Philips on designing innovation and cultivating partnerships – part two

Market Access
healthcare within Africa

This article follows part one of our two-part series, where we discussed how Philips designs innovation and digital health solutions for areas of India's healthcare system where options are sparse. 

Ties Kroezen, venture leader of Community Life Centers and business development manager for Philips Africa, tells us about the challenges present within the African healthcare system, solutions the company developed to help patients and providers connect, and how pharma can assist with delivering better care to African residents.

Patients today face considerable obstacles when searching for effective healthcare within Africa, primarily due to a lack of funding and, therefore, a lack of availability.

"The challenges in Africa are probably somewhat similar to those in India. But maybe to an even higher level. If you talk about access to care globally, around 50% of the world population doesn't have access to care. In Africa, it's more than 80%," Kroezen says.

In contrast to India, there's not only a lack of healthcare facilities, but the facilities are not offering the services needed.

Barriers to care

Several years ago, African leaders committed to spending 15% of their government budgets on healthcare in the Abuja Declaration. Still, only about two countries in Africa live up to that commitment.

In Kenya, the government did research a few years back and found that their public primary care facilities, on average, met less than half of the standards in terms of staffing, quality management, and more.

In other words, the gap between what should be there and what is there is significant.

"A lot has to do with the poor state of the healthcare systems in Africa, where we see the same picture as India. In the cities, there are a lot of private providers, and those who can afford it or those who have insurance have access to quality care. For people in the lower income brackets in the cities and rural areas, the health infrastructure is just not what it should be," Kroezen states.

It's not just a lack of money that results in a poorer healthcare system; spending is inefficient.

Another pain point is a lot of money, including foreign donor funds, is spent on equipment. Still, a lot of the equipment is not in use because there's no infrastructure, no electricity to run it, no spare parts, or no expertise to repair it.

"Estimations run between 30% to 70% of medical equipment in Africa is not being used, which, of course, is a huge waste of resources. So, while there is a lack of funding, the money there is could be spent much better towards improving health outcomes," Kroezen states.

To counter this, Philips does Continuum of Care (CoC) projects, in which it typically tries to include longer-term maintenance contracts. Hence, the company is responsible for ensuring the equipment continues to work.

Ensuring the equipment works is vital to adequate care and the first step in improving healthcare outcomes, especially in the primary care setting where diseases or illnesses are often first recognized.

Community Life Centers

Philips advocates for starting at the primary care point to have the most significant impact but noticed the lack of availability in that sector in Africa. In response, the company developed Community Life Centers.

"We at Philips are innovators, so we like to develop a nice innovation that will solve the issue. But in this case, we found that the issue is so broad – ranging from a lack of personnel, a lack of infrastructure (like electricity and water supply), and a lack of equipment and maintenance. Consequently, we needed to develop a broad solution addressing multiple customer needs," Kroezen states.

Community Life Centers' (CLC) combine varying elements, such as infrastructure, equipment, training, and maintenance, to make primary care systems functional. The only aspects Philips does not provide are health workers and the supply chain for drugs.

"We work in partnership with governments and others to ensure those components are there because you need them to have a functional healthcare system. It's a package, and sometimes we deploy one or two modules, sometimes multiple modules in a project. It all depends on the needs and the available budget in a particular project," Kroezen says.

CLCs are different than the portable units deployed in India. However, they follow the same philosophy and are designed using the same approach, except India focuses more on ICUs while the African team focuses on primary care.

Primary care facilities are like general practitioners' offices, except in Africa, there are hardly any GPs.

"If you have a health issue in Africa and you’re low income, you go to a primary care clinic. That clinic is a simple building with, if you're lucky, one or two nurses that may not offer the services that you need," Kroezen says.

"The solution we developed aims at making such facilities more functional by adding infrastructure, equipment, and digital components and ensuring that they actually do what they're supposed to do. That there's electricity, that there is water, etc. So, we follow the same philosophy as India but apply it to a different component of the healthcare system."

