Delivering High Quality, Low Cost Care at Scale through Primary Care: A Case
Study from Gertrude's Children's' Hospital, Nairobi ,Kenya
Gordon Otieno Odundo
Chief Executive Officer
Background of Gertrude’s Children's Hospital Outline the context of Child Health in Kenya
Overview of our activities Governance and ownership CSR – Un Global Compact Information Technology
Staff and Capacity Development Patient Safety and quality
3
4
Causes of Child Mortality - Kenya
Source: World Health Statistics 2011, WHO
16%
20%
9%
11% 1% 10%
10%
8%
3%
19% 3%
Pneumonia Diarrhoeal Causes HIV/AIDS Malaria
Measles Prematurity Birth Asphyxia Neonatal Sepsis
Congential Anomalies Other diseases Injuries
Cause Deaths
Total Deaths 188,928
Diarrhoea 38,802
Pneumonia 30,406
Malaria 20,666
Neonatal causes = 31% of under 5 mortality
6
North Eastern
80
Eastern 52
Rift Valley
59
Nyanza 149
Western 121
Central 51
Nairobi 64
Coast 87
Child Health Situation- Kenya
Deaths per 1,000 live births for the 10-year period
before the survey
Kenya National Bureau of Statistics & ICF Macro
Kenya 74
Under-five Mortality by Province
Child Health Situation- Kenya Progress in Infant and Under-five Mortality Rates, Kenya
1990/2009 (KDHS)
8
9
Hospital Entrance
Our Network
Governance
Registered Trust with tax exempt status
Board members serve on a voluntary basis
All surpluses reinvested in the hospital
12
Hospital Morbidity
14
15
16
17
19
20
21
22
23
24
26
27
Clinical Governance
The hospital was ISO 9001:2000 accredited in July 2008 and recertified ISO 9001: 2008 in September 2011 and in July 2014. Pursuing JCI in 2015
29
Gertrude’s Children’s Hospital wins Millennium Development Goals Award
for the second year …For their efforts towards reducing
child mortality
The awards were presented at a special ceremony organized by United Nations Development Programme in Kenya, Ministry of State for Planning, National Development and Vision 2030, Millennium Development Goals Trust Fund and the Government of Finland and attended by various players.
31
The American Academy of Paediatrics (AAP) states that a variety of factors are associated with potential for increased
demand for paediatrician services Trend
Increased insurance coverage and improved access for children when health care reform provisions are implemented
A growing shift in the number of pediatrician office visits for children
previously cared for by family physicians (who may have increasing numbers of adult patients in their practices for the
same reason)
Changes in the type of and demand for pediatric services deriving from advances
in genetics and other technologies
Increasing numbers of medically complex and/or fragile pediatric patients
Increasing need for pediatricians to address developmental, educational, and mental health issues with their patients
Increasing prevalence of chronic diseases in children
Our observation
70 % of our clients have insurance cover
We attend to children only
It will be while for this to impact us in Kenya
Evidenced by high referral to ICU
We offer one stop services
Greatest growth has been in chronic attendance clinics
32
Critical Skills Needed
AAP in a 2008 survey found that
• There were too few local child/adolescent psychiatrist s to meet referral needs
• 87% cited a shortage of developmental-behavioral pediatricians
• 82% reported insufficient pediatric dermatologists.
• More than half of those surveyed reported shortages of pediatric medical subspecialists in rheumatology, neurology, adolescent health, endocrinology, and gastroenterology
Gertrude’s Institute of Child Health and Research
35
36
37
38
39
