Penda Health is a fast-growing provider of low cost care in Nairobi and its surrounding areas. With ambition to be the leading hospital chain in Kenya and Africa, we had an interview with the company’s co-Founder & CEO Stephanie Koczela on their 10-year journey and how technology and focus on superior patient care have been critical to their growth
The wide smile and easy demeanor of Stephanie Koczela is quite disarming. However, her drive, passion and determination to change the face of healthcare in some of Nairobi’s highly populated, low-income areas shines through, as you engage with her and meet her teams at the company’s medical centres around Nairobi.
We meet for the first time with Stephanie at her company’s head office, located not far from Nyayo National Stadium in Nairobi, and the discussions start in earnest about Penda Health – the firm she helped co-found and has been running since 2012 – and many other issues of the time, such as the raging Covid-19 pandemic.
Attentive and engaging, Stephanie comes out as a leader who is truly passionate about the important role a functional healthcare system can contribute to better the lives of individuals and families in Kenya.
Having spent most of her early years in social impact projects in developing countries and Kenya in particular, Stephanie clearly embodies her company Penda Health’s mantra of providing healthcare that each patient can trust, with love at the core of each team member at the company, beginning with herself.
UNIQUE CONCEPT, LOW COST
Founded in 2012, Penda Health Limited is an award-winning, for-profit social enterprise that provides high-quality primary healthcare services to families who might have little to no access to trustworthy, affordable medical care in urban and peri-urban areas in Nairobi and its surrounding areas. Its first medical centre opened its doors in Kitengela town, some 30 kilometres from Nairobi.
The company completed its latest phase of expansion in late 2021, reaching a physical footprint of 21 medical centres, with plans of adding another 9 centres in 2022 – becoming one of the largest healthcare providers in Kenya – including its new referral centre at the heart of Nairobi city on Kimathi Street.
The healthcare provider closed the 2021 year on a high – serving its one millionth patient since it began operations in Kenya – just a few months away from celebrating its 10 year anniversary!
Each of Penda Health’s centres is stocked with medical supplies, medicines, laboratory tests and essential equipment and are staffed by well-trained clinical officers, nurses, and clinical coordinators, with physician oversight from the Clinical Quality team.
“The medical centres provide low-cost consultations, diagnostics and treatment, in areas ranging from chronic ailments to acute illness treatment, family planning, antenatal and postnatal services including KEPI vaccines,” Stephanie informs the HealthCare Africa team during an interview at the Kimathi Street Centre, which is one of its most advanced. The Centre offers specialist services such as advanced diagnostic, pediatric and gynecology consultations and will soon have X-ray services.
To further build and improve capacity of its staff, Penda has also invested in an innovative medical training centre housed behind one of its medical centres.
“At the medical training centre, our Clinical Quality team trains medical centre staff – both medical and administrative – in delivering clinical quality, ensuring patient-centered care, and using the electronic medical records (EMR) system appropriately in their daily patient activities. Penda aims to always provide consistently accessible, affordable, and high-quality primary healthcare services for the whole family. About 81% of our patients don’t have insurance.”
Stephanie is proud of her team’s achievements, with several awards motivating the team to continue improving, while giving confidence to its customers and investors that they are on the right track in their ambition to be the leading provider of affordable healthcare services in Kenya, using the latest technology.
Penda Health has been awarded as Kenya’s top healthcare company to work for 2018 and in 2021 achieved SafeCare Level 4 certification, a globally-recognized and accredited standard by the International Society for Quality in Health Care External Evaluation Association. It also took the first runners up position for the Award of Excellence in Improving Access to Primary care Services Category and second runners up for the Health Facility Innovation Project of the Year Category at the Quality Healthcare Kenyan Awards 2021.
FILLING THE GAP WITH A SMILE
According to Stephanie, for over 40 million Kenyans, affordable healthcare sometimes means compromising on quality.
“The choice is often between cheap, low-quality care or expensive, high-quality care – leaving most families in a tough choice between getting quality healthcare and spending on other essential areas. Simultaneously, most healthcare providers have not fully taken advantage of medical innovations, meaning that many patients are not benefiting from global advances in healthcare,” she states.
With patients in Nairobi dissatisfied with the care they are receiving, Stephanie says that Penda Health’s low-cost, high-quality model fills a gap that continues to grow, as more Kenyans flock to the city of Nairobi and its environs seeking employment and better lives.
With operational medical centres in Nairobi and its environs with accumulative patient visits of more than 1 million since its opening, Penda Health is one of the largest providers of healthcare in Kenya. Penda Health’s patients are served in friendly environments.
“We are currently in three counties: Kajiado, Kiambu and Nairobi counties and are on schedule to hit more than 400,000 visits this year,” Stephanie informed us during the interview towards the end of 2021. “We are one of the top 10 largest outpatient healthcare providers at this point, with most of our patients paying in cash, while we are also serving quite a growing number of NHIF patients. We are also one of the leading partners to insurance companies.”
Penda provides high-quality, accessible and affordable primary healthcare services by building on three key strategic areas: the right infrastructure, the right technology and the right model.