In addition to offering physical centres to improve clinical workflow, Philips created a digital health option for tackling another of Africa's most prominent healthcare issues – mother and child care.

MOM

Most African countries have maternal mortality rates 100 times what you see in Europe, Kroezen says. Maternal and child mortality is a big issue, especially children dying during childbirth or the first year.

"If you break that down into what are the underlying reasons for this, one reason is that people do not seek care when they should and where they should. There's a lack of information and education," Kroezen says.

Philips developed a free app called Pregnancy Plus, which helps users better manage their pregnancy and guides them on when and where to pursue care.

"The next challenge when they decide to seek care is they now have to reach it, which sometimes is a physical distance or there's no transportation. That's where the MOM system comes in," Kroezen states.

Mobile Obstetrics Monitoring (MOM) was founded by Philips' Connected Primary Care Solutions (CPCS) ventures team, which Kroezen leads, and developed thanks to a group effort between Philips' African, Hamburg, and Amsterdam teams.

MOM, which was also adopted in India, is a digital solution that connects the patient to a community health worker, who are people in the communities with elementary education with access to the system. The primary care facility also has access to the system, as does the hospital.

MOM helps share information, provides protocols, supplies clinical decision support, and tells healthcare workers what to do in specific circumstances.

The platform brings in clinical expertise and allows different stakeholders to work together, including the patient.

"That is something very unique because there are lots of patient apps out there, but they do not communicate with the doctor. MOM does. And that's why we have seen in some of the clinical trials that we have done, that it really brings strong improvements to the maternal and child health outcomes," Kroezen says.

Though the above offerings will benefit African patients and the system overall, garnering partners helps companies such as Philips improve health networks in ways it couldn't otherwise do.

Collaborating with pharma

Philips often talks with big pharma companies that distribute drugs to try to close one of the most significant gaps within the African healthcare system – the drug supply chain.

"We are not a pharma company, so we don't have expertise in developing drugs, but what we see, especially as part of our CLC projects, is that the supply chain for pharma is very critical," Kroezen states.

"In simple terms, if a pharmacy in a primary care facility runs out of stock, which happens regularly, people don't come to the facility anymore because many people in Africa consider a visit to a facility where they don't get drugs a waste of time."

Once the word spreads around the community that no more medications are available at a facility, there's an immediate drop in the number of patients that come to that facility. A supply chain ensures essential medicines are in stock, which is critical.

"Next to that, there are certain diseases that require a diagnosis and then the treatment with drugs. So that's another area where there is potential to collaborate, where we, as Philips, may be able to develop a device to make a diagnosis. Then pharma can do the drug to cure the disease," Kroezen states.

Philips has set a target that by 2030, it wants to improve 400 million lives annually in access to care countries as part of its bigger ambition to improve the lives of 2.5 billion people annually.

"That is the big goal driving all these efforts, and one key element in what we do is partnerships. We are a health technology company. That's what we are good at," Kroezen states.

"We are innovators, but we cannot do it alone. We need health workers to serve patients. We need pharma and others to ensure the supply chain is working. So, we try to build coalitions around certain big challenges and bring different competencies together to create sustainable solutions."

About the interviewee

Ties KroezenTies Kroezen serves as director primary care, responsible for leading the Connected Primary Care Solutions venture in Philips, with a focus on countries with low access to care. This venture is part of Philips’ strategy for annually improving the lives of 400 million people in communities with poor access to care by 2030. Before joining Royal Philips, Kroezen served as business and strategy consultant working for a.o. Accenture and KPMG. He moved on to become a social entrepreneur in Africa, setting up and leading businesses in agriculture, solar, and IT. Kroezen has a master’s degree in business science from the University of Twente. He is the chairman of the supervisory board of Inuka, a social venture active in digital mental health.

About the author

Jessica HagenJessica Hagen is a freelance life sciences and health writer and project manager who has worked with medical XR companies, fiction/nonfiction authors, nonprofit and for-profit organisations and government entities.