Medical equipment leasing improves service delivery

**Richard Ngatia, chairman of the Kenya National Chamber of Commerce, Nairobi Chapter.**

President Uhuru Kenyatta has just launched the Universal Health Care programme, projected to significantly enhance medical care. After the piloting phase, focus will shift to the countrywide rollout and likely, how the private sector will plug in to actualise the programme. Overall costs involved would be huge, certainly, considering that the entire population of 45 million should benefit. Among the most practical solutions that would cut costs embracing is e-Health. This refers to using information and communication technologies all along the service delivery chain from observation to dispensing of drugs.

Creating a platform where medical personnel and patients can communicate virtually, say through a smartphone application is ideal. We could start by creating a database that holds user information for as many beneficiaries and medical personnel as possible for profiling. Such a database would also contain information about available healthcare facilities in various regions and respective specialisation. The idea is about enabling the patient to come online and make a request to be seen, possibly even selecting the doctor of choice among those available. In a way, we would have solved primary care challenges. With a well-functioning public health insurer, in this case the National Hospital Insurance Fund (NHIF), the billings would be done immediately and payments to the various players promptly processed.

Linking hospitals with drug distributors such as Kenya Medical Supplies Agency (Kemsa) would enable stocks management, essentially ensuring there are no stock outs in some places. Other lessons we will learn from the pilot phase is demand for various medical services, personnel and equipment. It is obvious that pressure on healthcare facilities will soar because the services would broadly be more accessible. Huge steps have been taken in enhancing training of staff, with current enrollment for the various courses being the highest in country’s history.

By end of 2017, we had 11,000 medical officers and still growing. Then we are left with equipping the hospitals. Six years ago, the government started what would move the country forward in provision of quality and accessible medical solutions. Management of hospitals, except the national referral facilities, were handed to the county governments. Kenya also adopted leasing of medical equipment as opposed to outright purchase, likely after learning the benefits accrued from the police vehicle scheme. Essentially, the service providers would insure and service the vehicles when due, even providing replacements when any vehicle is withdrawn from the fleet. It is exactly the same with the medical equipment where a third party is responsible for ensuring they are working at all times.

Five clusters of medical services have so far been rolled out under the Managed Equipment Services (MES). We have definitely done well on the MES that even more developed economies like South Africa are looking up to Kenya. Rwanda and Tanzania are also benchmarking against the Kenyan success, at providing medical services at the lowest possible cost and with highest efficiency. Through partnerships with our development partners including China, the State began negotiations to overhaul the healthcare sector. A rigorous vetting was done involving the World leading Original Equipment Manufacturers. The idea of working with the selected manufacturers was to guarantee that the specifications of equipment delivered was the best possible and at the lowest price.

However, for the interest of promoting local content, the manufacturers would work with local firms as subcontractors – which is noble. The result of this arrangement is skill transfer, most importantly, and that some of the funds actually remain at home. But then there was the little matter of finances. It is for this reason that leasing of the equipment was settled on. Benefit for this option is that the State is only paying for the service as per the level agreements, rather than outright purchase whose immediate challenges include maintenance. A cost-benefit analysis of the available options has leasing of the medical equipment as the best. In the arrangement, the manufacturer issues warranty on the equipment covering the whole contract period.