Leveraging the power of partnerships: spreading the vision for a population health care delivery model in western Kenya

Abstract

BackgroundThe Academic Model Providing Access to Healthcare (AMPATH) has been a model academic partnership in global health for nearly three decades, leveraging the power of a public-sector academic medical center and the tripartite academic mission – service, education, and research – to the challenges of delivering health care in a low-income setting. Drawing our mandate from the health needs of the population, we have scaled up service delivery for HIV care, and over the last decade, expanded our focus on non-communicable chronic diseases, health system strengthening, and population health more broadly. Success of such a transformative endeavor requires new partnerships, as well as a unification of vision and alignment of strategy among all partners involved. Leveraging the Power of Partnerships and Spreading the Vision for Population Health. We describe how AMPATH built on its collective experience as an academic partnership to support the public-sector health care system, with a major focus on scaling up HIV care in western Kenya, to a system poised to take responsibility for the health of an entire population. We highlight global trends and local contextual factors that led to the genesis of this new vision, and then describe the key tenets of AMPATH’s population health care delivery model: comprehensive, integrated, community-centered, and financially sustainable with a path to universal health coverage. Finally, we share how AMPATH partnered with strategic planning and change management experts from the private sector to use a novel approach called a ‘Learning Map®’ to collaboratively develop and share a vision of population health, and achieve strategic alignment with key stakeholders at all levels of the public-sector health system in western Kenya.ConclusionWe describe how AMPATH has leveraged the power of partnerships to move beyond the traditional disease-specific silos in global health to a model focused on health systems strengthening and population health. Furthermore, we highlight a novel, collaborative tool to communicate our vision and achieve strategic alignment among stakeholders at all levels of the health system. We hope this paper can serve as a roadmap for other global health partners to develop and share transformative visions for improving population health globally.

Effects of social health insurance on access and utilization of obstetric health services: results from HIV+ pregnant women in Kenya

“…AMPATH is one of the largest and most comprehensive HIV/AIDS healthcare systems in SSA providing care to more than 150,000 HIV+ individuals in Western Kenya, tests approximately 80,000 pregnant women annually for HIV, and has robust electronic medical records [35] [36]. AMPATH has also been at the forefront of helping the Kenya Ministry of Health (MOH) formulate and implement healthcare policy initiatives and changes [37].…”

Predictors of Health Insurance Enrollment among HIV Positive Pregnant Women in Kenya: Potential for Adverse Selection and Implications for HIV Treatment and Prevention

“…AMPATH is one of the largest and most comprehensive HIV/AIDS control systems in SSA, providing care to more than 150,000 HIV positive individuals in western Kenya, testing approximately 80,000 pregnant women annually for HIV, and has robust electronic medical records (EMRs) [56,57]. AMPATH has also been at the forefront of helping the Ministry of Health (MOH) in Kenya formulate and implement healthcare policy initiatives and changes [58].…”

Layering and scaling up chronic non‐communicable disease care on existing HIV care systems and acute care settings in Kenya: a cost and budget impact analysis

“…While salary for clinicians and programmatic staff were the largest costs, task shifting between clinician levels to increase care coverage while still offering comprehensive care for complex cases reduces costs [9,[27][28][29]. However, human resource constraints may limit proposed scale-up, and needs to be monitored using the CDM needs-based health workforce assessment that can approximate the gaps in human resources as the program grows [26].…”

“…More complex patients are referred to higher levels of care as needed, and the programmatic staff and AMPATH Medical Records System (AMRS) provides consistent chronic disease tracking. The CDM programme was initially delivered on top of AMPATH's HIV care but has since expanded across other existing MOH or not-for-profit facilities, and now accepts NCD patients regardless of HIV status [9]. Partnering with established health facilities enables the CDM programme to provide comprehensive care without having to create new facilities.…”