PPPs key to improved health access in Africa

DEVEX
Malia Politzer

The Githurai-Langata health facility in Kenya. Philips, in partnership with the local county government, transformed the facility as a model for its Community Life Centers project. Photo by: Armstrong Too

Approximately 1 billion people worldwide lack access to primary health care facilities. The situation is particularly severe in sub-Saharan Africa, in which an Afrobarometer survey of 36 countries found that approximately half the population living in rural areas lacked access to such facilities. Almost half of those questioned also said that they, or a family member, had gone without medicine or medical care in at least one year prior to the survey.

To help address these issues, technology giant Philips recently signed a memorandum of understanding with the United Nations Office for Project Services in Ethiopia and Sudan to improve primary health care outcomes resulting from poor facilities, and a lack of equipment and human resources, through the construction of primary health care facilities called “Community Life Centers.”

Devex caught up with Philips’ Head of Research in Africa Bahaa Eddine Sarroukh to learn more about Philips’ strategies for improving health access in Africa — from their role in creating effective partnerships and effective community engagement strategies, to their take on emerging opportunities for private sector players. Here are some highlights from the conversation.

Why should private companies interested in improving health outcomes focus more on Africa?

As you may know, Philips is quite big in health care. Our global vision is to improve the lives of 3 billion people annually by 2025. It’s something we are very serious about. Right now, we are at 2.1 billion people — that is the number of people whose lives have been meaningfully impacted by our health technology. But if we look to those numbers, they represent the markets where we are already dominant.

If we want to reach our goal of 3 billion people, we have to look beyond America and Europe and focus on developing countries, particularly in Africa. From our annual reports, you’ll see that we have currently reached just 5 percent of the population in African countries — that leaves a lot of room to improve.

Wow, 5 percent is pretty low. How do you plan to reach more people?

The Community Life Centers are our strategy to unlock the African market. We launched the Philips Africa innovation hub in March 2014, a research center to develop locally relevant solutions and an incubator with social entrepreneurs, where we bring them to develop effective business models. This is how we will develop our presence in the market, by unlocking the needs in the continent.

How do you engage with the community, to ensure that the Community Health Centers meet their needs?

The Community Life Centers are actually built around community engagement. Globally, around 70 percent of preventable deaths happen at the community level. Those deaths can happen for many reasons; maybe people stay home with their health challenges because health centers are too far away. Or the health facilities aren’t well equipped, or the staff lacks training, leading to misdiagnosis.

If we really want to improve health care, we can’t just talk about providing X-ray or MRI equipment — we need to talk about how the community accesses health care. That means we need to talk to the community, and truly understand their health-seeking behaviors before we look for solutions.

For example, we built our first Community Life Center in Kenya. We focused on Kiambu county, and started by doing different types of assessments. We invited women’s groups, men’s groups, care givers and entrepreneurs. We conducted assessment sessions with each group, so we could understand their needs. In this way, the center becomes a community hub that is actually co-created by the community.

What role do partnerships play in this strategy?

The Community Life Centers are a public-private partnership — so we work closely with governments and various nongovernmental organizations, such as UNFPA in Kenya, and Red Cross in the Ivory Coast, and of course we also have to work with many different suppliers, from energy companies, to companies working in construction. There’s also the matter of attracting and developing health professionals, both in terms of skills training, and how to properly use Philips devices, and once you have them, keeping them. So working together effectively is key to making the Centers work.

Patients waiting for consultation at the Githurai-Langata health facility in Kenya. Photo by: Armstrong Too

In your experience, what are some of the factors that are key to an effective partnership?

For a truly effective partnership, it’s really critical that everyone works together from a shared value perspective. That requires all partners to shift their initial perspectives somewhat. For example, if we look at an NGO or a United Nations organization — they often see the private sector as an actor that just wants to make money, and of course the private sector usually looks to NGOs through a charity lens. So maybe the U.N. or a government will introduce a project, and the private companies only come in once they’ve successfully bid on a tender. Or if the project comes from the private sector, it’s part of a CSR initiative.

But if we want to see a real transformation, all partners need start with the same shared vision of what we want to achieve and create social impact. For organizations, that might mean bringing private partners in earlier, so we all plan and realize the project together, drawing on our strengths, rather than bringing companies in when the project is already planned out.

For private companies, that often requires a shift in how they see profit. It still needs to fit into core business strategy, or it won’t be sustainable. But it means valuing long-term social and economic development over short-term returns. It requires more up-front investment, and adopting long-term strategies for long-term growth. For example, the Community Life Centers [take] a very long-term approach — it’s an investment in the development of the community and the society, but in the long run, it is also an investment in opening the market.

How can the private sector expand its role in improving health systems in African countries?

Particularly in Africa, effective innovations come from having consistent community-level engagement and data. For example, we have what we call an “outreach backpack” — a backpack we give a community health volunteer, which contains simple devices to collect vital signs data like blood pressure — the sort of data you need when a woman is pregnant, to see if the pregnancy is going well. So we collect that, and then we have a mobile phone application that sends that information to health providers, so they can make the right decisions when it comes to delivery, even if the woman can’t come regularly to the hospital.

We also have what we call “remote monitoring” to remotely monitor the functioning of the facility and ensure that all the equipment at the facility is operational, so if there’s a problem it can be fixed quickly. Having real time data makes this possible.

Companies also need to approach health in developing markets from a shared value lens with the partners within the ecosystem. This is really a business opportunity for us — if it were not, it wouldn’t be sustainable. But it needs to be a very long-term strategy: If we look at developing countries, there are often very high costs in realizing projects that create impact. But that doesn’t mean that, in the long term, it can’t also be profitable and sustainable. Having private [sector] partners such as Philips makes the discussion about sustainability relevant. It’s a commercial activity, and in the early phase you need to invest, then once you have a proven model you can scale it up.

So, for example, our Community Life Centers are based on partnerships, and benefit a lot of people. Our investment in development is important to evaluate impact and develop the relevant business models.