Healthy Markets CoP Session - Kenya - January 2024

We are pleased to begin sharing the Healthy Markets Community of Practice newsletters on our Highlights page. Please see recordings of all past HMCoP sessions and newsletters on the HMCoP page of this website. Sign up for future convenings or subcribe to their e-news by emailing Elizabeth Peña (FHM Engage) epena@FHM-Engage.org

 Healthy Markets Community of Practice

FHM Engage is the Secretariat for the Healthy Markets Community of Practice (HMCoP). The current co-chairs are USAID (represented by Andrea Bare) and UNFPA (represented by Ben Light). The HMCoP is an evolution from the Total Market Approach Technical Working Group (TMA TWG) which has been operational since 2014.

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January Meeting

The January meeting of the Healthy Markets Community of Practice (HMCoP) was the second session focused on Kenya. We would like to thank our FHM Engage Private Sector Development Advisor Judy Mboya for all her hard work in helping to organize this meeting. 

As co-host of the HMCoP, USAID Senior Private Sector Advisor Andrea Bare started the meeting by introducing Jane Ngugi, Project Management Specialist for USAID Kenya.  

USAID Kenya has worked to develop a private sector engagement strategy that aligns with the global USAID policy and is pursuing partnerships with different private sector actors across the value chain from local manufacturing to service delivery in order to improve health outcomes. USAID Kenya is working to identify and to work more closely with entities that have market shaping solutions which will allow the private sector to play a role in health areas that have been historically public. This work will also focus on leveraging private sector expertise. USAID is working with different partners across five key areas, which include local manufacturing, optimized private sector capacity and expertise to expand coverage and quality, access to finance, strengthening government oversight, and engagement with the private sector. 

In the next part of the meeting, speakers gave brief presentations of their work.   

Judy Mboya, Private Sector Advisor for FHM Engage, provided a brief overview along with highlights from the first Kenya meeting that occurred in October. The October meeting showcased trends in Kenya's family planning private sector market. One of note is the overall decline in total fertility marked by an increase in uptake in contraception for rural women but with a decline in uptake for urban women. Judy also shared some key constraints, such as challenges around demand generation and financing. The meeting included speakers from organizations that are involved in changing how health products and services are delivered, health finance, and those who are working to improve contraceptive commodity availability. Presentations focused on innovation in the delivery of health products and services, leveraging technology, health financing, and sustainably increasing the delivery of implants through the private sector.

Nancy Njoki, Program Lead for Girl Effect, gave an overview of Girl Effect and their work in Kenya. Girl Effect is an organization that equips adolescent girls and young women with tools to address potential health concerns. They develop content that appeals to young people and use multiple platforms to directly engage girls. Girl Effect is creating safe spaces, sharing facts, and answering questions in a fun and truthful manner about health, nutrition, education, and relationships. Girl Effect partnered with MSD (Merck & Co.) to understand and identify key barriers and enablers for girls 15 to 24 on contraceptive uptake. Their intervention also worked with young people to co-create a digital minimum viable product (MVP) – a smart chatbot – for adolescent girls with sexual reproductive health (SRH) needs and to access contraceptives. In Kenya this MVP is called Wazzii and provides users a private online space to ask about sensitive issues they may otherwise not feel comfortable discussing.  The platform offered direct access to health professionals, which was attractive to new users to this service as they did not have to leave the platform. Through this four-month pilot, Girl Effect has been able to demonstrate success and will look to keep improving on Wazzii. 

Chemeli Priscah Cheruiyot, Head of Research Projects for Jacaranda Health, presented on a mobile health or mHealth approach to improve postpartum family planning (PPFP) among Kenyan mothers. Jacaranda Health is a USAID-funded maternal and newborn health nonprofit organization based in Nairobi that considers ways to improve uptake of PPFP among Kenyan mothers. Their mobile technology approach includes an AI-enabled digital health service, that aims to help new and expectant mothers better navigate the health system. The service includes three pieces, 1) a sequence of gestation state specific messages that empowers mothers with information to seek care at the right time and the right place, 2) an AI-enabled clinical help desk that reads and responds to incoming questions from mothers and starts a referral chain if a risk factor is identified, and 3) a comprehensive data structure that routinely prompts mothers to share feedback on the experiences of care which is then shared back to the hospitals. This approach is working to address nuanced behavioral barriers to PPFP through short messaging service (SMS). To date, the platform has reached approximately two million mothers across Kenya.  The mHealth approach has discovered that interactive flows that offer choices based on behavioral preferences have the highest engagement among women and men.  Additionally, messages sent out to mothers before and after delivery to enhance preparedness are also effective. These insights are key to helping determine future messaging and adapting to the needs of mothers. 

