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It is widely recognized that strengthening primary healthcare is the most efficient, fair and cost- effective way to organize a health system and achieve the goal of universal healthcare access. Philips has developed a platform for strengthening primary and community healthcare, empowering the community itself to sustain it. The Community Life Center (CLC) is a collaborative, holistic solution that provides infrastructure, digital innovations, technological equipment improvements, staff and management training, and community engagement and support.
Philips Foundation commissioned the KIT Royal Tropical Institute to conduct an impact assessment study to establish how this integrated approach performed compared to more traditionally set up primary healthcare facilities on aspects such as access, utilization of services, and perceived and realized quality of care.
The study evaluated the effects of CLCs in three settings across Kenya and South Africa. A mixed- methods approach was used in this cross-sectional study that compared CLCs to control facilities. Client exit interviews, in-depth interviews, focus group discussions, key informant interviews, and facility and consultation observations evaluated the relevance of services offered, healthcare-seeking behaviour, perceived and observed quality of care, and the appropriateness of support and management functions. The study was conducted between September 2019 and December 2020.
Overall, the primary care services were appreciated by CLC clients, well-aligned with national health priorities and the local burden of disease, and of sufficient quality. Improvements in physical assets and technologies contributed to an attractive and safe primary care experience for CLC clients. Process aspects of the CLC concept, such as community outreach and engagement, monitoring, and training and supervision, were less clearly defined and varied across study settings.
The community health worker/volunteer (CHW/V) outreach component of the CLC concept focused mainly on the use of a community outreach backpack, while other aspects of community engagement such as health literacy and dialogue on health needs were less apparent in the locations studied.
Differences were observed in how the CLC concept added most value in Kenya vs South African contexts. In Kenya, improved quality was mostly through structural improvements, while in South Africa it was more through attitudes and staff behavior. KIT suggests this may be related to overall higher level of health expenditure and, therefore, availability of resources in South Africa. The contextual situation should therefore be considered in further developing and positioning the CLC concept. For the CLC concept to succeed, it is important to establish a clear formal co-creation process that specifies the roles and responsibilities of local governments, implementing organizations, target communities, and Philips. These aspects are all important in order to optimally utilize the holistic set up and meet expectations of all stakeholders. KIT notes that the CLC model has great potential to align with the three interrelated and synergistic components of the renewed definition of primary healthcare as defined by global health experts and world leaders in the Astana Declaration on Primary Health Care. These components include: The synthesis study reports includes a more detailed assessment of the current CLC deployments related to these components.
When 2019 - 2021
Status Concluded
Where
Kenya and South Africa
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Project report
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