Innovative Partnership for Universal Sustainable Healthcare (iPUSH)

Leveraging on mobile technology to improve access to quality health services for Women and children under 5 in Kenya:

Health is a fundamental human right as well as an indicator for SDG 3 (Ensure healthy lives and promote wellbeing for all at all ages) by 2030. As defined by World Bank, the goal of Universal Health Coverage is to provide everyone with affordable access to quality health services. In line with WHO’s invitation for ‘Leaving no one behind’ the vision and commitment of the Kenyan Government through His Excellency the President to achieve UHC by 2022, is welcomed not only in Kenya but also globally. The Kenyan Constitution clearly supports attainment of UHC. As a result, the Kenyan government has developed strategies and frameworks including ‘Roadmap towards Universal Health Coverage 2018-2022’. The Kenya Health Sector Strategic and Investment Plan III 2018 and The Kenya National Health Policy 2014-2030 that outlines challenges and priorities in achieving UHC.

Innovative Partnership for Universal Sustainable Healthcare (iPUSH).
Amref Health Africa and PharmAccess Foundation have collaborated to change the healthcare landscape in Kenya through a UHC flagship model dubbed iPUSH. With a budget of € 11,700,000 from the Dutch Nationale Postcode Loterij (NPL) the program leverages on mobile technology to focus on inclusive health financing for Women of Reproductive Age (WRAs) in Kenya as well as increasing health knowledge on maternal and child health. Through a health wallet, the programme aims to empower low income communities in Kenya to effectively save for their health expenditure.

Mobile Health Technology as an Enabler for Universal Health coverage.

iPUSH contribute to efforts by the ministry of health to deliver universal health coverage. I-Push is differentiated from other community interventions by its use of mobile phone technologies to:

Improve efficiency in building the capacity of community health workers to deliver health information to households.
Increase the efficiency of data collection at community level, which enables local government to make more timely decisions on resource allocation to households.
Increase protection against financial risk by digitizing the enrolment of households to the national health insurance scheme.

Opportunities for scale

African countries have a high penetration of mobile phone technology, in addition countries in the region are working towards universal health coverage for their populations. We propose to scale the use of mobile phone innovations developed at Amref to support countries in the region achieve universal health coverage.

iPUSH explores health financing models linked to the social economic status of the women, identifying how to best enrol them into a pre-paid system.
Community Health Workers trained through LEAP, identify and enrol the women onto the NHIF, while at the same time providing health education around mother and child health issues and collecting health data through M-JALi.
Health facilities enrolled on iPUSH implement a quality Improvement model to provide better quality of services to WRAs and their households.
Data collected in this programme are used to inform decision making for all key stakeholders in the programme such as the ministry of health, county governments, NHIF as well as health facilities.

The iPUSH program is beginning to realize its dream of changing the healthcare landscape in Kenya, by leveraging on mobile technology revolution in Kenya to directly connect women to healthcare financing, quality health care and information empowerment, with an aim to improve access to better care for at least half a million Kenyans.

Dr Githinji Gitahi, Group CEO of Amref Health Africa, has this to say: “African women are potential vehicles for economic growth. Inequality is preventing this and is greatest in health; women are affected far worse than men in many health outcomes. Still today too many women die during childbirth, whilst most of these could have been prevented. Healthier women will have healthier girls who will be the drivers for change for Africa. And that is what the iPUSH partnership is about.”

In order to realize the objectives of achieving UHC, timely and accurate data is valuable to influence decision making at all levels. iPUSH utilizes mobile technology to collect data from communities and health facilities that is utilized by key stakeholders to prioritize health care services and resource allocation.

Monique Dolfing-Vogelenzang, Chief Operations officer, PharmAccess Group also adds: “Mobile technologies are changing Kenya at a fast pace in all layers of society. By leveraging on this technology, with i-PUSH we have the opportunity to bring together solutions to establish a paradigm shift in healthcare. This will positively impact millions of women and their families. All the ingredients are in place to make this happen.”

