Driving Healthcare Equity Through Partnerships

 Widely, healthcare equity is always an issue for discussion amongst the healthcare providers. It is defined as the absence of systematic disparities in health between social groups who have different levels of underlying social advantage/disadvantage in a social hierarchy. In discussing equity, the policy drivers are always concerned that many people assume that equity and equality are one and the same thing, bringing great confusion and a feeling of entitlement for all things. Equity seeks to ensure that there is just accessibility to healthcare services without anyone being subjected to financial hardship. Where there is healthcare equity, the social class of an individual does not expose them to the risk of not receiving the optimal health services being provided, nor vulnerability.

It has been found out that just because a health facility offers high quality services does not necessarily provide equitable solutions. In many instances globally, it has been found that the converse is true. To correct this, governments and private players are coming up with strategic plans to address factors that are hindering equity in healthcare. Amongst them is creation of a favorable environment that will help foster equity-driven partnerships amongst all the key players in healthcare.

Mr. Jayesh Saini, a private healthcare investor, states that, given the existing strengths and weaknesses in the industry, neither the public sector nor private sector can alone be able to deliver optimal healthcare services to the citizens. He believes that building partnerships that are healthy and properly guided will lead to equity in healthcare delivery and in turn will lead to the achievement of Universal Health Coverage (UHC) in the country. When the government joins hands with the private healthcare providers and other key players in the industry, they are likely to work out better mechanisms based on the information tabled by all the parties.

Observations are that as a key player in the delivery of UHC through the National Health Insurance Fund (NHIF), the government of Kenya is in a very critical place to ensure full involvement of the private sector in policy development, implementation and oversight because they remain the main player in service delivery. This kind of positive partnerships will ensure that all parties receive their fair share of resources and that they are able to be self-sustaining to deliver services and products.

Considering that most health facilities are mainly in the urban and peri-urban areas, there is great disadvantage for the populations in the rural areas who are denied access to health facilities either totally or partially due to limited services offered by mainly government run dispensaries. For equity’s sake, for example, the government can partner with the private sector through incentives to establish facilities that are more advanced in these areas without making the cost of accessing the services unaffordable for the target population.  

One such mitigation can be for the government to allocate an agreed amount of money of a supplementary fund in the budget that will go to the private healthcare providers to enable them cater for emergency cases such as road and fire accidents. The funds can also be used to cater for a universal health plan for all citizens as agreed in the partnership discussions by the policy makers. When partnerships are there, first aid or even other serious cases can be treated even at private facilities. Bearing in mind the chances of misuse of this policy and supplementary cash, a guideline should also be provided to govern the same and prevent misuse of the partnership as well as protect interests of both parties.

Corporate Social Responsibility (CSR) that is functional in many private organisations has played a major role in bringing forth equity in healthcare especially in sponsoring medical camps. Health facilities have also made inroads in CSR through medical camps and annual course-based activities such as the Mater Heart run that focuses on correcting heart conditions in young people. Mr Jayesh Saini urges the private healthcare providers specifically to go beyond just writing policies showing they support equity in their set ups and instead ensure that it’s a functional part by implementing the same, especially amongst the disadvantaged populations. He believes that the spirit and the letter of these polices should go hand in hand for its effects to be felt.

From this discussion, it shows that effectiveness of policies touching on equity will only be evident in outcomes of service provision through structures that are built on equity of services for all irrespective of their economic or social statuses. An example is the offering of first aid in emergency cases without necessarily asking for payment from the casualties. The National Health Insurance Fund (NHIF) which is steering the UHC agenda should, for example, come up with clear emergency packages that determine what to be covered and how much should be paid to the facilities. This will help alleviate the issue where Good Samaritans have found themselves in very slippery grounds when they have dashed people to health facilities and they are told they must provide some deposit before any care can be provided to people who are strangers. This unfortunate scenario has led to some casualties succumbing to their injuries while at the same time individuals shy away from helping in ferrying people for emergencies. Some facilities have also been left with unidentified individuals and or big bills in cases where they opted to intervene to save lives. Mr Saini, speaking on this issue, said that these are the items that must be clearly spelt out in policies and agreements between government and private facilities to ensure there is no abuse by any of the parties concerned. He noted the potential for citizens to pause as good Samaritans helping strangers while they are known and related to the casualties just to avoid paying bills for their kindred and facilities can also fraudulently claim compensation even when patients have paid privately.

With World Health Organization (WHO) commitment to building a fairer and healthier world by taking health equity much more seriously than before, is seeking to meet head-on the social and economic factors that hinders its achievement. Undoubtedly these collaborations will speed up the process and also help in advancing towards Universal Health Coverage (UHC). Such collaborative partnerships have proved to work in solving other health and non-health issues in the country and the health equity is no exemption.