For healthcare, try Rwanda model

By CHRISTABEL LIGAMI
Posted Saturday, March 1 2014 at 13:37
The third annual East Africa Healthcare Federation Conference will be
held in Nairobi from March 2-4, under the theme "Creating Business
Opportunities in Healthcare in East Africa."
The Kenya Healthcare Federation chief executive Amit Thakker spoke to
Christabel Ligami on emerging issues and opportunities in private
healthcare.
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Is the region on the right track on healthcare provision both through
the private and public sector?
Healthcare in the region has been improving gradually but
affordability remains a major problem. There is a big improvement in
the private–public partnership, ensuring that healthcare is being
accessed by everyone. However, the private sector needs to be involved
in training and health research to improve healthcare in the region.
Which countries are on the right track and what are they doing that
the other countries can follow?
I would say Rwanda is on the right track because they have focused on
preventive healthcare by ensuring that the small but most important
issues like keeping the environment clean are in place.
In Rwanda, healthcare starts at the community level and not in the
hospital as in many other countries. This has been successful through
health schemes and mandatory medical insurance covers for the people.
Uganda needs to improve its healthcare indicators and refocus its
financial resources on health.
Burundi is still growing and more information and data is needed that
will help to tell what health challenges the country is facing.
Why are people still resorting to treatment outside the region and
what should be done to ensure that the region is globally competitive
in healthcare provision?
The economic growth of countries like India is very high hence more
investment in healthcare in terms of technologies and work force. As a
result, the country has many specialist doctors and the latest health
technologies.
In East Africa, demand is higher than supply. People will, therefore,
travel to India for treatment because the costs are lower and quality
is high.
However, there are facilities in India, too, that do not provide good
healthcare and people should always be careful.
East Africa should, therefore, not be competing with India but
collaborating so that some of the skills are brought into the region
to help curb the issue of people travelling for treatment.
Governments and private hospitals should consider hiring specialists
on contract to work in our high end hospitals and be informed of the
new technologies in the health sector.
Also, there should be a mechanism of collaborating with the Indian
hospitals on referring patients for high level surgery that is not
available here but then the patients should come back for
recuperation.
Some Indian hospitals like Apollo hospital have partnered with the
Tanzanian government to provide same healthcare services provided in
India in Dar es Salaam.
To be globally competitive, the five partner states, therefore, need
to strengthen their healthcare delivery.
What about emerging trends like social franchising?
Social franchising is promising to improve healthcare in the East
African region. Clinics and health organisations like Population
Services International (PSI), Marie Stopes are positioning themselves
to ensure quality healthcare for rural people. In the arrangement,
patients get healthcare nearby and through branded social franchisee
like Tunza clinics and Amua in Kenya.
Currently, there are 895 clinics in Kenya under social franchising.
Similar clinics by PSI have also been set up in Rwanda and Tanzania
(the Family Welfare Clinics). All these clinics are required to comply
with the health standards set.
What are the challenges to healthcare systems in the region?
The main challenges in the region are geographical, financial, low
uptake of medical cover and limited numbers of health workers
especially doctors and nurses. Currently, we have only 45 per cent of
the WHO recommended medical work force.
The challenges of disease burden and financing are similar in all the
countries but there are differences when it comes to the work force
shortage.
In Tanzania, the shortage of doctors is worse compared with the rest
because of its socialist past, where doctors were only allowed to work
for the government and everybody fled the country. It was only in 1992
that they were allowed to work for the private sector.
Burundi has a serious problem of government structures that need to be
sorted out.
What is being done to address these challenges?
Efforts are in place to set up new training facilities, e-training
systems and increase the number of faculties in universities across
the region to ensure that more doctors and nurses are trained.
In Kenya, the private sector has entered into partnership to set up
the Afya Elimu fund to be launched in the second quarter of the year
to ensure everyone who wants to train as a health worker has access to
funds.
The private sector has introduced health insurance policies for the
the poor like Linda Jamii and Changamka for the case of Kenya.
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