Innovative health systems solutions through partnerships

Health Policy and Regulatory Reforms

IHA works with governments to analyze health policies and develop regulatory reforms and assists private health association to understand the impact of proposed legislations and changes in
regulations.

 

Examples include IHA:

  1.  Assisting private sector associations in Kenya to analyze the impact of Kenya 2010 Constitution and give inputs to Kenya Health Policy Framework 2015 -2030 and the Health Bill.

  2. Working with the Malawi (2012) and Uganda (2015) Ministries of Health to develop country level PPP Strategy to harness and align private sector activities to Ministry goals.

  3. Reviewing Health Policy laws and regulations in Kenya (2009), Malawi (2011), Uganda (2016), Tanzania (2012) and Ethiopia (2012) to identify barriers to leverage private healthcare businesses to support public health objectives.

  4. Developing tools and methodologies to analyze health policy and design inclusive reform initiatives

  5. Assessing the private health sector (6 African countries, 1 South Asian country, and 2 Caribbean countries) to provide valuable data on the scope and the role of the private health sector and lays the foundation for governments and development partners to engage and partner with the private sector.

Health Financing Mechanisms Design and Evaluation

The IHA team have strong skills and expertise in a variety of health financing areas including:


Research and evaluation of public and private health insurance
 IHA, a part of the Deloitte team, conducted a strategic review of the National Hospital
Insurance Fund (NHIF) and assessed the market for private prepaid health schemes (2010-
2012). The NHIF review established benchmarks for the NHIF reforms and the market
assessment is a key input in the Kenyan government discussion on Universal Health
Coverage.
 IHA, in partnership with Swiss Tropical Health Institute, will commence (2018 -2020) work in
Kenya funded by KfW to strengthen the NHIFs core systems and processes (e.g. governance, claims, payments, ICT, etc.) and assist them to expand social health insurance coverage to the informal sector in partnership with ten counties.

 

Health Markets Facilitation

IHA is a leader in the emerging area of health market facilitation. Experience ranges from:


 In partnership with World Bank Institute, IHA staff helped develop the ground-breaking work
managing health markets to benefit the poor. Building on the DFID work on markets for the
poor, IHA staff adapted this approach to the health sector. With World Bank and DFID
funds, IHA staff-co- wrote a manual on MM4H and co-lead a course for DFID and World
Bank staff in the concept of and strategies to shape health markets (2014, 2015).
 IHA team members published a paper (2016) for the BEAM Exchange on the challenges
confronting private providers to participate in market mechanisms such as contracting,
national health insurance schemes and vouchers
https://beamexchange.org/practice/research/non-traditional- sectors/health-market- systems/
 As a technical partner with Cardno Emerging Markets on the Kenya DFID-funded PSP4H
program (2013-2016), IHA pioneered and evaluated different market-based approaches to
address healthcare delivery access and quality gaps for low income consumers. They
included the formation of PHARMNET- a network of quality-assured private pharmacies managed through the Kenya Pharmacy Technician Association and the introduction of Afya
Poa, a low-cost micro insurance produce for Jua Kali artisan working in the informal sector.

 

Health Program Design and Evaluation

IHA staff have participated in multiple evaluation and redesign of health projects in Kenya and
the throughout the region.

 

Key examples include:
 Review and design of projects in 4 Kenyan counties under the USAID Kenya Supply Chain
Systems Strengthening (KSCSS) Project (2017)
 Mid-term evaluation of USAID Kenya APHIA II service delivery project (2009).
 End-term evaluation and redesign of USAID Kenya commodity and supply chain
management project (SPS 2010).
 End-term evaluation and redesign of USAID Kenya commodity and supply chain
management project (HCSM 2016).
 Mid-term review of Pharmacess Foundation healthcare financing programs in three African
countries (Kenya, Tanzania and Nigeria 2011-2012).

Quality and Other Health Systems Strengthening

Under the USAID Private Health Support Program in Uganda, IHA has helped the Uganda health councils to develop and scale-up nationwide an innovative, web-based quality improvement system - SQIS (Self-regulatory Quality Improvement System) for private
healthcare providers. SQIS aims to not only improving service quality among private providers
but also build the oversight and regulatory capacity of the councils.


IHA is also assisting the four health councils to streamline and modernize the professional and
facility licensing processes in addition to award and monitor CPD hours. The E-Health Licensing
portal permits the accurate tracking of the number of public and private healthcare professionals
as well as identify and monitor all private health facilities. Moreover, the portal now links the
SQIS to professional and facility license renewal.

 

Under several USAID and World Bank projects, IHA has worked closely with Ministries of Health
in Kenya, Malawi, Tanzania and Uganda to design the new institutional arrangement and
operating systems enabling them to engage and contract with private healthcare providers.
Tasks ranged from developing the Terms of References for the PPP Nodes, to drafting job
descriptions for the Node’s staff, to creating systems to track and monitor health PPPs in the
pipeline.

 

IHA has also helped build staff capacity in these PPP Nodes to draft new regulations,
strategic plans, and PPP policies to create the regulatory framework and systems needed to
engage the private health sector.

Design and implementation of innovative health financing for low income households

IHA has worked for a variety of public and private clients to design low cost health insurance
products. Examples include:


 Over the last 5 years, IHA developed innovative, low-cost health insurance products for
several private health insurers in Kenya, Uganda and South Sudan (UAP Insurance, CIC
Insurance) targeting underserved, low-income groups (2009-2011).
 IHA, through the African Collaboration on Health Financing Solutions (ACS), conducted two
country consultations (Uganda and Tanzania) in 2017 to identify health financing gaps and
innovative solutions to assist countries on the path towards Universal Health Coverage.
 For Merck for Mothers, IHA examined the potential to create an urban OBA scheme for low-
income mothers that would offer a full range of maternity and reproductive health services to
be delivered by private providers located in the greater Kampala area (2016).

