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Can Private Health Insurance Companies be used as a Tool
to Reach the Poor?: Innovations in Increasing Access to Gender Based
Violence Services by the Kenyan Urban Poor
Rukia Yassin, Snr. Program Officer
GBV & Human Rights Component
GTZ Health Sector Programme, Kenya
International Conference on Urban Health
New York Academy of Medicine
27th October, 2010
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Increasing Access to GBV Services
Public Private Partnership (PPP) between a private insurance
company and two GBV service providers in Kenya
Strategic Relevance
To demonstrate that private financing/ management
sector can deliver public goods very well and is an
important partner when planning and implementing
social health protection strategies
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Increasing Access to GBV Services
GTZ Health Sector Programme (GTZ HSP)
A technical advisory organization that supports the Kenyan government in
implementing the National Health Sector Strategic Plan as well as consecutive
planning processes for policy advocacy, reforms and implementation
Works in the areas of sexual reproductive health, health policy, health financing,
gender based violence & human rights including FGM with quality assurance as
cross-cutting
Gender Based Violence and Human Rights Component Objective
To ensure that attitude and behaviour in regard to GBV incl. FGM and its
treatment and legal sanctions have improved
Works with partners at Central level (GoK) and district level with MoH, CSO
and health facilities
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Increasing Access to GBV Services
Public Private Partnerships (PPP)
PPP describes development partnerships which are jointly planned, financed
and realized with common risks by companies and development aid organizations
The cooperation between business, the state and civil society
Both partners reach their objectives faster, cheaper and more efficiently
Developmental Private
PPP Sector Goals
Goals
Public Private Partnerships combine business interests of
companies with developmental goals
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Increasing Access to GBV Services
AAR Health Services Limited
A private healthcare company since 1984
Provides preventive & curative health care services incl. care, case
management, evacuation services, health promotion & corporate plans
Based in Nairobi with operations in Kenya,Uganda,Tanzania & Rwanda
Nairobi Women’s Hospital (NWH)/ Gender Violence Recovery Centre (GVRC)
Since 2001, Non-profit making charitable trust of NWH, a private institution
specializing in obstetrics & gynaecological services
Mobilizes resources to provide free quality comprehensive medical,
psychosocial treatment, clinical management & referral for GBV survivors
Moi Teaching & Referral Hospital/ Centre for Assault Recovery of Eldoret (CAR-E)
Since 2007, 2nd major GBV service provider after GVRC in Kenya
Provides free quality comprehensive services to GBV survivors
including provision of expert witness in court
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Increasing Access to GBV Services
Kenya’s Health Sector is Challenged in Financing for GBV Services !
Purpose of the PPP between a Private Health Insurance Company
and 2 Urban GBV Centres in Kenya (since 2009)
Quality improvement of services offered to GBV survivors
Increasing access to GBV services by the urban poor
Increased advocacy for available GBV services
Management of funds provided for by GTZ for GBV services by a private health
insurance company
Efficiency of utilization of GTZ funding
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Increasing Access to GBV Services
Services Provided through the PPP
Case Management
Claims Management
Service Provider Management
Quality Assurance
Case managers assess management of individual cases and follow up progress
of GBV survivors from admission to discharge
Includes claims vetting & ensures funding is spent as per contractual
agreements & care provided
Entails contracting, accreditation & supervision of providers incl. documentation
of standards of services
Undertaking of quality audits to ensure that care is as per the national standards
and protocols for SGBV service delivery
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Increasing Access to GBV Services
How does it work…?
Contracts between GTZ and AAR (PPP management agency) + GVRC & CAR-E
(provision of quality comprehensive care to survivors)
Submission of invoices to AAR by GVRC & CAR-E for
verification as per contracts
Submission of claims by AAR to GTZ
for re-imbursement
Funds transfer by GTZ to GBV
service providers
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Increasing Access to GBV Services
Provider Management
Market value= Kshs 105, 000/ year
AAR contribution to PPP= Kshs 52, 500/ year
Case Management
Market value= Kshs 420,000/ year
AAR contribution to PPP= Kshs 210, 000/ year
Claims Management
Market value= Kshs 315, 000/ year
AAR contribution to PPP= Kshs 157,500/ year
Quality Assurance
Market value= Kshs 210,000/ year
AAR contribution to PPP= Kshs 105,000/ year
AAR charges clients 15% admin fee (market value of scheme) & 7.5% for the PPP
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Increasing Access to GBV Services
Achievements so Far …
Increased financial access (especially by the urban poor) to quality GBV
services as a result of proper fund management
Ensuring accountability
Adherence to national quality standards and protocols
Increasing competency of private sector in GBV service provision
Involvement of the private sector in increasing healthcare access by the poor
GVRC attends to approx 230 clients per month (3000 beneficiaries so far)
AAR ensures funding is spent clients per month (1600 beneficiaries so far)
CAR-E attend to approx 110 as per contractual agreements & care provided
Highlights the role of private sector in healthcare and sustainable development
Replicable model in Kenya and beyond with a significant role for future health
financing models
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Thank you for your attention!
For more information:
rukia.yassin@gtz.de
www.gtzkenyahealth.com/blog
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