Food4Health - health insurance in the dairy aisle of Kenyan supermarkets


The “lab of tomorrow“ is all about finding new ways to new business by solving challenges in developing and emerging countries. As a project of Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH it runs on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ). One business idea developed during the lab of tomorrow is Food4Health, a bonus programme linked to health services that enables customers to build up health savings by buying needed food and commodities at no additional cost. Points are earned on a mobile account and can then be used to receive health services at several facilities.

In Kenya, finding alternative ways of health financing is highly relevant. While access to quality health care is a constitutional right and public health insurance is available, millions of Kenyans cannot afford to pay for health services at public or private clinics as only 20% of the population has access to some sort of medical coverage. Only 7% of Kenya’s poorest 40% are covered by the National Health Insurance Fund (NHIF), the largest insurer in the country (Ogando, 2016). Employees working in formalized contractual relationships are often insured through their employers. Informal sector workers can join insurance on a voluntary basis, but a certain mindset regarding precautionary insurance prevails: Why spend a part of their scarce income on health insurance now if it is uncertain that they will need it? This leaves as many as 35 million Kenyans still excluded from quality health care coverage.

 

So how to enable middle and low-income populations to take precautions for health allowing them to access to health care services in Kenya? This is the question that the working group around “Food4Health” focussed on during the 3rd lab of tomorrow in May 2016, an innovation process with the umbrella theme “Access to medicines and diagnostics in Kenya”. Oftentimes, low-income families lean on their social networks for assistance as hospital visits typically represent a significant financial burden. A quarter of total health care spending comes from unforeseen out-of-pocket expenses. The strong team, formed by experts of German research-driven pharmaceutical company Boehringer Ingelheim, Kenyan integrated health financing company Changamka Microhealth Ltd. and German development agency Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, are looking to provide families with an innovative financing option for health care. In their search for a solution they dared to look further than the industry boundaries and made an unprecedented connection.

Buying food is a necessity. Building a program that links routine purchase transactions with the provision of health coverage is a win-win for both - participating companies and customers. This is the underlying principle of the Food4Health program. Customers can buy certain goods at the supermarket marked with a Food4Health sticker, such as milk or maize flour. After the code is transmitted with the help of the Food4Health app or USSD, an alternative service to SMS, points are collected on a personalized account and accumulate over time. The points can be redeemed for health services or can be donated to friends or family members in need for health coverage. At the present moment, the project uses the health wallet “M-TIBA”, a platform administered by CarePay Ltd., which is accepted in more than 600 hospitals, clinics and health centres.

Asked whether the team is doing pioneer work, Oloo replies “I’d like to think so, Food4Health is very unique.” The Food4Health team agrees, it is common for the lab of tomorrow that everyone looks at the challenge with their expertise and new solutions are then co-developed. “It is not so much about finding the overlap in existing activities between all parties, but creating new business models from scratch while integrating everyone’s individual capabilities“, says Caroline Masabo of the lab of tomorrow. The second iteration workshop that took place in the country allowed the team to sharpen the business model by exchanging ideas with local parties and testing the concept in a local context. Dr. Ann-Katrin Gonschior, Head of Market Access, Emerging Markets, at Boehringer Ingelheim, says “The concept has an innovative status. Bonus programs are well known and accepted in Kenya – but combining daily food purchase with health care precaution is new. The program creates the possibility to put the smallest amounts aside and start saving for health care.”

Three organisations cooperating across two continents


Fast forward to the summer of 2018. The team has been tirelessly working towards the pilot phase for nine months. Two years after the innovation process started, the pilot test is finally on its way. For five weeks in June and July, two supermarkets in Nairobi’s neighbourhood Ongata Rongai hold goods, which are part of the Food4Health basket. Essential foods such as bread, cooking oil, maize flour, milk and water are linked with the programme’s codes. A total of 419 customers are registered and 2,700 vouchers issued, more than half for milk purchases. “I can use these points as they accumulate, to access healthcare for myself and my family. I’m happy, very happy. And I hope you will even take the promotion elsewhere, not only this place”, says one customer. The hard work has paid off and the approach also resonates with the target group.

“We have been creating something new between the public and the private sector over such a long period of time”, says Masabo, “considering this is a team that did not come from a single organisation, the cooperation is remarkable.” Oloo adds „What makes this project special is that despite our different backgrounds and company sizes, we were always able to sit and work together as equal partners”.

At the end of the pilot phase, the team still shows an incredible spirit. „Food4Health is an excellent platform to leverage synergies between healthcare providers, food manufacturers and public stakeholders”, says Ann-Katrin Gonschior. “We are not deterred by the challenges that are yet to come, but encouraged by the high acceptance among customers.“ The team hopes to raise awareness amongst Kenya’s policy makers with the programme and to scale it up by cooperating with food manufacturers and possibly the NHIF in the future. Food4Health could itself become a brand for health education and healthy lifestyle. It is without a doubt a journey worth following and we stay tuned to see if the programme goes “global in the developing world”, as Zack Oloo would very much like it to.

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