Innovative models to support the future of African healthcare systems- Event Report

Hosted by Dr Nick Mangeya, Head of Medical Affairs at Roche South Africa, and featuring an expert panel, it was an ideal opportunity to discuss alternative funding models to improve healthcare outcomes in Africa and drive forward universal healthcare coverage (UHC).

The panel consisted of three speakers: Dr Catherine Kanari, UHC Director at Amref Health Africa; Dr Yakubu Agada-Amade, General Manager of the Head Standards and Quality Assurance Department for the National Health Insurance Scheme in Nigeria; and Professor Saber Boutayeb, medical oncologist at the University of Morocco.

Dr Kanari kicked things off by highlighting Kenya as an example of a public mandate “delivered through efficiencies from the private system”, particularly around maternal and child health. Kenya, Dr Kanari noted, has a policy that reimburses public health facilities for costs incurred while providing delivery services. But although this system was in place, it wasn’t working as it should due to technical problems in processing claims.

According to Dr Kanari, the private sector can play a major role in fixing these problems by “building infrastructure and giving the technical assistance necessary for efficiencies in systems”. She concluded by saying, “It is possible, feasible and affordable to carry out public-private partnership (PPP) in primary health care, and deliver on the same in terms of measurable impact and ensuring that there are efficiencies brought on by the private entity.” You can read her remarks in full here.

Next up was Dr Agada-Amade. He touched on the slow progress towards UHC in Nigeria, which is mainly due to its decentralised system in which local, state and federal levels of government all play a role in health policy.

However, a new law has made it mandatory for all Nigerians, and legal residents in Nigeria, to hold a health-insurance policy. As Dr Agada-Amade pointed out, Nigeria is “a resource-poor country and the government definitely cannot take on the health budget entirely”, so this new law is “very important as a means of healthcare financing”.

Summarising the impact of the legislation, Dr Agada-Amade boldly stated that “in the next few months we will be on the final march towards UHC”. You can read his remarks in full here.

Finally, Professor Boutayeb focused on PPPs. He pointed out that there is often a gap in African countries “between the needs of the population and the resources that are allocated by the government”. PPPs, he said, can play a crucial role in filling that gap.

To illustrate the point, Professor Boutayeb highlighted an interesting recent example of political support for PPP in Morocco, following the publication of a white paper on eHealth. This was presented in Rabat in the presence of three government ministers, who then signed a sponsorship agreement for a Health Innovation Centre.

Drawing on academics from the private and the public sectors, this innovation centre has already organised numerous conferences and competitions for e-health projects. Professor Boutayeb concluded by saying that “PPP was the best way to unite the different partners and to develop a global health initiative”. You can read his remarks in full here.

In the Q&A session, a lack of political will from African leaders was highlighted as a major challenge to UHC. Dr Agada-Amade was asked how this had been tackled in Nigeria; he replied that the NHIA was able to secure support for the mandatory health insurance policy from other Nigerian governors at a recent meeting at Chatham House, and also pointed out that the president’s backing for the scheme had been crucial.

Dr Kanari was asked about improvement in quality of care through PPPs and innovation, which is often left behind in UHC efforts. In response, she highlighted the importance of going to the community and seeing what it wants. In terms of primary health care in Kenya, for example, she discovered that one of the key priorities for pregnant mothers is not having to go to another facility for antenatal tests. 

According to Dr Kanari: “This is where the private element comes in, by ensuring that the infrastructure is sorted. This is also where the county comes in and says, ‘If this is the priority of my community, then I will put up some money for this.’ ”

Finally, Professor Boutayeb was asked how you ensure PPPs are sustainable with limited resources. He said that private partners offer two kinds of support. The first is technological: “They have a lot of engineers and they offer free help to young developers to create apps, local information systems or tele-medicine platforms.”

Secondly, small amounts of private funding should allow each developer to “formulate his own business model”, for example producing products that have commercial value for a hospital. They could then look for additional financial support from banks or private equity funds. 

The event concluded with Dr Mangeya thanking the panel, while emphasising that “we do need better benchmarks to improve the quality of life for our patients and our health care systems”.