Access to Care Strategies

Access to healthcare should be a right, not a privilege. Yet in Nigeria, many face barriers that make essential care out of reach, from geographical challenges to financial constraints. Making healthcare accessible is about bringing care closer to people—wherever they are and whatever their circumstances. Improving access requires targeted solutions that address the unique challenges in our communities. Here’s how we can create a more accessible healthcare system across Nigeria: 1. 𝐃𝐞𝐜𝐞𝐧𝐭𝐫𝐚𝐥𝐢𝐬𝐢𝐧𝐠 𝐒𝐞𝐫𝐯𝐢𝐜𝐞𝐬: Establishing primary care facilities in underserved rural areas is essential. By adopting a “hub-and-spoke” model, with community-based centres connected to larger facilities, people can receive timely, appropriate care without long travel distances. 2. 𝐄𝐱𝐩𝐚𝐧𝐝𝐢𝐧𝐠 𝐓𝐞𝐥𝐞𝐦𝐞𝐝𝐢𝐜𝐢𝐧𝐞: Technology can bridge the gap between rural populations and healthcare providers, enabling remote consultations and assessments. Telemedicine has already shown promise, particularly during the COVID-19 pandemic, when in-person visits were limited. 3. 𝐀𝐟𝐟𝐨𝐫𝐝𝐚𝐛𝐥𝐞 𝐎𝐩𝐭𝐢𝐨𝐧𝐬: High out-of-pocket costs deter many from seeking care. Subsidised programs, insurance schemes, and innovative financing models can ease the financial burden and make care more attainable. 4. 𝐏𝐮𝐛𝐥𝐢𝐜-𝐏𝐫𝐢𝐯𝐚𝐭𝐞 𝐏𝐚𝐫𝐭𝐧𝐞𝐫𝐬𝐡𝐢𝐩𝐬 (𝐏𝐏𝐏): Collaboration between government and private sectors can expand healthcare reach. Through PPPs, we can build and manage facilities that meet high standards of care while remaining accessible to the public. 5. 𝐂𝐨𝐦𝐦𝐮𝐧𝐢𝐭𝐲 𝐇𝐞𝐚𝐥𝐭𝐡 𝐖𝐨𝐫𝐤𝐞𝐫𝐬 𝐚𝐧𝐝 𝐌𝐨𝐛𝐢𝐥𝐞 𝐂𝐥𝐢𝐧𝐢𝐜𝐬: Trained community health workers can bring education, preventive care, and basic treatments into remote areas. Mobile clinics can deliver essential services like vaccinations and screenings to populations without easy access. 6. 𝐑𝐞𝐝𝐮𝐜𝐢𝐧𝐠 𝐭𝐡𝐞 𝐔𝐫𝐛𝐚𝐧-𝐑𝐮𝐫𝐚𝐥 𝐃𝐢𝐯𝐢𝐝𝐞: The disparity in healthcare between urban and rural areas must be addressed. Investing in rural healthcare infrastructure ensures that all Nigerians, regardless of location, can access quality care. 7. 𝐒𝐭𝐫𝐞𝐧𝐠𝐭𝐡𝐞𝐧𝐢𝐧𝐠 𝐏𝐫𝐢𝐦𝐚𝐫𝐲 𝐂𝐚𝐫𝐞: Emphasising primary care as the first point of contact allows for early intervention, reducing the need for more complex and costly treatments. Strengthening primary care access also alleviates pressure on specialised facilities. Creating an accessible healthcare system in Nigeria requires focused efforts addressing geographical and financial barriers. By prioritising community-level care, supporting it with technology, and forming partnerships that reduce costs, we can make healthcare inclusive for all.

