WHP commits to expand Sky, the rural health social franchise network launched in Kenya in June 2014. Through this commitment, WHP will add 30 clinics, 300 community health volunteers (CHVs), and 75 pharmacies to its existing network in Kenya by December 2015, expanding the delivery of quality health services to approximately 50,000 individuals in Kenya's most vulnerable and rural communities.
WHP's strategy harnesses and strengthens existing resources, primarily outside of the public sector, to create an ecosystem of care that plays a large supplementary role to public sector services for the poor. The Sky network is a branded social franchise network that private providers can join and receive targeted interventions that will improve the quality and reach of health care services available in rural areas. WHP provides a package of healthcare, technology, and business development training that maximizes providers' entrepreneurial abilities towards a revenue-generating model that is less reliant on donor support, incentivizing local health workers to deliver better standards of care to communities in need.
As part of its Commitment to Action, WHP will conduct a regional scoping evaluation to identify the most appropriate areas in Kenya for program expansion. WHP will work with a local partner, the Kenya Medical and Education Trust (KMET), and KMET's existing Huduma Poa provider network in the selected areas to identify and recruit candidates to join the Sky network. As new providers join the Sky network, they will be supported by improvements to the network supply chain, ensuring that all Sky network providers have stable supplies of essential medicines and rapid tests. WHP will then develop infrastructural improvements and distribute necessary technology to allow for telemedicine linkages between patients in rural communities and qualified doctors in major urban centers.
Project scoping study: October 2014
WHP will conduct a regional scoping evaluation to identify viable expansion regions. In each of these regions, WHP will identify existing health care use patterns among communities in order to more appropriately target high-impact providers. Result: Mapped service outlets adhering to WHP's Sky network criteria for inclusion.
Outreach and network creation activities: October 2014 - December 2015
Over the course of the network creation period, WHP will, at a minimum, recruit 30 new clinics, 75 new pharmacists, and 300 new CHVs.
- October 2014: Refine criteria for inclusion of clinics, pharmacists, and CHVs for inclusion in Sky.
- October - November 2014: Identify and map, in collaboration and consultation with KMET, clinics, pharmacists, and CHVs to be networked into Sky.
- October 2014 - December 2014: Network 15 new clinics, 37 pharmacists, and 150 CHVs into Sky.
- January - March 2015: Network 15 new clinics, 38 pharmacists, and 150 CHVs into Sky.
- November 2014 - May 2015: Expand and roll out marketing and sensitization campaign to new providers and communities.
- November 2014 - December 2015: Initiate training of enrolled providers and continue delivering refresher trainings.
Result: Expanded Sky network.
Improve network supply chain: November 2014 - May 2015
In concert with network creation activities, WHP will link every clinic, pharmacy, and CHV through a supply chain delivery network, ensuring that even the most rural communities have access to quality commodities and medicines.
- October - November 2014: Identify essential and fast-moving commodities at Sky facilities, adjusted for seasonality of disease burden.
- October - November 2014: Conduct market analysis of existing supply chain options, their efficiency, reliability, and costs.
- November 2014: Produce written recommendations and costed (to the network and provider) options of reliable supply chains.
- January 2015: Establish a reliable supply chain(s) for the networked providers.
- February 2015: Develop considerations and options for Sky-branded generic commodities.
- January 2015 - May 2015: Train and provide follow-on trainings to providers on establishing pipelines and commodity management.
Result: Reliable availability of essential drugs and commodities at networked facilities.
Increase network capacity for telemedicine consultations: October 2014 - December 2015
Sky network providers will act as the conduits to facilitate these telemedicine consultations.
- October - November 2014: Develop a training for enrolled providers on streamlining teleconsultations and effective patient interaction.
- November 2014 - December 2015: Roll out the training and continue delivering refresher trainings.
- November 2014 - February 2015: Identify additional part and full time medical doctors to provide remote teleconsultations.
- January 2015: Conduct a legal and liability assessment of involving medical doctors outside of Kenya to deliver teleconsultations.
Result: Reliable remote connection to qualified doctors at the point of service.
Conduct end of project survey to measure impact and efficacy: October 2015 - December 2015
- October 2014 - January 2015: Conduct baseline study.
- October 2014 - February 2015: Refine and introduce network-wide electronic data capture system.
- January 2015: Institutionalize ongoing customer satisfaction surveys.
- March 2015: Conduct facilities assessment.
- October - December 2015: Conduct baseline household survey in program communities.
Result: A report detailing approach impact and recommendations on improvements and lessons learnt.
World Health Partners (WHP) focuses on delivering health services to the most underserved communities. The need in Kenya is great: 56% of Kenya's population lives in poverty, 75% of which reside in rural areas (World Bank, 2012). National health indicators remain poor, with high rates of maternal mortality, under-five mortality, and infant mortality. Additionally, there is a severe shortage of medical personnel, particularly in rural areas, with only 65,000 qualified nurses, 8,600 clinical officers, and 7,000 doctors for 44 million people (Kenya National Bureau of Statistics, 2011).
While basic health indicators remain poor, Kenya has a vibrant private sector, an enabling policy environment, and advanced communication technology infrastructure. Together with the country's important role in the East African Union, Kenya makes an ideal testing ground and launch pad for expansion of the Sky network, the rural health social franchise network that forms the core of the WHP approach. The Sky network builds upon existing human resources, transforming informal providers into access channels that allow rural communities to reach higher-quality health care. Providers brought into the Sky network are supported by a supply chain, receive technology platforms to aid diagnosis, use technology to facilitate telemedicine links with qualified doctors, receive access to a referral network, and become empowered as entrepreneurs. At each tier of the Sky network (community health volunteers, pharmacies, and clinics) WHP conducts rigorous training to increase the scope and quality of the services offered.
In June 2014, after four years of successful operations with over 5,000 franchised providers in India, WHP realized its global vision by expanding its program to Africa. The initial launch introduced six clinics and 60 community health volunteers (CHVs) into the Sky network. With this commitment, WHP aims to expand access to quality health services for over 50,000 Kenyans.