The Tunza Family Health Network was established in December of 2008 to serve vulnerable and underserved populations in Kenya. The network comprises of select medical practitioners who have an existing and licensed private practice offering primary health care services to the community.
Population Services Kenya (PS Kenya) uses a social franchising model by entering into contractual agreements with health providers to deliver a specified package of franchised services in accordance with franchise standards under a common brand.
By being a part of the network, providers enjoy access to an array of benefits at subsidized or at no cost. Benefits include: access to clinical trainings and support supervision; subsidized family planning commodities; subsidized medical equipment and consumables; free branded medical protocols, job aides and customer education materials; free marketing to increase customer awareness and create demand for Tunza services through mass media advertising, wall branding and Interpersonal Communication (IPC); support in quality improvement leading to certification and accreditation; access to business training and linkages to affordable loans to help providers improve/expand their facilities.
The network currently has a membership of 415 privately owned clinics across Kenya’s 40 out of 47 counties.
Family Planning, with a focus on the more cost-effective, long-term and reversible methods such as intrauterine devices (IUCDs) and implants was the flagship of Tunza services after inception. However, with time, PS Kenya has integrated other services into the network; these include Cervical Cancer Screening and Preventative Treatment (CCS&PT), Safe Motherhood, HIV Testing and Counseling (HTC), HIV Care and Treatment, Integrated Management of Childhood Illnesses – IMCI (Malaria, Diarrehea, Pneumonia), Immunization, Tuberculosis screening and treatment, Hypertension and Voluntary Male Medical Circumcision (VMMC).
The Tunza network has a dedicated Social Behavior Change Communications (SBCC) team of over 100 Community Health Workers (CHWs) commonly referred to as Tunza Mobilizers (TMs). Their mandate is to create a robust and informed demand for the franchise by mainly targeting women of reproductive age individually or through small group sessions to educate them on PS Kenya’s supported health areas and refer to franchisd clinics. The Tunza Mobilizers are recruited, trained and supervised by PS Kenya Communication staff.
PS Kenya uses a two-pronged approach in ensuring that providers are meeting and continuously improving on the quality of care offered to clients. At a macro level, Tunza supports the provider to holistically improve clinic quality through Safe Care International Health Standards—a certified, step-wise quality improvement process, that begins with a comprehensive baseline quality assessment to identify gaps at a clinic, followed by provision of training and technical assistance necessary to address gap areas. At a micro level: Tunza works with providers to help them enhance proficiency in service delivery by ensuring that franchised services are offered in accordance with national guidelines and Standard Operating Procedures (SOPs). In 2019, PS Kenya will be introducing the government owned Kenya Quality for Health Model (KQMH) as the principle quality assurance framework for quality improvement within the franchise
The Government of Kenya aspires to achieve universal coverage by 2030 and the National Health Insurance Fund (NHIF) plays a pivotal role in taking this agenda forward. To this end, PS Kenya has worked closely with NHIF to ensure that Tunza franchised facilities receive NHIF accreditation status. Currently over 50% of the Tunza network is accredited and offers services to over 480,000 NHIF members registered with Tunza for out-patient care. On the demand side, PS Kenya has continued to support the NHIF marketing team to educate and enroll customers to their health micro insurance products, especially Supa Cover and Linda Mama.
PS Kenya works with franchised facilitates to offer business training and support. The key objective of this program is to support health providers in building business skills that would allow them to run profitable health enterprises. The program is also designed to extend affordable loans to healthcare providers (traditionally considered high risk borrowers by banks) to help them upgrade equipment and infrastructure or increase the scope of services offered.
Using a Social Enterprise model, PS Kenya and PSI are jointly seeking to evolve classic social franchising that is donor-reliant to a more sustainable model. In 2018, PS Kenya, commenced work on the social enterprise, and 65 facilities registered interest to join the new model. Branded as Tunza Platinum, PS Kenya’s vision for the social enterprise is to sustainably deepen access to quality and affordable health services by bringing together three critical players; healthcare consumers, private health providers and insurance organizations (NHIF/private). At the core of Tunza Platinum is ensuring that the poor have access to affordable payment mechanisms and can seek care in private facilities.
As part of Tunza Platinum, PS Kenya introduced an automated Clinic Management System (CMS) which 35 facilities have purchased and installed. The principle objective of installing the CMS is to help clinics increase client volumes and revenue by capitalizing on efficiency gains presented by improved clinic operations because of automation. The CMS is part of a five pillar Tunza Platinum value proposition, which, once fully implemented, promises business growth for member clinics. The other elements of the value proposition include improved business processes, quality and clinical improvements, access to affordable medical equipment and drugs, marketing, and aggregation of insurance business. PS Kenya’s will monetize various VP pillars to earn revenue to fund its franchise operations. Progressive scale up of Tunza Platinum is running concurrently with the pilot.