What if the key to unlocking Africa’s future wasn’t technology or infrastructure—but healthcare? In too many communities, preventable diseases are taking lives, holding back progress, and costing billions in lost potential. Without access to quality care, families suffer, economies stagnate, and the cycle of poverty deepens. But here’s the good news: community healthcare centers are changing the story—and the data proves it. Here’s what makes these centers so effective: Accessibility: ↳ Mobile clinics bring healthcare directly to underserved areas. ↳ Affordable services ensure no one is left behind. Quality: ↳ Skilled professionals and reliable medical supplies build trust. ↳ Infrastructure ensures consistent, effective care. Education: ↳ Preventive health education reduces the spread of diseases. ↳ Communities are empowered to make better health decisions. Sustainability: ↳ Local partnerships create long-term impact. ↳ Investments focus on models that grow alongside community needs. Real Results: 🌱 In Zambia, maternal mortality dropped by 70% in two years. 🌱In Kenya, over 30,000 patients were treated in a single clinic in 2024. 🌱 In South Africa, community HIV programs reached 3.5 million people, cutting infection rates significantly. Healthcare doesn’t just save lives—it builds economies, strengthens communities, and creates a better future for all. What’s your take on scaling healthcare solutions to transform lives and economies? Share your thoughts below or let’s connect to explore opportunities. ♻️ Share this story with your network - let's spread this information far and wide! 👉 Follow Ben Botes for more insights on Leadership, Entrepreneurship and #ImpactInvestment.

A compelling access case isn’t built in the final year before launch. It’s built over years. Yet many teams still wait until 6-12 months pre-launch to engage payers only to hear the same thing: “There’s a gap. And the evidence to address it will take years to generate.” That’s a hard (and expensive) lesson. Hearing payer perspectives after the evidence strategy is finalized is too late and often leads to avoidable delays. When payers are engaged years before launch, clinical development, HEOR, and market access can be aligned with the commercial strategy. That alignment matters because it: - reduces internal rework - prevents late-stage conflict - avoids evidence that satisfies regulators but fails decision-makers Talking to payers early allows teams to: - de-risk reimbursement - strengthen value proof - optimize pricing and access plans - accelerate time to patient uptake Why I recommend early engagement: 1) Identify gaps in awareness Confirms payer understanding of disease, burden, and unmet needs with current options and management criteria. 2) Shape the evidence strategy early Ensure endpoints, RWE, and HEOR plans are built to answer payer and HTA questions, while there’s still time to course-correct. 3) Align the value narrative Refine target population, place in therapy, and value drivers based on how payers understand the disease and unmet needs. 4) Reduce launch and access risk Surface coverage, contracting, or utilization concerns early enough to adjust evidence, stakeholders, and pricing strategy, before restrictions appear. 5) Collect competitive insights Understand how payers view current and emerging alternatives, and where true differentiation can be credibly established. 6) Build credibility and trust with payers Consistent, early engagement signals partnership, and informs pricing corridors and the feasibility of value-based or risk-sharing agreements based on trends with current management 7) Improve internal alignment Provides a shared payer-informed foundation across clinical, HEOR, market access, and commercial teams to refine assumptions on access requirements, confirm evidence investments, and adjust forecast scenarios. Access isn’t won at launch. It’s earned years earlier by designing your evidence for decision-makers. --- Where Alkemi can help: We help teams use early payer engagement, including structured payer advisory boards, to design access rather than react to it. Specifically, we support teams by: - designing and facilitating early payer advisory boards that surface decision criteria - translating payer feedback into clear implications for clinical, HEOR, and RWE strategy - pressure-testing value narratives, target populations, and pricing assumptions - aligning clinical, access, and commercial teams around a shared, payer-informed foundation The objective is simple: shape evidence early, reduce access risk, and avoid late-stage surprises.

