Intergrated public health care model ppp case study in kenya


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  • A group of international, private, non-denominational development agencies Empowers communities and individuals to improve livelihoods and opportunities Focus on poor people in resource-poor areas The AKDN offers a different, coordinated approach. AKDN a group of international, private, non-denominational development agencies and institutions. It seeks to empower communities and individuals to improve their living conditions and opportunities, and it usually works with poor people in resource-poor areas. In response to the question raised in the slide above, AKDN replies that financing alone is not the answer. The recent World Bank HNP stratgegy notes that ‘ money for medicine and equipment alone, without the right chain of events isn’t enough to save lives.’ The AKDN shares this conviction and affirms that: (a) the development perspective must be long-term; and that (b) there must be a focus on human resource development (remember Botwana), proper governance, effective management and community involvement. AKDN’s vision is improving living conditions and opportunities for people in the poorest parts of the developing world .
  • ‘ Assets’ in East Africa
  • Intergrated public health care model ppp case study in kenya

    1. 1. A Case Study –Integrated Primary Health Care in East Africa A model developed by the Aga Khan University East Africa and the University of California, San Francisco The EAAG Givers’ Lounge 30 March 2012 Dr. Michaela Mantel Aga Khan Foundation/Aga Khan University
    2. 2. Aga Khan Development Network 2
    3. 3. The AKDN Integrated Health System in East Africa – proposed settings Income pyramid Core provision  Sustainable health services of high qualityWealthy at primary, secondary and tertiary level in East Africa  Most care offered in AKDN-assetsMiddle class  8-10 clusters in the entire EAC to serve large number of patients with full continuum of care at highest standardsAspiring Access expansion • Target is a small number of geographically defined populations with patients acrossStruggling the wealth spectrum • Provide select types of care and partner with government/mission assets to Poor complete offering • Focus on selected districts and demonstrate how to improve access andDestitute quality in a sustainable way 3
    4. 4. Integrated Primary Health Care Start-Up Project (IPHC S’UP) Aga Khan University East Africa University of California, San Francisco Aga Khan Foundation June 2011-May 2012
    5. 5.  To develop an IPHC model that ◦ recommends effective mechanisms for partnership between district health systems and higher education institutions and ◦ identifies social innovations to increase access to high-quality primary health care services in resource poor, rural East African communities with focus on maternal. Newborn, and child health (MNCH) Planning grant for proposal development and Resource identification and mobilization for testing of the IPHC model in selected geographical area(s).Objectives
    6. 6.  Kaloleni District, Coast Province, Kenya Aga Khan University (AKU) University of California, San Francisco (UCSF) Community Health Department, Aga Khan Health Service- Kenya Aga Khan FoundationThe Partners
    7. 7.  Signing agreement with the Provincial Govt.  Community engagement exercise  Health facility assessment/mapping  Capacity building (district & AKDN internally)  Social innovation workshop and internet research  The nursing alumni conference  E-health training and health system workshopKenyan women on the way to the clinic  Testing the role of family medicine doctor in a district health system  Workshop with nurses/midwives  Building a partnership with the Kaloleni District Health Management andWhat we did the Hospital teams
    8. 8. Delay to seek care Delay to reach care Delay to receive careDistance to Health Insufficient money for Lack of capacity of healthCenter (HC) transport facility staffDelay in recognizing Lack of means of Insufficient linkagesdanger signs transport between health facilityLack of community Impassable roads staff and the Communityknowledge of the link Lack of communication Health Workers (CHWs)between improved between communities, Insufficient materials,maternal and newborn and first facility level medications andoutcomes and a skilled and referral level equipmentattendant at delivery Lack of community Poor motivation of healthLack of maternal engagement in local staff and inadequatedecision making power transport solutions attitude(men as main decision Poor quality of care andmakers) inappropriate caseConcern over costs of managementhealth care accessCultural beliefs ofdelivering at homePerceived poor qualityof health careThe three delays in maternal care
    9. 9. We learned about How to engage the communities to identify gaps and barriers in MNCH Community demands and priorities Engagement with community leadership and importance of participatory approaches in planning and monitoring Health workers needs for capacity building and effective methodologies for training /mentoring District management needs including the need for community based HMIS Strategies that have high potential to enhance community health, primary health care and referral system Cost-effective interventions and innovations ( technology), franchising, output-based approach and other good practice models We also learned about structures and processes that are essential to meet the universities’ needs in terms of education and research relevant to local health systems .What we learned
    10. 10. AKDN Integrated Health System in Partnership with the Public Health System Aga Khan University Hospital National (6) Provincial (5) Other Aga Khan Health Referral Services Hospitals District Hospital (4) Community Clinics Health Centres (3) Dispensaries (2) Community Units (1) AKDN Multi- sector input Source: Dr. Armstrong,
    11. 11. Integrated Primary Health Care Partnership Model Ministry of Health AKDN External ResourcesCore Principals Partnership Critical Inputs Values s Innovations, tools and other Quality ion rc h ice AKU/UCSF u cat esea Serv resources Accountability Ed R Bi-lateral Provincial Donors Impact Government Transparency Global Aga Khan Initiatives Relevance District Hospital Hospitals Sustainability & District Health Management Team International Access Foundations Resilience Aga Khan Community Primary Health Care Clinics Local NGOs Community Health Workers AKDN Multi-sector input Community Members become resilient, self sustaining and newly informed consumers in an emerging market while experiencing improved quality of life through a Multi Input Area Development approach
    12. 12. Partnership Model(AKU/UCSF/Local Govt. & AKDN/other): Education Research Services Critical Inputs from external resources (resource mobilization) Monitoring and evaluation – documentation and dissemination – informing/influencing policy Initial focus on MNCH Model of an open concept: changing focus according to changing needs and priorities; e.g. NCD, environmental health; even beyond HEALTHEnvisaged IPHC partnership programme
    13. 13. Next steps:Developing a AKU/UCSF partnership proposal for testing an IPHCprogramme in a selected district (Kaloleni District) for a period ofthree yearsResource mobilization to support to the partnership model toprovide ‘Critical Inputs’
    14. 14. We believe that we can make a difference! PARTNERSHIPTo create an IPHC partnership model that contributes to the health of communities in resource poor areas through community engagement, improved access to quality care, and strengthening health systems offer students unparalleled access to divergent communities provide faculty a unique opportunity to apply for research funding to undertake multidisciplinary, multi-sectoral research enabling AKU- UCSF / AKDN to design innovative, locally applicable, globally relevant solutions Develops education programmes relevant to local needs and utilizing locally applicable modern technologies to build multi-sector capacities addressing the current inequity in health and education Can bridge communities across three continents (AKDN focal regions)Our vision
    15. 15. Community based solutions  Support tools and innovations Training and mentoring of  Material and learning tools community health workers  Communication systems Increasing systainability of  Infrastructure improvements CHW system e.g. through  e-health system small enterprise ◦ e-learning development ◦ tele-medicine Franchising of community ◦ m-health midwifery services ◦ Information systems Voucher system for maternal  Local media services  Support to training and Birth planning and capacity building preparedness (savings for  Support to alumni networks transport)  Technical assistance to Resilience and positive develop tools and deviance approach innovationsCritical inputs: examples
    16. 16. Comments? Questions?Asanteni SanaThank you