Responding to a crisis: Increasing access to healthcare during a pandemic
Access to healthcare is a persistent issue in developing countries and removing the barriers to access is crucial. The COVID-19 pandemic has only increased the urgency of the challenge.
Healthcare providers not only faced a battle simply to stay open for patients but also needed to source personal protective equipment (PPE) to ensure the safety of their own staff as they worked against the virus.
Based on our experience of working with these organisations in our markets, teams at CDC knew they had to find a way to address the issue of patient access to healthcare as quickly and effectively as possible. While the virus spread at the start of the year, the full impact was unknown and supporting healthcare facilities to prepare was key.
One of our partners, Medical Credit Fund (MCF), which provides finance to small and medium-sized healthcare facilities across Africa, has been at the heart of supporting pharmacies and clinics in their response. We first invested in MCF in 2017 to increase access to healthcare for underserved populations, and since then our investment has been supported by our technical assistance facility, CDC Plus.
The expertise from working with MCF pre-COVID informed our approach to using technical assistance to meet the demands of the pandemic. In total CDC Plus has developed and funded eight projects across Africa in partnership with MCF in response to the pandemic, totalling $800,000. These projects are predicted to train over 2,500 healthcare professionals, protect over 2,000 clinicians and health-workers with PPE, and support clinics that reach over three million patients annually.
For example, one project in Nigeria is supporting a chain of pharmacies and clinics, Express Pharmacy, to develop remote access tools for patients. These include e-pharmacy and telemedicine platforms, enabling remote access to healthcare and medicines.
Having experienced the vulnerabilities of Liberia’s healthcare system during the Ebola outbreak, one of MCF’s customers, a clinic based in the country’s capital, Monrovia, recognised the risk COVID posed. The country is categorised as severely lacking in infection prevention controls and, in close partnership with the Healthcare Federation of Liberia, we’ve supported the clinic to take a leading role in the country’s COVID response. That’s included supporting the clinic to lead ‘case management’ and ‘infection control’ trainings and coordination across the country. To date, 86 facilities have been trained.
To ensure other medical services didn’t become de-prioritised during COVID, another CDC Plus project with MCF has supported a Ghanaian specialised supplier for cancer care products, Erith Health, to reach new and more rural customers. The project has included setting up a customer engagement office which works to reach new rural customers, as well as providing existing customers with care and technical support.
The project, in partnership with WHO and several Ghanaian universities, has also been developing an online learning platform with materials on PPE use, correct disposal, as well as general COVID advice in six local languages.
The pandemic has thrown the challenges already faced by many small healthcare providers, including clinics and pharmacies, into a harsh light. Even in normal times, these types of providers need finance to help them reach more patients and increase their impact. But in countries without mature or diverse financial institutions, these businesses miss out on funding as banks view them as too risky for investment, leaving them unable to grow.
Innovative financing solutions, such as the small local currency loans provided by MCF, are needed to bring these businesses formal funding and help them build a credit history. Despite the additional risk involved, MCF remains focused on serving the underfunded SME healthcare market across the continent, providing them the small loans that suit them, at an average loan size of $20,000.
Loans are also combined with expertise to increase the quality of care. For example, with each loan, the borrower undertakes a healthcare-quality assessment, and then receives support to create and implement an improvement plan. And training is provided to healthcare employees – infection training has always been an essential part of this and MCF has developed special tools to help clinics during COVID. An Insight study we produced in partnership with MCF, found that bundling loans with this kind of technical assistance is driving clinical improvements.
Since its creation in 2009, MCF has reached 10 million patients. Over half of the patients attending MCF clinics are reported to be from low to very-low-income groups. The company has disbursed around 5,000 loans to 2,000 clinics across Kenya, Ghana, Nigeria, Tanzania, and Uganda.