With the #Medicare & #Medicaid announcement on #GLP1 medication access, we need to turn our attention to obesity care access and #SharedMedicalAppointments. What the explosion in GLP1 medication access for those with private insurance has taught us is that WE DO NOT HAVE AMBULATORY CAPACITY for managing these medications in traditional #PrimaryCare and #ObesityMedicine practices that focus on 1-1 care. Access to 1-1 visits is a perennial pain point across the country, and the complexities of managing these medications worsens the problem. Let's be clear that these medications are FDA approved "as an adjunct to a reduced-calorie diet and increased physical activity," in addition to requiring frequent up-titration. That is a lot of work! The solution, of course, is not to decrease access for these medications. What we need is to create access to care through reimbursable and scalable #SharedMedicalAppointments. We can't "1-1" our way out of this; we need to leverage the advantages of group-based care to meet the needs. In our #MGHHealthyLifestyleProgram, we have been running GLP1-focused #Virtual #SharedMedicalAppointments for over a year now. The attendance is great, the patient education is great, the uptitration of GLP1s with prudent side effect management is great, and the patient feedback is great. And, all of this happens outside of the traditional 1-1 #PrimaryCare system. The administration's announcement should be a wake up call that we need to be treating #Obesity with the longitudinal, comprehensive care it deserves and #SharedMedicalAppointments are an underutilized solution.

💊 Expanding Medication Availability: A Strategic Lever for Better Patient Care & Volume Retention One of the most underestimated drivers of patient experience and service sustainability in healthcare is medication availability at the point of care. When healthcare centers expand their medication and therapeutic portfolio, the impact goes far beyond formulary lists: 🔹 Improved clinical outcomes – Timely access to appropriate therapies enables evidence-based treatment, reduces delays, and supports continuity of care. 🔹 Enhanced patient trust & satisfaction 🤝 – Patients are more likely to stay within the system when their treatment needs are met without unnecessary referrals or external dispensing. 🔹 Stronger volume retention 📈 – Availability of therapies keeps patients engaged in follow-up, chronic disease management, and preventive programs within the same care network. 🔹 Reduced care fragmentation 🧩 – Fewer external prescriptions translate into better adherence, clearer clinical oversight, and safer medication management. 🔹 Support for clinicians 🩺 – An expanded therapeutic toolbox empowers physicians to practice at the top of their license and deliver guideline-aligned care. Healthcare systems that invest in a robust therapeutic portfolio are ultimately investing in better outcomes, patient loyalty, and sustainable growth 🌱.

🌍 Planning National Telemedicine and Health Hotline Services: A Toolkit for Governments In the wake of the global pandemic, the importance of accessible healthcare has never been clearer, especially for communities in low- and middle-income countries. Telemedicine and health hotlines emerged as lifelines, bridging gaps where traditional healthcare infrastructure was limited. Now, it's crucial to empower governments to lead these efforts sustainably. Governments play a pivotal role in ensuring equitable access to healthcare solutions. From integrating these services into national strategies to allocating necessary budgets, their stewardship is essential for long-term success. This toolkit is designed to guide governments through the multi-phased process of establishing national health hotlines and telemedicine services, focusing on primary care accessibility. This comprehensive resource empowers decision-makers to: 📊 Strategically plan and budget for telemedicine implementation 🤝 Collaborate with service providers and mobile network operators 📝 Design efficient systems tailored to community needs By empowering governments with ownership and strategic foresight, we pave the way for sustainable healthcare solutions that reach every corner of our societies.

