Caring for high-need, high-cost patients an urgent priority

By Dr. Majwala Meaud Major

Improving the performance of Africa's health system will require improving care for the patients who use it most: people with multiple chronic conditions that are often complicated by patients' limited ability to care for themselves independently and by their complex social needs.

Focusing on this population makes sense for humanitarian, demographic, and financial reasons. From a humanitarian standpoint, high-need, high-cost (HNHC) patients deserve heightened attention both because they have major health care problems and because they are more likely than other patients to be affected by preventable health care quality and safety problems, given their frequent contact with the system.

Demographically, the aging of our population ensures that HNHC patients, many of whom are older adults, will account for an increasing proportion of users of our health care system. Worst still, these elderly people look after many orphans and more vulnerable grandchildren abandoned by their parents/caretakers yet they are also vulnerable and disadvantaged to manage such dare responsibilities. And financially, the care of HNHC patients is costly.

One frequently cited statistic is that the elderly compose the 5% of our population that accounts for 30% of the continent's annual health care spending, yet the children account for 40% of the population and account for 52% of the continent's annual healthcare spending.

Many poor families have extreme financial limitations to the detriment of their health. Some have mostly severe, persistent behavioral health challenges. Others have conditions that are greatly exacerbated by social factors such as lack of housing, food, and supportive personal relationships. As the charity organizations are increasingly intervening to offer a helping hand to redeem the health sector in Africa. 

One international charity establishment-Humanity Direct-working with Platinum Hospital as partners in Uganda to reduce maternal and child mortality among disadvantaged communities enabling them to access free medical services.

Mr. Kasozi Dickson, who coordinates Humanity Direct activities in Uganda reveals that "We have so far bailed out over 1200 needy children on the health front, yet too many children still suffer or die from a lack of medical care simply because their families cannot afford the cost of treatment they need. We are changing that by enabling donors to directly fund life changing   surgery/operations and life-saving treatment for the most poor, most vulnerable children".

Humanity Direct mobilizes donors on its website, mass media and social media, participate in fundraising activities like marathons, cycling, swimming and other sporting drives, while Platinum Hospital provides a team of medical professionals especially surgeons to bail out children from very poor families who cannot afford even the very basic medicine and so being able to afford a surgery is out of the question and not in their arm's reach.

According to Dr. Dan Namuguzi, one of the surgeons at Platinum Hospital in Uganda, many children from poor families are usually referred to them from Mulago National Referral Hospital and other health facilities because they do not have the financial muscle to pay for their medical bills especially when it requires surgery.

He says "Because the health sector in most African states is under stress, even with this med-business partnership, as health professionals, we are not afraid of our freedom to deliver a basket of success; we are trusted to deliver excellence as we are not ashamed of being party to this accomplishment to save the lives of the many innocent souls''.

He continues that "We have patients who need surgical operations from neurosurgery, Hernia, Circumcision, orchiectomy, colostomy to skin grafts with an average cost of £250''.

We therefore need to develop functioning models of healthcare for the children and the elderly especially those who have no access to health insurance policies.

Writer is the President of Sustainable World Initiative-East Africa