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.
But
how?
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.
Source: www.mhtf.org
