Kenya

Tanykina Community Healthcare Plan (TCHP)

Introduction
In Kenya the Health Insurance Fund has launched a program called the Tanykina Community Healthcare Plan (TCHP). TCHPis a plan for the members of Tanykina Dairy Plant Ltd and their dependents. Through the dairy plant members sell their milk and receive services like agro-vet and artificial insemination, and so the dairy plant is crucial for the lively hood of its 4000 active members and their families, in total 20.000 people. It was on request of Tanykina that PharmAccess, the implementing partner of the Health Insurance Fund, started discussions on how to address the health challenges in the community.  The result of these discussions has been the introduction of an affordable healthcare plan for all the members of Tanykina Dairy Plant Ltd. and their dependents. This healthcare plan is called the TCHP and is tailored to the needs of the community.

The need for the healthcare plan
As is often the case in Africa the people of Tanykina pay their healthcare largely out of pocket. In Africa healthcare systems have been unable to efficiently deliver healthcare. As a result, almost 60 percent of healthcare, often obtained in the private sector, is paid by patients out-of-pocket, causing many to fall into a poverty trap. In case of the Tanykina members this means they would need to sell a cow, which would impoverish the members even more It is also a risk to Tanykina as a whole since it, amongst others, affects the sales of milk to milk processors. Tanykina Dairy Plant Ltd is owned by its members and wants to be a reliable supplier without being affected by a lack of access to health care. Therefore, the TCHP does not only reduce the members’ health related risks but also helps Tanykina Dairy Plant Ltd to mitigate health-related business risks.

Local Partner
The local partner for TCHP is AAR. AAR brings vast experience to the table as it is the largest and most successful private health care company in the region. AAR’s mission is to provide healthcare solutions that make a difference to life. It has over 150.000 clients who have subscribed to AAR as their healthcare provider of choice. However, the Tanykina Community Healthcare Plan (TCHP) is the first program in Kenya which provides affordable quality health care to farmers and their families that AAR has partnered in. AAR's contribution in this partnership is the extensive service AAR offers across Africa with systemized clinical history and benefit administration for all members. The well trained workforce has contributed to the steady implementation of this program as well as AAR’s partnerships with various healthcare providers i.e. doctors, specialists and hospitals across the country

Enrollement
To enhance the concept of group enrollment and solidarity, family pricing was introduced. The contribution from the members adds up to 75% of the full costs of the health plan, with the remaining 25% currently being subsidized by the Health Insurance Fund. The contribution of the members will be automatically collected by deducting it monthly from their milk proceeds. Enrollment is not compulsory for Tanykina members, it is a voluntary scheme. However, to avoid adverse selection it was decided to make family enrollment compulsory. To manage the scheme financially some restrictions, like waiting periods for non-urgent surgeries, were introduced.

Five clinics
The Tanykina Community Healthcare Plan assures that there is quality healthcare available at the clinics and that what is offered can be provided. Five clinics - mission, community and public clinics –  participate in TCHP and provide services to the community. The basic capacity and quality of these clinics and hospitals have already been improved by PharmAccess and AAR. Further stepwise quality improvement plans are being drafted, dealing with infrastructure, medical equipment and with medical and administrative training of the staff members. An independent accreditation organization called SafeCare will monitor the stepwise quality improvements of the clinics involved. SafeCare has been established by COHSASA of South Africa, Joint Commission International of the US, and PharmAccess, to introduce standards to improve healthcare delivery in resource–restricted settings. Compliance to these standards can be measured and rewarded.

Collection of data
The insurance programs are generating important data that are used to improve the quality and efficiency of the TCHP program and share lessons learnt. Data generated include information on: the disease burden of our populations, the use of healthcare services and the costs of those services. Independent socio-economic and biomedical operational research is carried out by external organisations to measure the actual outcome and impact of the program and to provide recommendations for improvement.

Click here to watch our film on TCHP.