Project Lead(s): Melissa Menke
Issue
About 60% of urban Kenyans live in slums, where access to healthcare is inconvenient, unreliable and unaffordable.
Residents in the slums choose between crowded, under-resourced facilities or informal chemists, who sell pills but not healthcare. Medication supplied by unregulated, underqualified chemists can be inappropriate for the patient, counterfeit or expired.
Self-medicating or going without treatment only increases the disease burden, and the cost to the patient and the community.
Solution
Access Afya runs a chain of micro-clinics in the informal settlement of Mukuru in Nairobi, Kenya, that provide affordable, quality healthcare products and services to the low-income residents of the slums.
The Healthy Schools program was piloted to provide healthcare services to groups outside of the clinics.
The program was planned and implemented with specific goals:
· Improving school child health through early detection of illness and prevention activities.
· Collecting data to quantify the impact of good health through school attendance records.
· Creating a new and sustainable revenue stream through Healthy Schools subscriptions.
· Reaching new clients for Access Afya clinics through parent and teacher engagement.
Two schools, Rekebisho and Bright Star Academy, were involved in the project.
The business model is that the school pays per term based on the number of students covered by the program. Parents consent to the program and pay an additional $2.25 per term for the services.
The school provides additional in-kind support by disinfecting toilets, reinforcing hand washing behaviour, cooking healthier snacks and reporting risky symptoms to a clinical officer.
Outcome
The pilot Healthy Schools project in Kenya was successful both in delivering health services to students and as a business.
As a result of the project, 317 children received access to care and 533 people received health and hand-washing education. The program reached an additional 150 people through adult education, and trained 14 intermediaries (school staff) in healthy behaviours and risk factor modification.
A key achievement has been in educating the community about the clinics, and having healthy behaviours reach entire families. As a result, parents and even grandparents have started to use Access Afya clinics.
The project team has applied for (and been awarded) scale-up funding from Grand Challenges Canada.
The project has also received international recognition through participation in the Ashoka Nourishing Schools Collaborative. The group is collectively working on documents for publication about nourishing schools and the broader doorstep health model.
Access Afya is refining and preparing both clinical and non-clinical programs for expansion and then scale.
The long-term vision is to have a network of primary care clinics, field-based care sites (such as schools and workplaces) and community health workers all providing low-cost but still self-sustaining care for the informal settlements in Kenya.
The project will continue to expand, first in the Mukuru slums, then throughout Nairobi and beyond.