By Karl Hofmann, President and CEO, PSI
The COVID-19 pandemic has shown us that innovative approaches to meet rapidly evolving health needs are here to stay.
Since the pandemic’s start, health consumers globally have demanded more health information and treatment from the safety and convenience of their own homes. We’ve seen the speed at which health systems can adapt to meet changing needs. Health systems have:
- Integrated multi-channel communications and telehealth that extend support beyond clinic walls.
- Re-allocated resources to develop public health emergency operation centers to rapidly respond to emerging health challenges.
- Unleashed digital trainings to build health worker capacity, all without further endangering an already COVID-effected workforce.
Our takeaway: continuing to respond to COVID-19 and ultimately achieving Universal Health Coverage (UHC), requires that we continue to invest in designing health systems from the bottom up in ways that meet consumers where they are with what they need.
At PSI, that’s what we call a Consumer-Powered Approach to Healthcare (CPH). This Devex World, I’m reflecting on why CPH matters now more than ever.
consumer-powered healthcare
Consumer insights inform how we design, deliver and scale health solutions. Put simply: consumers share what they want so we, in partnership with consumers and government, can respond to their needs.
Here’s how:
- Consumers want quality, accessible and affordable care – no matter their starting point. In response, we shape mixed health systems that bring together the private and public sectors.
- Consumers want options that go beyond health services at the clinic. In response, we support health systems to deliver self-care solutions, equipping consumers to take their health into their hands.
- Life changes fast – but health access must remain constant. In response, we support health systems to adapt to meet consumers’ evolving needs.
Together, we can do more.
Designing from the ground up requires health systems to re-think how they capture consumer voices to ensure that interventions are designed to meet the diverse needs of consumers, wherever and whenever they need care. This will require integrating robust measurements of client experience into routine data collection, as many private institutions have already done.
Here’s why that matters.
DESIGNING A MIXED HEALTH SYSTEM
Despite decades of investment in the public-sector backbone of health systems, many consumers continue to seek care in the private sector. However, without financial protection and robust quality control mechanisms, consumers share that they too frequently experience financial hardship and sub-standard clinical outcomes.
As it did when faced with a pandemic, the public system needs to find ways to work with and alongside the private sector to provide an integrated offering of generalized to specialized primary, secondary and tertiary care.
Best yet, this doesn’t always require a healthcare provider, lessening the burden on an already overstretched health system.
Case study
Unlocking domestic resources
In India, PSI is assisting the government of Uttar Pradesh in the development of an online platform, the Hausala Sajheedari (HS), that helps unlock domestic resources. The platform simplifies the entire process from the moment a private healthcare provider applies for accreditation to the moment that provider gets reimbursed for services provided. This helps to overcome systems barriers and enables the existing actors in the health system to play their role as expected. The platform increases efficiency, accountability and transparency. It allows public money to flow seamlessly to accredited private providers, who are now able to deliver quality sexual and reproductive health (SRH) services to poor and vulnerable populations that would otherwise not be able to access them. The platform is now being replicated in other states, and its scope is being expanded to also include other primary healthcare services beyond SRH.
SELF-CArE FOR STRONGER HEALTH SYSTEMS
Emerging self-care technologies allow consumers to safely and appropriately test, treat and monitor their health concerns from the privacy of their own home. Take COVID-19. Consumers can access trusted sources for information about COVID-19 symptoms and preventive behaviors. They can purchase an at-home COVID-19 test and have the tools and access to in-person care, should they need.
But not all self-care technologies offer that blended service. We need to integrate self-care technologies into the broader, mixed health system to offer consumers a seamless journey when they require higher levels of care.
case study
Catalytic introduction of new diagnostic technology
In 2005, PSI recognized that a short-term catalytic investment in new diagnostic technology could result in longer-term sustainable scale-up. With support from Unitaid, PSI began working to bring HIV self-testing (HIVST) to high-burden countries by combining a targeted research agenda; global policy and guideline development; active market creation facilitated by donor commitments; and a rapid implementation timeline. The Initiative has already demonstrated laudable successes. In the course of this work, PSI distributed 5.3M HIVSTs – and, in the process created a market that is expected to reach 29M HIVSTs per year by 2025.
