Harnessing North-South Partnerships to improve quality in healthcare

90 percent of Germany’s 80 million citizens are insured by statutory sick funds, with  comprehensive health basket for patients. This presents a stark comparison to Kenya, which has only 10 percent of its 40 million citizens having some form of health insurance[1].

This came up during a scientific lecture presented by Professor Joachim Szecsenyi, a quality management expert from the University of Heidelberg Hospital in Heidelberg; and also the managing director of the AQUA Institute for applied quality improvement and research in healthcare, Goettingen, Germany. The talk, titled ‘Harnessing North-South Partnerships to Improve Quality Healthcare’ was held at the Strathmore Business School auditorium and attracted various participants in the health sector. These included medical professionals, researchers, policy makers, development partners and medical students.

The South has much to borrow from the German system that has implemented strategies of improving quality in healthcare through disease management programs, peer reviews, hospital benchmarking,evidence based approach, accreditation and quality management in hospitals and ambulatory care.This can only be achieved through sharing of experiences, ideas and technology from the North and South to bridge the existing gaps in the Kenyan health sector. Of particular importance are the in-patient management systems. For instance, 84 % of Kenyans who report an illness seek care in an outpatient setting, while the outpatient healthcare expenditure accountsfor 39% of the health expenditure compared to 22 % for inpatient care[2].

In order to harness these gaps in quality management, an indicator-based Integrated Quality Management System (IQMS), developed by GIZ Health sector as part of its Reproductive Health (RH) component is being implemented by a consortium comprising evaplan GmbH consulting group in International Health at the University of Heidelberg, Germany; the AQUA Institute, Göttingen Germany and the Institute of Health Policy Management and Research in Nairobi. It is based on a tool known as the ‘European Practice Assessment (EPA)’ and grounded in the Kenya Quality Model for Heath (KQMH).  IQMS will be both paper-based and IT-Based, borrowing heavily from that used by EPA, called VISOTOOl®. The unique focus of IQMS is on the interface between outpatient and inpatient care. The development and implementation is set out to run for a period of two years.

The panel of experts which met earlier last week at a workshop registered 350 indicators. Another workshop to be held later this year will use a standardized method to evaluate and validate these indicators to arrive at a final set.These will then be tested in 3 facilities and then rolled out in a larger group of another 17 facilities in 2013.

The expert panel has a multidisciplinary approach, with representatives from the Department of Standards, Research &Regulation, Department of Primary Health Services, Division of Reproductive Health, Division of Health Management Information Systems, obstetrics and gynaecology specialist, nurses/midwives, health facility in-charges and hospital managers.

[1]Scott.Obrien.McKenzie-Health Insurance goes Mobile in Kenya, Oct 2011

[2] Household Health Expenditure Survey


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