To accelerate Universal Health Coverage (UHC) in sub-Saharan Africa, addressing the region's multifaceted challenges is essential. With a UHC service coverage index of 46, several strategies are crucial: 1. Strengthening Health Systems: Upgrade infrastructure, enhance supply chains for medicines and equipment, and invest in health information systems to improve efficiency and management. 2. Increasing Funding: Boost investment in health care by increasing domestic funding, exploring innovative financing mechanisms, and ensuring effective use of resources. 3. Expanding the Health Workforce: Address shortages by training more health professionals, improving their working conditions, and ensuring equitable distribution across regions. 4. Improving Access to Services: Enhance both geographical and financial access by expanding services to remote areas, reducing out-of-pocket expenses, and subsidizing essential health services. 5. Strengthening Primary Health Care (PHC): Invest in PHC by upgrading facilities, focusing on preventive care, and integrating services to provide comprehensive community-level care. 6. Addressing Health Inequities: Ensure marginalized and vulnerable populations have access to services by addressing social determinants of health, such as education, nutrition, and living conditions. 7. Leveraging Technology: Utilize technology like telemedicine, electronic health records, and mobile health apps to improve service delivery and efficiency. 8. Promoting Community Engagement: Involve communities in health planning and decision-making to ensure services are culturally appropriate and meet their needs. Community health workers can bridge gaps between the health system and communities. 9. Enhancing Governance and Accountability: Implement transparent policies and oversight mechanisms to ensure efficient operation of health systems and effective use of resources. 10. Strengthening Partnerships: Collaborate with international organizations, NGOs, and the private sector to leverage additional resources, expertise, and innovations for UHC goals. James Tumaini Kengia (PhD) Wilson Agutu Wilson Kitinya Bruno Sunguya Dolorosa Duncan Ivony Kamala Faustine Ndugulile Dr. Syriacus Buguzi Winnie Makori Dr Winnie Mpanju-Shumbusho-Julie Makani Queen-Ruth Msina Baraka Mfilinge CPA(T) Boniface Christopher Mwakajinga Katalyeba S. Vitalis Rafia Iddy Rabia Saad Rabia Esmail Catherine Kahabuka. MD. PhD CATHERINE GITIGE Federica Margini Rutasha Dadi, PhD, Sadiki Fulgence Jean Kaseya Tedros Adhanom Ghebreyesus Prudence Masako Brenda Msangi Banda Khalifa MD, MPH, MBA Tanzania Health Summit Anodi Kaihula

Bridging the Healthcare Financing Gap in Emerging Markets! A significant concern for emerging markets is the prevalence of out-of-pocket payments for both public and private services. For instance, approximately 75% (2020) of all health expenditure in Nigeria is out-of-pocket. Addressing the financial gap for health services in emerging markets is a complex challenge that requires a strategic approach. The goal is to establish a coherent system that delivers maximum value for the citizens and ensures equitable access to health services. Here are some examples of strategies to consider. They may seem common sense, but implementation can be challenging. It underscores the need for more systemic thinking in addressing healthcare financing gaps in emerging markets. 1. Evaluate Fiscal Space: Assess the government's budgetary capacity to maintain or enhance healthcare spending, both now and in the future. Identify the gaps and plan services more intelligently to get more value from every dollar spent. Formulate sustainable health financing strategies that adapt to fluctuating economic conditions and health needs. 2. Foster Public-Private Collaboration: Explore how appropriate partnerships between public and private sectors can help fund health services and infrastructure. 3. Aim for Universal Health Coverage: Maintain the focus on universal health coverage, which hopefully guarantees everyone access to necessary health services without financial hardship. 4. Allocate Resources Efficiently: Utilize available financial resources more effectively. Plan and prioritize essential health services in a more organized way by aligning provisions and removing programmatic silos. 5. Explore New Health Insurance Models: Given the fiscal gaps in many countries, it may not be viable to replicate comprehensive models like the UK's NHS. There's an urgent need to investigate various public and private health insurance models that fit the country's context and needs. 6. Invest in Digital Health Innovations: Allocate resources to health technology, including digital health and artificial intelligence, to reach underserved populations and enhance service delivery. 7. Seek but align and Integrate International Support: International organizations and donors can help fill the financing gap, particularly in low-income countries. However, this should ideally be done in a way that does not result in long-term dependency, and all inward funding should be coordinated through government planning. 8. Establish Regulatory Frameworks: Set up regulatory frameworks that incentivize investment in healthcare and ensure transparency and accountability. The out-of-pocket scourge impacts the public and private health sectors in many countries. The fault does not automatically reside with public or private providers but a failing financing system. When planning new or updated services, we must ask who pays and how this does not become an unrealistic out-of-pocket burden.

