Experts urge African leaders, stakeholders to advance value-based health care


From Juliana Taiwo-Obalonye, AbujaAt the conclusion of the Nextier-organized policy discourse on advancing value-based healthcare in Africa as part of its Universal Health Coverage Series (UHC), experts agreed that public sector stakeholders, policymakers, private sector actors, and clinicians should cooperate to advance value-based healthcare.Additionally, it was decided that a value-based strategy should be used to allocate health resources based on illness prevalence and population requirements.The experts also urged African nations to reconsider the metrics they use to evaluate the effectiveness of their health systems and to think about switching to a value-based framework.The UHC series serves as a platform for key stakeholders to discuss challenges and contextual peculiarities limiting UHC in Nigeria and worldwide. Experts at the event included Prof. Sir Muir Gray, Founding Director of the Oxford Value and Stewardship Program; Dr Regis Hitimana, Deputy Director General in Charge of Benefits, Rwanda Social Security Board; Julia Ouko, Branch Manager, National Health Insurance Fund, Kenya; Dr Nnenaya Kalu Umeh, Technical Assistant to the Director General, National Health Insurance Authority, Nigeria; and Dr Adwoa T. Twum-Barimah, a Ghanaian Health Economist. Dr Francis Ayomoh, a DPhil Candidate in the Nuffield Department of Primary Care Health Sciences at the University of Oxford, moderated the discussion.Stakeholders at the event explored how their health systems can benefit from a shift towards value. Furthermore, they discussed the rudiments of a value-based healthcare model and brainstormed policy and culture shifts necessary to drive value-based healthcare in Africa.Prof. Muir Gray promoted the use of value as a benchmark for measuring the effectiveness of the health system in his keynote speech. He exhorted participants to deal with concerns of variance in healthcare volume and quality in relation to need.He emphasized the importance of a care model that focuses on population outcomes and cited inefficiency as a major problem in the healthcare system.He clarified that the creation of value-based healthcare programs should be adapted to the particular requirements of the population.Additionally, the design should promote a culture of ownership and shared accountability and guarantee equitable service delivery.The Rwanda Social Security Board’s Dr Regis Hitimana stated that value-based healthcare is still in its infancy in that country.He acknowledged that the Rwandan healthcare system’s use of the fee-for-service payment method did not promote efficiency.Rwanda has implemented capitation and case-based payment as provider payment mechanisms to address this and maximize effectiveness and population value. He further clarified that although value-based healthcare is a positive development for Rwanda, its implementation may be constrained by a lack of reliable funding and data.According to Julia Ouko of the Kenya National Health Insurance Fund, Kenya pays its providers using a combination of capitation, fee-for-service, and case-based payments.She accepted that value-based healthcare would help the Kenyan health system because it would save costs, boost efficiency, improve results, and lower medical errors. However, she emphasized that advancing value-based healthcare required sustainable financing.The Nigerian National Health Insurance Authority’s Dr Nnennaya Kalu-Umeh noted that although value-based healthcare is a novel idea, Nigeria would embrace it due to its advantages. She emphasized the need for cultural shifts in the healthcare system so that the emphasis is shifted from outputs to outcomes.She recommended conducting a pilot value-based healthcare program to provide evidence for a scale-up. Furthermore, she explained that with the Basic Health Care Provision Fund, Nigeria has more healthcare resources and opportunities that can be leveraged to advance a value-based approach to service delivery.

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