7th World Medical Tourism and Global Healthcare Congress presentation to the 3rd Annual Medical Director Summit held on Sept. 21st during the Annual Congress. The Congress took place September 20th -24th 2014 at the Gaylord National Resort & Convention Center in the Washington, DC area. The esteemed presenters were CEOs and Healthcare Leaders from around the world who recognize the value of the event as the largest medical tourism event in the world where people come together for prearranged business to business meetings to maximize their ROI. The Summit gathered Chief Medial Officers and Medical Directors from top hospitals and insurance companies from around the world to collaborate and network regarding the challenges in providing quality healthcare and insurance to local and international patients, and allowed discussion with peers in other countries and learn best practices to strategically improve our organization’s planning. The presentation centered on Delivering High Quality, Low Cost Care at Scale through Primary Care : A case Study from Gertrude's Childrens' Hospital, Nairobi Kenya.Gertrude's Children's Hospital, Nairobi Kenya is the longest established paediatric hospital in East and Central Africa. The hospital is reaching out into peripheral clinics to offer child health services, vaccination and primary care. Seven day working, a shared record and IT for scheduling ensures that waiting times are very low and that continuity of care is maintained. In a competitive market forming an early relationship with children and their families is important and a well organised clinic, in a convenient location and staffed with skilled and well qualified professionals is an important part of this strategy. The model is very successful and won a Millennium Development Goal Award and is being copied by other providers in the country.

1. Gordon Otieno Odundo
Chief Executive
Gertrude’s Children’s Hospital

2. Presentation Content
Background of Gertrude’s Children's Hospital
Outline the context of Child Health in Kenya
Overview of our activities
Governance and ownership
CSR – Un Global Compact
Information Technology
Staff and Capacity Development
Patient Safety and quality

3. The country has a young population, with 73% of residents aged below 30 years
because of rapid population growth from 2.9 million to 44 million inhabitants over
the last century. 1.5 million children are born each year

4. Causes of Child
Mortality - Kenya
Cause Deaths
Total Deaths 188,928
Diarrhoea 38,802
Pneumonia 30,406
Malaria 20,666
2 October 2014
3%
8%
Source: World Health Statistics 2011, WHO
16%
20%
9%
1% 11%
10%
10%
19%
3%
Pneumonia Diarrhoeal Causes HIV/AIDS Malaria
Measles Prematurity Birth Asphyxia Neonatal Sepsis
Congential Anomalies Other diseases Injuries
Neonatal
causes =
31% of
under 5
mortality

5. North
Eastern
80
Eastern
52
Rift
Valley
59
Western
121
Nyanza
149
Central
51
Nairobi
64
Coast
87
Under-five
Mortality by
Province
Deaths per 1,000 live births
for the 10-year period
before the survey
Kenya National Bureau of Statistics & ICF Macro
Kenya 74

6. Child Health Situation- Kenya
Progress in Infant and Under-five Mortality Rates, Kenya 1990/2009
(KDHS)

7. Hospital Entrance

8. Centres of Excellence

10. 300000
250000
200000
150000
100000
50000
0
Total no of patients.
5106654953544836020464570
Total Out Patient Attendances.
263564
247898243954
224605
206487
178050
153512
111927
93981
2000 2001 2002 2003 2004 2005 2006 2007 20082009 2010 2011 2012 2013
Years.
Year
Total

11. Peripheral clinics provide primary care including immunization with
specialist services provided at the campus in Muthaiga

12. Governance
Registered Trust with tax
exempt status
Board members serve
on a voluntary basis
All surpluses reinvested
in the hospital
Eight member
board of Trustees
With a shared
belief that
hospitals can serve
their primary
function of saving
lives while being
ran and managed
along accepted
business principles

15. Patient Safety & Quality
Pursuing JCIA
Patients judge their
experience by the way
they are treated as a
person not by the way
they are treated for
their disease.”
ISOO Certified
“Patients reserve their
good word of mouth
and loyalty for
hospitals where they
feel their needs were
anticipated and met by
a courteous caring
staff.”

16. Critical Skills Needed
AAP in a 2008 survey found that
• There were too few local child/adolescent psychiatrist s
to meet referral needs
• 87% cited a shortage of developmental-behavioral
pediatricians
• 82% reported insufficient pediatric dermatologists.
• More than half of those surveyed reported shortages of
pediatric medical subspecialists in rheumatology,
neurology, adolescent health, endocrinology, and
gastroenterology

17. Connectivity
Received awards for E-tendering
and our IT
deployment
One outpatient Record
ensures continuity of care
HMS Navision
Kranium
Information
Systems
MS Outlook
Qpulse
Social Media
Presence

18. The American Academy of Paediatrics (AAP) states that a variety of factors
are associated with potential for increased demand for paediatrician
services
Associated trend
• Increased insurance coverage and improved access for
children when health care reform provisions are
implemented
• A growing shift in the number of pediatrician office
visits for children previously cared for by family
physicians (who may have increasing numbers of adult
patients in their practices for the same reason)
• Changes in the type of and demand for pediatric
services deriving from advances in genetics and other
technologies
• Increasing numbers of medically complex and/or fragile
pediatric patients
• Increasing need for pediatricians to address
developmental, educational, and mental health issues
with their patients
• Increasing prevalence of chronic diseases in children
Our observation
 70 % of our clients have insurance cover
 We attend to children only
 It will be while for this to impact us in kenya
 Evidenced by high referral to ICU
 Offer one stop services
 Greatest growth has been in chronic
attendance clinics

19. Conclusion
With the medical skills shortage in Africa there is room
to develop patient referral mechanisms to established
medical hubs
To do this we need to figure out
Who Pays for the healthcare provided
Be innovative in skills retention
Make saving lives a priority so that we can ensure a
good quality of life for our children and their families

20. ASANTENI SANA