 IHA assisted Pharmaccess Foundation to design a health micro-insurance product for low-
income earners in an agricultural cooperative society in Kenya (Tanykina Health Scheme
2010).
 IHA, with KfW funding, assisted the Kenyan Ministry of Health to design a prototype
of a health micro-insurance product targeted at low income earners in the informal
sector to be delivered through microfinance institutions (2013-2014).
 With Abt Associates, IHA carried out an assessment of the African and Asian
experience of OBA voucher programs for safe motherhood and family planning
(2009).

Private Health Sector Engagement

IHA has pioneered inclusive policy design and implementation approach called public-private dialogue (PPD) which purposefully brings together public and private stakeholders, creates a structured dialogue process, and serves as an honest broker to build the stakeholders capacity to engage and interact together on often difficult and politically sensitive topics. Examples include:
 

 Under the Africa Collaboration for Health Financing Solutions (ACS) project, IHA staff is
developing the inclusive approach – including tools and methodologies - to facilitate
dialogue between public, private and civil society organizations to identify priority constraints to implementing Universal Health Coverage, identify innovative health financing solutions,
and reach consensus on a way forward (2017).

 

 DANIDA has engaged IHA to help public and private Tanzanian stakeholders to design and
establish the recently formed Public-Private Health Forum (2016-current) whose purpose is
to promote public private engagement and partnerships. IHA staff conducted the
stakeholder analysis, reviewed existing dialogue platforms, helped the Tanzanians create
the structure for the PPHF platform, and is currently building the Board’s capacity to
effectively dialogue.

 

 IHA staff co-authored a paper with World Bank staff discussing the emerging trend in public-
private dialogue in the health sector, the benefits of investing in PPD in strengthening policy
design and implementation, and common approaches found in African and South Asian
countries experimenting in PPD (2015).

 

 IHA staff served as the technical lead on PPD for the World Bank and University of
Edenborough’s courses on MM4H, encompassing the literature review, writing the textbook
chapter, designing the training curriculum, recording the MOOC seminar on PPD, and
conducting multiple trainings (London, New Dehli) on PPD (2015-current).

 

 Under the SHOPS project and World Bank Health in Africa (2009-2012), IHA helped
establish the first ever public-private forum in Kenya that brought together MOH officials,
Faith-Based Organizations leaders and private sector leaders to discuss pressing policy
issues such as the new Constitution,

Healthcare Leadership and Management Capacity Building

Healthcare Leadership and Management Capacity Building IHA team members also contributes significantly to the development of Africa’s future leaders in the healthcare industry through teaching positions and strategic alliances with leading universities:


 With the University of Edenborough, converting the MM4H course to a Massive On-Line
Open Course (MOOC) to be available for policy makers, healthcare managers, global health
professionals and university studies for free (currently).
 In partnership with the World Bank Institute, developed the Managing Markets for Health
(MM4H) course aimed at health policymakers to introduce new concepts such as health
markets, tools of governance and strategies to shape health markets (2015).
 At the Strathmore Business School in Kenya, we have facilitated new programs such as
Executive Healthcare Management Program, LeHHO and Managing Healthcare Businesses
(2012-2014).
 Under the University of Nairobi UNTID program, train HIV/AIDS and other healthcare
managers in health systems strengthening and quality assurance principles (2009 -2011).

Advisory services for commercial health insurance

IHA has extensive experience not only in product design but also provider panel development,
contracting, tariff negotiations and quality assurance.

 

Private clients include:
 Strengthen UAP reimbursements procedures (2006-2009)
 Consolidate UAP ICT platform (2006-2009)
 Streamline UAP QA system (2007)
IHA has also advised insurance providers on how to expand their services in the existing and
low-income markets (Occidental Insurance 2015).

 

Audits and evaluation of commercial health insurance schemes (2013-2016)

IHA team reviewed and audited various in-house medical schemes for large companies
such as KCB and Equity Banks.


 IHA conducted health insurance scheme performance and fraud reviews for various
commercial health insurance providers such as UAP, GA and Alexander Forbes.
 IHA conducted the Medical Insurance Fraud Survey for the Association of Kenyan Insurers
at the industry level.

 

Health Infrastructure and Technology Investments

IHA team has experience in conceptualizing, facilitating and coordinating major healthcare
infrastructure development projects from primary to tertiary levels in the greater eastern Africa
region.

 

The projects covered both new facilities development and upgrading of existing ones
and included the deployment of the latest medical technology to deliver quality and cost- effective care through innovative approaches such as leasing. The projects span the public, university teaching hospitals, FBO and private healthcare sectors. Examples include the Kenya Govt Managed Equipment Service (MES) Project (2015 and ongoing) that is upgrading healthcare infrastructure in 2 hospitals per county (in all the 47 counties).

 

The upgrades focus on maternal and child health services, ICU, Theatre, Diagnostic radiology and oncology. A
similar project is being developed for other East African Countries. This project has brought in a
new innovation in the market by introducing comprehensive leasing services (including maintenance) and payment by utilization (uptime).
IHA also conduct health sector/market reviews and health sector orientation for prospective
local and international investors seeking to enter and/or expand in the Kenyan health market.
(Due to commercial reasons the list of clients is confidential).

 

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