Tackling NCDs And Creating Social Impact

Over 6.5 million Kenyans living in rural Kenya are afflicted by Hypertension and/or Diabetes. 90% of them have no controlled treatment because they are either unaware of their condition; but even for those who are aware, many lack access to a quality facility and also often cannot afford the cost of treatment, as medication is expensive as a result of a bloated pharmaceutical value chain.

CDMS has structured solutions that aim to achieve the following outcomes and impact:

Raising awareness among the community on NCDs
Identifying high risk patients via a pre-screening and referring them to a hospital
Lowering procurement costs for small and medium sized-hospitals
Lowering the costs of NCD medication for the end user

Solutions

1. Awareness Raising Among The Community On NCDs

Working together with Hospital Healthcare Workers (HCWs) and Community Health Volunteers (CHVs), we conduct outreach activities at organized community activations, in marketplaces and religious events.

2. Access: Identifying High Risk Patients Via A Pre-Screening And Referring Them To A Hospital

We screen clients at selected outreach clinics where high yields are expected. CHVs screen clients in the community and all those with elevated blood pressure and blood sugar refer them to the outreaches where they are confirmed, referred to a contracted referral hospital, enrolled, put on treatment and followed up subsequently. In order to ensure easy access to quality treatment, we have identified several small and medium sized hospitals with the capacity to provide comprehensive long-term treatment of Non Communicable Diseases. We contract these hospitals as hubs for referral of patients identified at the screening activities.

3. Affordability

1. Lowering procurement costs for small and medium sized-hospitals

In order to provide affordable drugs to hospitals, CDMS has set up a Group Purchasing Organization that aggregates demand from small and middle-sized hospitals, and procures drugs on their behalf. This aggregated demand results in our receiving quantity discounts from pharmaceutical suppliers, which are passed on to the hospitals and on to patients as low dispensing prices. Supplies from Pharmaceutical Access programs complement this effort where certain NCD drugs are provided at subsidized prices.

b. Lowering the costs of NCD medication for the end user

The majority of Kenyans cannot afford the cost of treatment as they pay out of pocket. According to the Kenya Medical Association, only 20% of Kenyans have health insurance. We have a two-pronged strategy to tackle the challenge of affordability:
i) Registration for NHIF
All referred patients are first registered for membership of the National Health Insurance Fund, which charges $5 premium per month for a family cover.
ii) Low priced medication
Patients are placed on long-term treatment and management using affordable drugs supplied by CDMS.

4. Value Propositions Across The Value Chain
a)To the Hospitals
The CDMS activations generate new footfalls for the hospitals. The results in our first pilot hub hospital have showed that out of 5,000 individuals screened, 24% had abnormal blood pressures and/or blood sugar levels, thus generating 1,250 additional long-term patients to the hospital. 20 additional hospitals are ready to sign up for the scale up phase of the program.
b) Patients
Patients are better informed about their NCD status and those with elevated blood pressure are able to access NHIF financing and savings on their drug purchases.

c) CDMS
CDMS creates social impact by providing a holistic NCD solution i.e. creating awareness at the community level and facilitating access to NCD treatment for a population that had little hope of finding a manageable solution to their problem. As a result of the demand created at the hospitals, CDMS is able to operate a sustainable and scalable model by supplying more drugs and generating revenue.