About Leap the mHealth platform

Leap the mHealth platform is a mobile learning solution for training health care workers, wherever they are, whenever you need to, using their mobile device, whether basic or smart phone. Leap employs an appropriate mobile learning, micro-learning approach, known as mPedagogy to build the capacity of Community Health Workers (CHWs) on on health-related topics such as family planning, mother and child nutrition, sexual and gender based violence and health insurance www.leaphealthmobile.com/

About MJALi

M-Jali, Mobile Jamii Afya Link, is a Community Based Health Information System for data collection and reporting at household level, by CHWs. MJALi operates even in the most remote areas of Africa, providing Governments and health facilities access to timely, accurate and complete health data; at the press of a button. The MJALi is application is applied to capture data at the household level on health indicators to improve efficiency of health reporting at the community level, enabling decision-making and appropriate action, which leads to improved health indicators http://mjali.amref.org/mjali

About M-TIBA

M-TIBA is a mobile health wallet that has the potential to fundamentally change healthcare. With a mobile phone in hand, anyone can have access to healthcare. M-TIBA facilitates low-cost insurance, savings and donations for the health of individuals and families. The IT platform collects vital data that enables providers and insurers to improve healthcare delivery and empowers patients to make informed decisions about care. This will lead to better care and improved lives www.m-tiba.com

Organizational profiles

About Amref Health Africa

Amref Health Africa is a non-governmental organisation founded and based in Africa with

more than 60 years of experience in health development. Amref’s mission is to increase

sustainable health access to communities in Africa through solutions in human resources for

health, health services delivery and investments in health. www.amref.org.

Amref Health Innovations (AHI) is the social enterprise arm of Amref Health Africa that is

Responsible for delivering sustainable social value through incubation and commercialization

of innovative solutions conceptualized and developed throughout the organization

About PharmAccess Foundation

PharmAccess believes in doing healthcare better. With a focus on sub-Saharan Africa, we are an international NGO that works on improving healthcare markets so that they can deliver for everyone.

Our work has long focused on achieving greater health access, echoing the global call for universal health coverage, by mobilizing private and public resources, measuring and improving quality of services, and reaching even the most excluded people with financing options to pay for care https://www.pharmaccess.org/

Value proposition

iPUSH uniquely focuses on an improved supply of healthcare, as well as an increased demand for healthcare.

Community Health Workers trained through Leap, enrol women onto NHIF; while at the same time increase their awareness around health issues and collecting health data through M-Jali.
Through the mobile health platform, M-Tiba, the five-year program (2016 – 2021) aims to empower low-income women of reproductive age to get access to a health cover from the National Hospital Insurance Fund for themselves and their families and to save money to be able to co-pay for their premiums in the future with the use of behavioural economic techniques. With a lack of healthcare financing for UHC, iPUSH explores health-financing models linked to the social economic status of the women, identifying how to enrol them best into a pre-paid system with crowding-in in as much financial means as possible.
Facilities that are connected to M-Tiba, provide treatment to the women and receive support to improve the quality of care.

Key Milestones

000 women and their families have an NHIF insurance
000 lives are insured to access health services from NHIF accredited facilities
2,600 community health workers are trained and have access to Leap learning platform and equipped with mobile devices for improved service delivery
160,000 households comprising of 462,000 people are routinely tracked on a digital data collection platform
75 health facilities, mostly primary health care facilities are on-boarded onto the Quality Improvement model.

Spin-offs of iPUSH

Household Socio-Economic Mapping tool developed to identify poor households for the national health insurance scheme.
2,6 million people in three of the four UHC pilot counties benefitting from the UHC scheme
Nairobi and Kakamega County governments have made 1,2 m euro to support additional households to access health care services
The program’s impact is being scientifically evaluated by the
Amsterdam Institute for Global Health and Development and generating evidence for policy influence.
iPUSH takes active part in the Technical Working Groups on
UHC and Quality Improvement both at national and county levels in Kenya – -internally contributing to the future frameworks that enable UHC implementation in Kenya.

Lessons learnt

Use of community led innovations optimizes equity for access to quality health services by poor and low-income households in Kenya.
Building the capacity of Community health Workers can be used effectively to educate and enroll target populations to better health services.
Public private partnerships brings a unique set of infrastructure and resources that can be leveraged to enhance inclusive health financing.

Innovative Partnership for Universal Sustainable Healthcare (iPUSH)

Organizational profiles

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