Chelsea Swanson and Caesar Lubanga-kene
The One Family Health (OFH) model is a phenomenal response to the health care worker shortage which is a perpetual challenge to the health care system of Rwanda. The model is well-thought out, effective, and requires comprehensive cooperation from a number of players both in the private and public sector both locally and internationally. OFH has adapted its practices to offer healthcare under the Mutuelle insurance, obtain essential technologies like Lifesense, and train its employees in quality treatments and additional skills like human resource, financial and supply chain management, while offering a sustainable plan.
However, despite all of these progressive and impressive qualities, OFH may be on the verge of a downward spiral. The recent withdrawal of Glaxo Smith Kline (GSK) a major partner from the financial support of the model is calling into question whether OFH can continue to be an effective player in the health care worker shortage and continue operations to improve health in Rwanda.
GSK, as the main funder, was a backbone for the OFH model. It gave the Rwandan government and local banks faith in the program. The loss of GSK as a funder may mean the loss of faith from the local government and local banks that deemed loans to the local enterprise to risky to provide loans a gap that GSK had well covered. It is a domino effect that is in urgent need of saving.
First we ask why GSK dropped out? Well, according to them, they felt the risk was too high, and that they would lose more than they gained. Next we ask what could have been done differently when recruiting and obtaining funders for the program?
Here is where some of the problem solving can begin. The back bone is made up of vertebrae, but with GSK as the backbone funder to OFH, there is no smaller vertebra to fall back on. By starting out with more investors and venture capitalists, the likelihood of failure due to one investor pulling out is much smaller. There are many investors willing to invest small sums and if pooled this could incrementally fill the enormous funding gap left by GSK.
Another potential solution would be a government intervention through a co-operative incentive scheme. This would be where the government offers money to a group of health clinics at once. The goal of OFH would be to recruit and stratify the health clinics, possibly by geographic location like a district, and conform them into an association that the government can support financially. While governments in Africa have limited funds, the successes of the OFH model in strengthening the health system, demonstrates both the need and worth of funding.
This might also be a productive way to gain local support for the health clinics within each community. The combination of social support and accountability make it harder to misuse the money from the government to the association other than individuals.
In sum, OFH still has time to find funders and hopefully get back on its feet in the wake of GSK’s exit. Government support and a multitude of smaller private investors are two potential solutions to the problem in order to sustain the model of OFH keeping its public private partnership goodwill while maintaining a source of health care workers and supply providing quality health care for the people of Rwanda.
Picture: Rwandan health workers preparing for a ward round.