Building on our work with HIVST, PSI has expanded its portfolio of catalytic projects and is now working to replicate this approach supporting the introduction of Hepatitis C and COVID-19 self-testing. PSI is conducting research to identify areas and populations where COVID-19 self-testing could increase testing uptake and evaluate acceptability, feasibility, costs and usability of COVID-19 self-collection and self-test kits, management of results and linkage to community and clinical care. This demonstrates the use of digital tools in capturing end-to-end data to support reporting tool for rapid outbreak monitoring and linkage data, among other activities. These activities further recognize the importance of both the public and private sectors in bringing to scale new diagnostic technologies, something that cannot be done without necessary research, systems thinking and advocacy.
THE CASE FOR AN ADAPTABLE, CONSUMER-POWERED HEALTH SYSTEM
COVID-19 will not be the last global humanitarian challenge we face. Climate change will only exacerbate current healthcare challenges and increase the need for adaptable consumer-powered health systems.
Accelerated urbanization in response to climate-driven drought and famine will elevate the risk of the next pandemic, requiring improved public health surveillance and emergency management capacity.
Finally, we know well that these effects will be felt most acutely by the poor and vulnerable, including women and young people. Remaining vigilant that these evolving health systems continue to provide the services that matter most to these consumers, including sexual and reproductive health services (including quality, safe abortion services where legal), along with robust financial protection is the only way to accelerate progress toward UHC.
case study
strengthening national malaria control programs
While having worked to deliver 450M bed nets, testing more than 90M people for malaria and treating nearly 180M malaria cases, PSI is increasingly working to support countries in their efforts to strengthen their own systems and health workforce for malaria diagnosis, treatment and drug-based prevention across health facilities and community outlets. With support from the United States Government through IMPACT Malaria, PSI works to strengthen quality of and access to malaria case management (CM) and prevention. For example, PSI supports national governments to provide the right diagnostics and treatment to more patients with suspected fever and confirmed malaria cases and increase the provision of intermittent preventive treatment (IPTp) for pregnant women; deploy innovative approaches, including seasonal malaria chemoprevention (SMC), mass drug administration (MDA), or other drug-based approaches, as appropriate; and strengthen malaria health systems and the rigorous use of data for decision making.
WHERE DO WE GO FROM HERE?
COVID-19 has demonstrated how now, more than ever, CPH matters for reaching UHC. Extending financial protections to meet consumers where they are, incorporating consumers’ voice into the system and equipping consumers to be agents of their own health through digital, self-care and private sector integration will make health systems more resilient and responsive, providing better health outcomes and more financial protection.
Building robust health systems from the bottom up is the right way to respond to the health challenges of today and tomorrow.
case study
#thevword (yes, that v word): A forward look at how we're meeting health consumers where they are
Since its inception, PSI has understood what consumers want – easy access to the healthcare products and services that allow them to live healthier lives and plan the families they desire. We’ve worked relentlessly to deliver on that commitment. Much of this work has focused on advancing self-care by increasing multi-channel access to contraceptives, self-care, including condoms, oral contraceptive pills, emergency contraception and medical abortion. Creating and developing these markets required stepping in to supply products, build awareness by creating compelling brands and providing information. And while much of this work was achieved with the support of donors, PSI, over the last few years, has transitioned a large portfolio reaching over 5M users each year to be self-sustaining, maintaining access to leading brands in global markets. Maintaining this self-sustaining portfolio of self-care contraceptive products requires creating a platform that responds to our consumers evolving needs and wants.
Today, this means providing an integrated Femtech solution for women’s end-to-end reproductive needs. PSI launched VIYA, its first global sexual wellness lifestyle brand – igniting a movement under #TheVWord aimed at disrupting the narrative around women’s healthcare and supporting women to make and own their health choices throughout their lifecycle. Harnessing technology including artificial intelligence, e-commerce and telemedicine, VIYA plans to deliver SRHR information, products and services across the stages of their lives – from menstruation to menopause – to women across low- and middle-income countries (LMICs).