As a physician and advocate, I've seen the stark realities of healthcare inequality up close. It's a multifaceted challenge, deeply rooted in socioeconomic disparities, systemic barriers, and historical injustices. Yet, it's not insurmountable. We have the tools, the knowledge, and the collective will to forge a more equitable future in healthcare. The path forward involves a holistic approach: 1️⃣Embrace Preventative Care: Early intervention can prevent conditions from escalating into serious diseases. Community-based health education and accessible preventative services are key. 2️⃣Expand Telehealth: Telehealth can transcend geographic and transportation barriers, making healthcare accessible for all, but we must ensure it's equitably deployed. 3️⃣Diversify the Healthcare Workforce: A workforce that reflects the diversity of the population it serves can improve patient outcomes and trust. 4️⃣Advocate for Policy Change: Systemic change is essential. We need policies that ensure universal healthcare access and tackle the social determinants of health. Change won't happen overnight, but each step brings us closer to a healthcare system defined by its inclusivity and equity. Let's work together to make healthcare a right, not a privilege. #HealthcareEquity #SystemicChange #PreventativeCare #Telehealth #DiversityInMedicine #PolicyChange

𝐓𝐨𝐝𝐚𝐲 𝐢𝐬 𝐖𝐨𝐫𝐥𝐝 𝐂𝐚𝐧𝐜𝐞𝐫 𝐃𝐚𝐲, 𝐚𝐧𝐝 𝐭𝐡𝐞 𝐭𝐡𝐞𝐦𝐞 "𝐔𝐧𝐢𝐭𝐞𝐝 𝐛𝐲 𝐔𝐧𝐢𝐪𝐮𝐞" 𝐜𝐨𝐮𝐥𝐝𝐧'𝐭 𝐛𝐞 𝐦𝐨𝐫𝐞 𝐫𝐞𝐥𝐞𝐯𝐚𝐧𝐭 𝐭𝐨 𝐭𝐡𝐞 𝐰𝐨𝐫𝐤 𝐰𝐞 𝐝𝐨. As a cancer surgeon and health systems researcher, I see this every week: patients being diagnosed late because the pathway to care is fragmented, expensive, and difficult to navigate. “Access" in #cancercare is not just whether services exist, but whether patients can actually reach them. Access is a continuum: awareness → early detection → accurate diagnosis → timely referral → affordable treatment → long-term follow-up. Weakness at any point undoes progress everywhere else. The barriers we talk about: • Limited infrastructure • Shortages of trained oncology professionals • Inadequate diagnostics The barriers we miss: • Time poverty (choosing between seeking care and maintaining employment) • Indirect costs (travel, accommodation, lost wages) • Income determining when and whether patients seek care • Geography as one of the strongest predictors of outcome A technically available service is not truly accessible if it requires resources patients don't have. If we're serious about changing the status quo, three priorities stand out: 1/ Design cancer care around people, not facilities Integrate services into primary care. Ensure continuity from detection to survivorship. 2/ Invest in health systems, not just technologies Workforce development. Diagnostics. Referral pathways. Data systems that measure inequities instead of ignoring them. 3/ Protect patients from financial catastrophe Reduce out-of-pocket costs. Expand effective coverage. Push toward universal health coverage. We are united by the shared challenge of cancer. But our patients are unique in their circumstances, risks, and needs. Equity will not come from one-size-fits-all solutions, but from systems that recognize difference, anticipate barriers, and respond with dignity. → On this #WorldCancerDay, let's commit not only to fighting cancer, but to building cancer care that truly meets people where they are. Q: What's the one barrier to cancer care in your context that often goes unspoken? #WorldCancerDay #UnitedByUnique #CancerEquity #KeepingAbreastWithDrMiriam