The Role of the Private Sector and Social Franchising in UHC: A Case Study from KenyaJoyce Wanderi, PS KenyaSeptember 18th, 2015

A refresher: What is social franchising?

Branding

Training

Standards

Commodities

Approximately 43% of Kenyan’s rely on the private sector for FP (KDHS 2008)

Private sector especially the lower levels that serve majority of Kenyans have varied quality

Social franchising, organizes the private sector reducing variability in quality of care

It also offers a way of scaling up successful solutions to meet a greater need

Why social franchising?

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Typical Profile of Tunza clinic ~55% are in urban areas

serving urban & peri-urban

~60% of facilities are small, outpatient only

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Big Medium Small

Qualification of health service...0%

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Nurse Clinical officerDoctors

~80% are run by a nurse and refer complicated cases

Text

SIFPO support in Kenya Expanding competence of

providers to include LARC – Implants and IUCDs

Strengthening quality monitoring to ensure client safety and informed choice

Increase in scale of the network to increase access points

Addressing demand for services

Impact: Changes in IUCD & Implant Method Mix in Tunza -

2011 2012 2013 20140

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IUCD share (%)Implant share (%)

pills; 24%

injectables; 61%

implants; 8%IUCDs; 7%

2011 – 300,000 women

pills; 17%

injecta-bles; 56%

Implants; 15%

IUCDs; 12%

2014 – 350,000 women

Impact: Increase in the Scale of the Network

HTC/ HIV

care &

treatment

Cervical

cancer

ANC,

Skilled

delivery,

PNC

One key lesson learned - Integrated Service Delivery

Challenges encountered….

Managing quality efficiently in the context of increased

scale and scope

Skills erosion through staff turnover

Patient management – referrals and follow up systems

due to lack of automated record keeping

The Future 1: Supporting Integrated Service Delivery and Evidence Based Decision Making

ASSESS: undertaking quality assessments IMPROVE: provision of structured feedback PLAN: Work planning / scheduling of visits MONITOR: Monitoring performance of network providers over time

The Future 2: Navigating New Health Financing Towards Universal Health Coverage

A maternal health focused savings card

The expanding National Hospital Insurance Scheme

An out-patient oriented micro insurance scheme

The Future 3: Coordination! Coordination! Coordination!

Thank you