Improving Healthcare Access in Developing Nations
Outside Kenya's capital Nairobi lies the small farming town of Embu, which is filled with roadside stalls where farmers sell their mango, potato and rice crops. This remote region, nestled near the hills of Mount Kenya, is the setting for the second phase of the Familia Nawiri (Healthy Family) initiative, one example of a Novartis 'social venture.'
Social ventures are designed to build local, sustainable solutions to address healthcare challenges for underserved communities in emerging markets by tackling issues that impact access to healthcare – such as education, infrastructure and distribution.
Familia Nawiri employs a market-based approach improving access to healthcare for poor people living at the bottom of the economic pyramid. After creating a large-scale social venture in India, Novartis has replicated the model in Kenya and is now training health educators to teach communities about good health, hygiene, nutrition, common diseases and disease prevention. In addition, Familia Nawiri is increasing access to medicines by informing local physicians and pharmacists about treatment options. Similar initiatives have also been rolled out in Vietnam and Indonesia.
Since launching the pilot in India in 2007, Novartis has trained more than 500 health educators and supervisors, and improved access to healthcare across 10 states – home to 70 million people. In the past three years, more than 10 million people in India alone have attended health education sessions and another 450,000 people have been diagnosed and treated in health camps.
Major challenges to healthcare at the bottom of the pyramid
During its expansion to new markets, Novartis has learned that cultural factors play a significant role in local beliefs about and delivery of healthcare in many countries. In both India and Kenya, poor people often have minimal knowledge about disease and tend to delay treatments. Because they lack faith in modern medicine, many still visit traditional healers. For this reason, Novartis is putting an emphasis on health education and awareness through its Familia Nawiri initiative.
Other issues impacting public health in these two countries include lack of access to clean water and sanitation, geographic isolation, inadequate infrastructure, low stakeholder engagement, weak healthcare capacity and limited availability of doctors and pharmacies. Although some medicines are free in impoverished areas, there is often an associated lab cost or physician fee. In addition, many delay seeking care because perceptions of public health services include long wait times. Since many remote villages lack modern healthcare facilities, and many patients in these areas cannot afford to travel for care, health is often a low priority.
There are many patients who visit private clinics in search of better quality and convenience. It is also essential to improve health infrastructure to better serve these patients and understand the importance of market segmentation even at the bottom of the pyramid.
While there are many similarities between rural Kenya and rural India when it comes to health care delivery, there are also major differences including population density, distance to doctors or pharmacies, and travel costs when seeking treatment. The low population density in rural Kenya means that residents are often spread out. This increases the amount of travel outreach workers must undertake to communities for health-education sessions. It also means that patients in Kenya need to travel greater distances than patients in India to seek care. This adds an extra burden as people must often walk great distances to seek treatment and if there are other means to travel, the cost may exceed that of the treatment.
Education is the key to improving health outcomes
To overcome these challenges, Novartis focuses on community outreach and education to raise awareness about diseases and preventive health measures. Local outreach workers deliver training in schools, churches and through local self-help groups and farm cooperatives. To best serve rural communities, the company also arranges health camps with qualified doctors and provides triage services on a monthly basis.
In addition, Novartis outreach workers partner with local community health centers to reach additional households, especially men, who are less likely to visit a doctor or obtain care. To date, the results have been impressive: in Kenya, close to 200,000 people have attended health education sessions in the past two years.
Through these efforts, Novartis has seen a growing interest in providing basic health education in the face of limited resources and a challenging regulatory environment. It is clear that scaling-up the Familia Nawiri initiative will go a long way towards improving health outcomes in Kenya while simultaneously producing economic impacts and new growth opportunities for Novartis.