”It gives me great pleasure to be part of this unique gathering that will be discussing and reflecting on the effective and sustainable ways of delivering quality health services.” These were the opening words in Professor Fred H.K Segor’s speech at the second SafeCare conference in Mombasa. Professor Segor, Principal Secretary of the Kenyan Ministry of Health, was invited as the special guest during the SafeCare conference themed: Quality in Practice; Towards Sustainable Quality of Care in Africa. Unfortunately, due to the recent terrorist attack he was unable to attend, however Dr. Kandie of the Ministry of Health read his speech on his behalf. ”At times like these the importance of good quality care is more evident than ever. When people need care in times of emergency, they need to be able to rely on the infrastructure, doctors, nurses and medication to cater to their needs.”
SafeCare acts as the custodian of internationally recognized, unique sets of standards that are realistic for resource-restricted settings. As such, it encourages people to think and talk about quality of health care. The central question that international experts from the public and the private sector from over ten countries discussed was how to achieve transparency of quality on a national scale. The participants represented ministries of health, national and private insurance companies, healthcare facilities networks, regulators and innovators in the field of sustainable quality improvement.
Transparency of quality of care is at the heart of creating trust in the healthcare systems, and encourages utilization and willingness to (pre)pay. To achieve this, governments have to set up the policy and legislative environment to regulate and enforce quality of care. Insurance companies, banks, investors and donors need to link improvements achieved with financial incentives to ensure sustainability. ”The Ministry realizes that linking quality of care to healthcare financing is fundamental for realizing the ambitions objectives of National Health Policy as well as the Vision 2030. To grow as a country, we need a healthy Kenyan population, and to achieve this, all Kenyans need to have universal access to quality health care,” emphasized the Principal Secretary.
”The government cannot just come up with regulations and expect everything to be okay. Changing health outcomes and saving lives is what we are trying to address”, stresses Senior Advisor to the Ministry of Health Nigeria Kelechi Ohiri. According to Kelechi Ohiri, the government needs to take up a more active role by setting up programs that actually change the health situation of the people.
Onno Schellekens, Managing Director of the PharmAccess Group, believes that it will be some time before such scenarios become reality. â€œWe have learned that in the end, Africa is facing an enforcement problem. A lack of enforcement causes costs and risks to go through the roof. This creates a huge waste in the economy, in a whole range of sectors, not just health.â€
A second problem Schellekens identifies is that health ”is not about spending money, it’s about attracting money. It is about crowding funding into the system and about spending it more effectively,” Schellekens explains that in OECD countries an average of 15 percent of GDP is spent on health; in Africa it is on average only a few percent. Without sufficient money in the system, itâ€™s no surprise that governments are struggling to meet the health needs of their populations.
”In addition, we need to know where investments need to go,” explains Nicole Spieker, Managing Director of SafeCare. ”We need to know how much money is needed, and for what. Quality health increases transparency and efficiency, which contributes to sustainability. Spieker stresses that makingquality transparent will increase trust and the willingness to pay among patients, doctors, insurance companies, banks, governments and international investors.”
”In order to create willingness to pre-pay and the benefits that come with it, the care provided should be reliable, effective and of the highest possible quality,” Professor Segor wrote in his speech. Only then can the stigma that surrounds health insurance be reduced.
Onno Schellekens concluded that ”the good thing about health care is that if you do it right, people will start to invest in their own future.”