Innovation in healthcare

provision towards achieving

universal coverage

Gordon Otieno Odundo

Chief Executive

Gertrude’s Children’s Hospital

Kenyan Context

• 2% of GDP on Health Spending

• Per capita spend of USD 12.6 vs USD 44 (WHO)

• Decline in recurrent expenditure and an increase in development expenditure

• Inadequate and poor state of Infrastructure

• Inadequate Human resources

• Frequent shortages of supplies and medicines

In summary

• At 6% of national budget funding is at 50%

below required level

• Prevalence of non communicable

diseases

• High poverty rates, inadequate funding,

shortage and misdistribution of health

personnel, low literacy levels, lack of safe

drinking water, sanitation and

infrastructure

Universal coverage ?

Dominance of Private Finance - 54%(84%

out of pocket)

Donor Finance - 16%

Government - 30%

The challenge is to use available resources

efficiently and deliver quality services and

improve health outcomes

Ownership Hospitals % Health Centre

% Dispensaries % Maternity/ Nursing Home

% Clinics % Total

MOH 273 58 579 68 2719 70 1 0.5 1 0.1 3570

FBO 80 17 174 21 164 4 21 11.5 78 3.9 1044

Other Public 11 2 47 6 691 18 0 0 35 2 429

Private 108 23 47 6 336 9 160 88 1870 94 2350

Total 472 100 847 100 3910 100 182 100 1984 100 7395

Statistics

MDG 4 on Universal Healthcare

• Affordable access to quality (meets patient needs) treatment and care for all, or to 80 per cent where such access was less than half in 2010.

• Continue to reduce the reach of TB, malaria and HIV/AIDS, and contain the spread of new drug resistant strains.

• Halt the rise in non- communicable diseases.

• Universal reproductive health services including access to birth control and to a qualified attendant at birth.

• Cut maternal mortality rate by at least ¾.

• Reduce the under five mortality rate by at least ⅔

Health Sector Reform• •

• Ensuring equitable allocation of government resources to reduce disparities in health status

• Increasing the cost effectiveness and the cost efficiency of resource allocation and use

• Continuing to manage population growth

• Enhancing the regulatory role of the government in all aspects of health care provision

• Creating an enabling environment for increased private sector and community involvement in health service provision and finance

• Increasing and diversifying per capita financial flows to the health sector

Michael Porter says

‘In health care, the overarching goal for providers, as well as for every other stakeholder, must be improving value for patients, where value is defined as the health outcomes achieved that matter to patients relative to the cost of achieving those outcomes. Improving value requires either improving one or more outcomes without raising costs or lowering costs without compromising outcomes, or both. Failure to improve value means, well, failure.’

Conclusion

Increased incomes improve health out comes due to healthy life styles and affording health insurance

Cost sharing though desirable requires domestic sacrifices and calls for greater management of the revenues

Restructure health provision and allow for social insurance for the poor

Requisite political backing (champion)