Serah Malaba, Chief Impact Officer for Tiko Africa, gave an overview on the use of an innovative financing instrument to expand access to both SRH and HIV interventions among adolescents and young people in Kenya. Tiko Africa, formerly known as Triggerise, is a global nonprofit organization headquartered in South Africa that uses innovative technology, real-time data, and behavioral insights to support adolescents and young people to make positive choices. The Tiko platform connects partners to provide end users with greater access to SRH products and services. Once users are enrolled, they are able to access services at both private and public facilities, including private clinics and pharmacies. With a Tiko membership, adolescents are able to access services through the private sector that are fully subsidized by donor funds. A crucial part of this approach centers on the development impact bond (DIB) that is being used to implement the program and underscores the critical role of the private sector’s investments in SRH services. The objective of the DIB is to reduce the incidence of unintended pregnancies, new HIV infections, and AIDS-related deaths among Kenyan adolescent girls by increasing uptake of SRH/HIV services and commodities. This is a tool which goes beyond a traditional grant mechanism and is aimed at addressing the lack of access to quality SRH services. The DIB is a scalable approach which encourages innovation and efficiency and allows donors and service providers to focus on social impact maximization. 

Sylvia Wamuhu, Director of Franchise and Partnerships for Population Services (PS) Kenya, spoke about the USAID Private Sector Engagement (PSE) program in Kenya. This is a health systems strengthening mechanism that is being implemented by three partners including PS Kenya. The purpose of the project is to improve health outcomes through increased patient choice of quality health products and services in the private sector. The private sector is critical in Kenya as 50 percent of the population uses it to access services. Their vision is a transformed health market delivered through country-led and country-owned partnerships that increase and optimize private sector resources to expand health options equitably and sustainably for the Kenya population. The project focuses on three areas, 1) identifying, testing, and expanding sustainable options for private sector distribution of health products and services, 2) improving quality and efficiencies in provision of private health sector products and services, and 3) strengthening support for local manufacturing of health products.  across five main health areas (malaria, HIV, tuberculosis, maternal newborn and child health, and family planning or FP). In the area of FP, the program will support capacity building, FP commodities security, and health insurance for FP.  By 2026, the Kenya Government will be expected to fund commodities fully without donor support, so it is crucial that these gaps be addressed. 

Pius Mutua, Global Operations Manager for MS Kenya (MSK), focused on the private sector strategy of MSK. Kenya has one of the most elaborate private sector networks, whereby the private facilities account for 50 percent of the health facilities available within the country and approximately 40 percent of the FP services are provided by the private sector. Most Kenyans seeking services generally encounter the private sector as their first point of contact. Through their collaboration with local partners, MSK has been able to increase their number of adolescent clients from 15 percent to 49 percent. MSK has worked to identify and understand the underlying market constraints that prevent full access to contraceptives. From their analysis of the market, MSK has identified five constraints, 1) inadequate family planning commodity security,  2) lack visibility of the private sector via data and information, 3) limited enforcement and regulation of quality standards in the private sector, 4) limited demand for family planning and SRH services due to misinformation and harmful norms, and 5) lack of financial support in accessing family planning (i.e., via insurance schemes, via the private sector).  In order to address these constraints, MSK has been part of a consortium working towards establishing a viable private sector supply chain mechanism.

To end, we extend a great thanks to all who participated in this session focused on Kenya, particularly to those that took the time to speak and prepare slides. We are excited that there was such a lively discussion amongst presenters and participants, and we are pleased with the continued engagement. We hope that those who have joined our sessions over the past year have come away with a greater understanding of FP and reproductive health market development and private sector approaches.

Resources

We have a web page! On the new USAID Health Market Links website, managed by FHM Engage, you can find our past session recordings, slide decks, or revisit past newsletters. See the HMCoP page here:

Healthy Markets CoP | FHM Engage (healthmarketlinks.org)

Future Meetings

The next HMCoP convening will focus on India and is scheduled for February 27, 2024; and a calendar invite has been sent. Please reach out if you have a country you would like to propose. If you would like to take part in or contribute to any future sessions, or you would like to make us aware of an organization or project, please email Elizabeth Peña at (epena@FHM-Engage.org) or Judy Mboya (jmboya@fhm-engage.org).

Questions?

Please email Judy Mboya (jmboya@fhm-engage.org or Elizabeth Peña (epena@FHM-Engage.org). 

 

Photo of rural healthcare in coastal Kenya from actionchange.org.