At D-tree International, the first challenge has always been core to our mission. We have long championed the utility of mobile decision support tools in assisting health workers adhere to countries’ clinical guidelines and report utilization data.
But access to decision support tools alone does not always motivate healthcare workers to use them. Could tying provider payment to decision support drive or improve its use? And how do you translate data from a decision support tool into payments that incentivize appropriate care?
In UHC provision by the private sector, there is need not only for quality care, there is also the need for data. Private clinics who provide care for the government must submit requests for payment along with information about the care provided. We know that classic D-tree digital health systems produce data as a by-product of care.
If we think back to the discussion of UHC, we see an opportunity -- by using data generated from decision support applications, we can create algorithms to calculate payment amounts based on pre-determined financial schemes. This incentivizes private health care providers to follow clinical guidelines and enables routine submission of government HMIS data.
The data by-product from an episode of care can play several roles in the system, including as automatic requests for payment from the clinic which provided that care.
The overarching goal is that the use and scale of such an approach will accelerate the reduction of maternal and neonatal mortality by fostering trust.
Trust by the pregnant woman and her family that this will result in access to respectful, quality care throughout her pregnancy. Trust by the healthcare provider that he will be paid promptly, allowing him to reinvest profits to strengthen his practice, and to view impoverished pregnant women as valued clients. And finally, trust by the government that the care provided in the private sector is good value for money, and that the approach strengthens its stewardship over the entire health ecosystem. We think this kind of approach can empower national and local authorities in Liberia and throughout sub-Saharan Africa and South Asia to overcome many of the key operational challenges for engaging the private sector in UHC.
Created with images by D-Stanley - "Mesurado River" • Erik Cleves Kristensen - "Monrovia" • Veronica Sparks - "4463" • Prof Ken Harper - "Liberia – By Ken Harper" • DFAT photo library - "Rose and Susan in the treatment room at Susa Mama health clinic, Port Moresby General Hospital, PNG" • DFAT photo library - "Rose in the treatment room at Susa Mama health clinic, Port Moresby General Hospital, PNG" • DFAT photo library - "Susu Mama's, Port Moresby General Hospital" • Synergos Institute - "namibia - drc clinic - synergos 2014-52" • Synergos Institute - "namibia - drc clinic - synergos 2014-62"