Providing integrated health care in East Africa
Aga Khan Health Services
Tanzania · 10 May 2022 · 4 min
AKDN / Lucas Cuervo Moura
This page is also available in“Many of our health facilities in Kenya and Tanzania started as small clinics focused on maternal and child health. Today AKDN runs a fully integrated health ecosystem in both countries, which is centred on four main hospitals, two in-patient medical centres and almost 100 outreach health centres, collectively providing care to nearly 1.8 million people in the region,” said Dr Gijs Walraven, Director of Health, AKDN.
AKDN’s health contributions in East Africa have expanded greatly since our precursor established the first health centre in Dar es Salaam in 1929. Three agencies are involved. The Aga Khan Foundation (AKF) and the Aga Khan Health Services (AKHS) work in community-based primary health care, providing information for communities, training health workers, contributing to policy and reaching vulnerable groups with low-cost, proven medical technologies. This is complemented by curative services in institutions ranging from dispensaries to health centres to full-service hospitals.
The Aga Khan University (AKU) undertakes world-class research and provides specialist health care through its teaching hospitals. It aims to produce leaders who will generate a lasting impact on the communities they serve. Its School of Nursing and Midwifery has contributed to the development of health workers in East Africa for over 20 years, in a region where nurses and midwives represent more than 85 percent of the health workforce and are often the only point of care. Almost 200 doctors have graduated from its Master of Medicine programme, which offers learning relevant to practice in Africa.
AKDN uses a hub-and-spokes health system to effectively integrate different levels of care. This provides health promotion and prevention activities at the community level, easily accessible primary healthcare centres for more serious illnesses and hospitals when needed for specialist services. Such integration goes beyond the healthcare system. The health of a community is heavily influenced by the socio-cultural environment: whether babies are getting sufficient nutrition; if clean water and sanitation facilities are available; what barriers exist to seeking health care. AKDN agencies work together and with partners to address the wider needs of societies, in turn improving health.
Digital health tools such as teleconsultations and remote learning enable many patients and medical staff to avoid the costs, inconvenience and environmental impact of travel.
AKDN / Lucas Cuervo Moura
Partnering for impact
Partnerships are key to our success in strengthening healthcare systems. We work with governments, local authorities and local and international partners.
One such partner is the Agence Française de Développement (AFD) Group, with whom we have collaborated in East Africa for over 15 years. AFD has provided more than US$ 120 million in financing to AKDN to support the health sector in East Africa. Together we have made the hospitals in Kisumu and Mombasa into referral facilities for the local population and established a high-level cancer and cardiology centre in Nairobi.
In 2019, AFD contributed 10 million euros to support the Tanzania Comprehensive Cancer Project (TCCP), while AKDN made a 3.3 million euro contribution. "The TCCP project will improve infrastructure, expand access to screening and detection services, and initiate a joint research agenda across all levels of the local health sector,” said Dr Walraven. Examples include the new ultrasound machine enabling improved cancer screening at the Ocean Road Cancer Institute in Dar es Salaam, and the mammography machine at the Bugando Medical Centre, improving the early detection of cancers.
At the onset of the global pandemic in Tanzania in March 2020, AKDN and AFD signed an agreement to establish a dedicated infectious diseases unit in the Aga Khan Hospital, Dar es Salaam and Aga Khan Medical Centre, Mwanza.
The latest grant, of 2.3 million euros, comes from Proparco, AFD's private-sector subsidiary. The grant was awarded to the Aga Khan Hospitals in East Africa as part of the "Health in Common" Initiative and will help improve access to health care. As well as the hospitals, the grant will benefit 94 medical and outreach centres in Kenya and Tanzania.
Another significant partnership is a nine million euro programme funded by the European Union and AKF to combat the impacts of COVID-19. AKF, AKHS and AKU are taking a multi-sector approach against the pandemic and its impacts in Kenya, Uganda, Tanzania and Mozambique, prioritising health system strengthening.
The programme includes disseminating COVID-19 prevention messages, reinforcing national health facilities’ resources, providing rapid response funds to civil society organisations to support vulnerable community members and providing entrepreneurship and employment skills training and start-up funds to young people. So far, we have:
- reached more than 42,000 community members with accurate messaging about COVID-19;
- conducted 9,500 COVID-19 tests within low-income communities in Kenya;
- renovated a defunct hospital ward, now a key facility for treating severe cases of COVID-19, at the Amana Referral Hospital in Dar es Salaam;
- used digital health platforms to train health workers and lab technicians;
- provided eHealth medical equipment in other areas in the region, aiming to provide COVID-19 training to a further 650 health workers; and
- provided items such as PPE, tests and processing equipment, or ventilators in 22 health facilities across the region.
“One of the areas where we’ve received quite a bit of disquiet lately in terms of the supply chain are the gloves. And I’m seeing they are one of the items that have been donated here today. You donate with your ears on the ground about the users and what is needed urgently,” said Hon. Charles Dadu, County Executive Committee Member for Health, Kilifi County, Kenya, on behalf of a recipient health facility.
At the end of the 30-month programme, we aim to have directly supported more than 140,000 people by improving their knowledge, resources and opportunities. Find out more.