthcare. ”
Local Amref health worker Ann talks to women in Makueni, individually or in small groups, about the importance of good healthcare.
The best of four worlds comes together in P4PC, with each partner doing what they are good at. The collaboration should stimulate a lasting improvement to healthcare and a self-supporting care system. Experience teaches us that a well-planned and accessible primary care system can prevent many basic diseases and improve the functioning of hospitals. After all, they are relieved of requests for care that often fall outside their remit.
This is how the roles are divided:
1. Invest International provides funding as well as legal and business knowledge, and studies future funding for a wider rollout. In that way, Invest International contributes to SDG 3.8[BN1] : achieve universal health cover, including protection against financial risks.
2. Amref Flying Doctors trains health workers, manages hospitals and supplies health information to the inhabitants of Makueni. To achieve this, community health workers like Ann, pictured here, are appointed. This reflects Amref’s ambition to educate more and better health workers and provide primary care for everybody.
3. Philips supplies infrastructure and medical facilities for the clinics. This reflects Philips’ ambition to provide 3 billion people with good quality care by the year 2030.
4. The local authority in Makueni County is responsible for implementing policy and regulations and employing well-educated medical personnel.
The World Health Organization (WHO) sees the strengthening of primary care as the most efficient and cost-effective way of improving health. In addition, Kenya’s president Uhuru Kenyatta has listed universal health cover as one of his ‘Big Four’ goals for his second five-year term. This is in line with the vision of the WHO, Kenya Vision 2030, and the SDG 3.8 of the United Nations.
Improved access to better primary care is expected to increase the demand for healthcare among households. Providing more healthcare and declaring the costs with health insurers will increase the income of clinics. They can then finance improvements to the clinics and relieve the care system, thereby completing the circle.
Femke Bos, responsible for project development at Invest International, is pleased with the collaboration: “For us, this is an important transaction that forms the basis for an intensive collaboration with Amref and Philips. It has resulted in a three-year partnership with both organizations, to develop business models that provide access to primary care for people in Africa. The P4PC model lends itself excellently for this purpose. A public-private collaboration is seen as the most promising way of improving access to and the quality of healthcare. By focusing on scaling up and attracting finance and investment capital, we are helping to strengthen this model.”
During the pilot project the number of visitors to participating clinics rose by 92 percent.
In July 2018 the participating parties started a pilot project to test the innovative business model in three clinics in Makueni County in Kenya. Costing 1.3 million US dollars , the scheme initially ran until August 2019, before being extended until January 2020. The first results are successful and promising.
The clinics saw their income rise by 400 percent. In the three clinics that took part in the scheme, visitor numbers rose by 92 percent. Pregnant women attended local clinics in greater numbers: prenatal examinations rose by 31 percent, and the number of births in the clinics rose by 78 percent grew over the past 1.5 years.
Around 3,000 people are now registered for health cover. They have a healthcare insurance card that offers access to clinics.
“During the pilot the number of births in clinics rose by 78 percent.”
Community health workers like Ann, seen here in the photos, play a crucial role in the success of the project. The community where Ann works chose her for this role. She is being trained by Amref, provides information on health issues, and helps residents to register for health cover. She also registers pregnant women and keeps a watchful eye on them. Ann regularly visits people in their homes, mostly speaking to mothers, since they are usually the head of the family.
A mother with her child waiting in front of a clinic in Makueni.
A further scale-up of the project in various districts in Makueni County is planned for 2022. Its introduction in other counties is also under discussion. Some 200 clinics in Makueni are initially planned. Besides other counties in Kenya, there is the ambition to export the model to other countries in Africa. The ultimate goal is to reach millions of people and thus contribute to universal healthcare for everybody.
Jasper Klapwijk
Business Development Manager & Health Lead
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