Satellite clinics bring healthcare to consumers’ doorsteps

For Kenyans attending regional meetings in Arusha, the short distance to Meru Primary School comes in handy when the strains and stresses of the day call for medical attention. For, on the way, sits a forlorn signpost proclaiming the Aga Khan Medical Services brand.

In Tanzania, the Aga Khan Hospital has outreach centres in Arusha, Dodoma and Dar es Salaam, which it has set up in its quest to take services closer to patients across East Africa.

Players in the health sector say the satellite clinics have radically changed the face of healthcare services, ending an era when financially able East Africans had to come to Nairobi for specialised services at the hospital’s facilities.

“The Kenyan hospitals with units in member states have taken with them quality medicine, expertise, and equipment that used to force patients to travel long distances to Nairobi,” said Dr Kamamia Murichu, chairperson of Kenya Pharmaceutical Manufacturers and Distributors Association.

“The health sector is far from its potential, but I can say this is one area in which the regional integration has played an important part in boosting access to medicine and healthcare,” said Dr Kamamia, who is also the Secretary of the East African Health Platform in an earlier interview.

In reality, however, the drive by major Kenyan hospitals to brand and chain small clinics has less to do with regional integration than with positioning in the market.

Whether the clinics are set within the country, or outside the national borders, the model is similar across the hospitals, the institutions’ bosses say.

To start a satellite clinic, all a hospital needs is a laboratory, physiotherapy unit, imaging facility, and other equipment that enables it to provide comprehensive service to patients, said Betty Gikonyo, CEO of Karen Hospital. These are the internal resources that are likely to drive any hospital into expansion.

Hospitals executives also talk of a desire to address time constraints that limit their clients by taking services closer to them. However, Dr John Muriithi, CEO of Mater Hospital, said hospitals set up outreach centres in smaller towns only if assured of manpower that will guarantee the same business model and service level as is available in the main hospitals.

“It’s just like opening a bank branch. You start from the scratch, but with responsibility for giving patients the same standard of service they’d get at the main hospital,” said Dr Muriithi.

In terms of external resources, the hospitals tend to follow the distribution of public health facilities to enable them to share manpower. This, he said, is a reality that the health sector, which has been grappling with shortages of specialised skills since independence, has to deal with.

At the satellite clinics, patients are mainly served by general practitioners, but specialists, including paediatricians and oncologists, have to be sent at regular intervals to attend to specific cases.

Similarly, satellite clinics tend to encourage the use of generic medicine, which is equally effective, but cheaper than the branded drugs offered at the main hospitals.

With the cost of medical care largely dictated by doctor’s fees and prescriptions, the executives say satellite hospitals end up charging less for their services than the main hospitals.

At the Mater Hospital, Dr Muriithi said deliberate effort is also made to discount consultation fees for clinics located in small towns to reflect the lower level of economic activities.

The Mater Hospital based in South B first opened its satellite clinic in Nairobi’s Development House in 2009. “With devolution, this (opening satellite clinics) is the way to go.

In fact, I expect more hospitals to expand presence through such outreach centres, as counties address the manpower shortage,” he said.

Dr Gikonyo agrees, saying the satellite clinics are more of a strategy to expand brand and increase access to healthcare, rather than about taking “convenience” to patients.

“Through these clinics, somebody who has never visited main hospital gets to learn of some of the specialised services on offer,” Dr Gikonyo said.

The Karen Hospital, which only took up the concept just recently, says it has been able to reduce consultation fees at some of its facilities to only 60 per cent of what the main hospital charges.

Every month, the hospital sends specialists to its satellite clinics to attend to patients as part of reducing crowding at main hospital.

“I believe that most of our outreach clinics will develop into fully fledged hospitals with time,” she said, adding that the hospital administration is currently gathering important data on the feasibility such facilities.

The Business Daily discovered that the dream of satellite facilities growing into fully fledged hospitals in future is a dream shared by almost all of the hospitals.

Clients

Apart from its main hospital and regional units, the Aga Khan Hospital, which together with AAR and Gertrude’s are credited with pioneering in setting up the satellite centres, has fully fledged hospitals in Kisumu and Mombasa. It also now has satellite clinics in most towns.

An urban centre as small as Ongata Rongai on the southern fringes of Nairobi, has, for instance, seen an aggressive foray of major hospitals, each of them citing internally compiled data to argue that a sizeable number of clients reside in the area.

Today, the centre has Gertrude’s Children Hospital and Nairobi Women Hospital, which set up operations there two years ago, joining Aga Khan and Meridian hospitals which were already established in the area.

On May 21, Gertrude’s Hospital management announced that the Sh30 million facility that it completed building in Mombasa this year will be converted into a fully-fledged children’s hospital, making its initial foray into counties outside Nairobi.

The hospital said similar units will soon come up in Kisumu, Eldoret and Nakuru.