In terms of infrastructure, Penda Health’s brick-and-mortar medical centers open every day of the week to walk-in patients and are in densely populated urban areas around Nairobi, such as Githurai, Pipeline, Kasarani, Umoja, Kawangware and Lan’gata, among many others. They are also found in Kitengela and Ngon’g.
Technologically, its fully operational electronic medical records system is designed to improve healthcare quality, telemedicine and digital healthcare tools to enable easier access to care and customer service, while its model as a mid-level healthcare provider enables it to utilise the right digital tools and training to provide high quality and low-cost care.
ONE MILLION PATIENTS MILESTONE
Stephanie’s involvement in social work activities in some of Nairobi’s low-income areas such as Mathare exposed her to the need in providing quality and affordable healthcare to meet the needs of communities in Nairobi.
She explains that in many communities, it was quite common to find one clinic being run by a doctor, while families lacked reliable hospitals where they could either pay in cash or NHIF card; and if they could afford the treatment in the first place.
“In the focus group meetings that we did with communities around Nairobi before opening Penda Health, lots of people complained that the staff at hospitals available in their areas did not smile at them; nobody took care of them and nobody provided that human touch. At Penda Health, what we are trying to do is to make healthcare that is very friendly and caring, that is very affordable and accessible.”
“When we opened our first medical centre in Kitengela we knew the problem we wanted to solve: patients told us that they wanted a good customer service experience, they wanted to feel very much loved and they wanted to be part of us. The Penda name, which is means love in Swahili, originated from one of the community focus group meetings we had organized,” she informs us.
The team at Penda Health is truly proud of its achievements so far – especially on how patients perceive its services. At the company’s headquarters reception area, prominently displayed is a board with the customer satisfaction scores for each of the medical centres for all to see – including visitors.
The Covid-19 crisis has certainly been a challenging experience not just for Penda Health but the entire health system. The company has used the pandemic to rejig its list of offerings including offering Covid-19 jabs
“If you visit any of our medical centres around Nairobi, it will become clear to you within moments of entering that great patient experience is just as important to us as providing high-quality medical care,” she enlightens us.
Stephanie believes that to provide excellent care to its customers, it all begins with recruiting the right people. “When we recruit new Penda staff, the first thing we look for is whether they will put patients first. Our branches are filled with clinicians, receptionists, lab techs, pharmacy techs, and cleaners who genuinely care about the patients we serve and often live in the communities where they work. The end result? Our Net Promoter Score, a common customer satisfaction metric, is on average 65%, compared to the Kenya healthcare industry average of -5%.”
“Ample evidence suggests that when patients have a great health care experience, they are more likely to stick with their treatment plan, more likely to feel better faster, and more likely to come back for re-assessment, if things aren’t improving as expected. We see all of these benefits adding up for our patients.”
And the results are all there for all to see. Having served more than 1 million customers in the last nine or so years, and more than 400,000 in the last year alone, the company has built adequate momentum to reach more of its potential customers across Kenya and beyond – and has set itself an ambitious goal of impacting the lives of 10 million patients within the next few years.
“We shall be at 10 million patients before you know it! Thank you to every team member who has served patients at Penda. Thank you to all the teams who work behind the scenes and thank you to all the patients who have trusted us with their health! Also, a special shout out to all our sector, government and financing partners. You have been a key part of this journey,” she commented as the news of the milestone came through.
SECRETS TO PENDA’S SUCCESS
Stephanie informs HealthCare Africa magazine that Penda Health has been successful because they have key core principles that have guided them, from the very start of their operations, to date.
She elaborates that one of the key success factors has been their focus on providing affordable, quality care, with the average patient visit to any of the centres costing about around US$15 (KSH 1,500), which include drugs and lab services compared to US$70 (KSH 7,000) per visit for comparable quality care at other alternatives in Nairobi.
She adds that the adoption of technology from the start has also given the firm the impetus to succeed. “We have invested in the right technology to ensure our patients are getting the highest quality of medical care every time they visit a Penda medical center. Our Clinical Decision Support system is the first of its kind in Africa and among the first in primary care globally.”
Penda also hires passionate, talented people who can deliver results for the company and then provides continuous training and digital tools to enable them provide quality care to its patients, she adds. Further, the firm is proud that approximately 70% of it’s patients become loyal, returning the next time they get sick, since the company has created a brand patients trust due to the high levels of patient satisfaction.
“We insist on a transparent, friendly, positive patient experience. Everything we do is centered around the patient,” she affirms. “One of the key objectives of Penda Health is to ensure that patients have a positive experience during their time of need and are vulnerable. From when a patient walks into the door, sees a clinician and our follow up calls as they get better ensure that a patient knows that our objective is to see them healthy and treated the best when unwell.”
Expounding further on Penda’s approach to its success, Stephanie adds, “The power of high-quality, tech-enabled, patient-centered primary health care is evident, certainly to the patients themselves, but also to the community, insurers, and the health system as a whole. Penda Health is overcoming difficult problems in executing this vision by combining a people-centered approach with world-class technology.”
She further adds that Penda Health also offers its patients convenience and accessibility. “Primary care must be available to people near where they live and work, at times that are convenient for them. Penda’s expansion over the last few years now places every Nairobian within one matatu ride of a Penda medical centre. In addition, we are open at least 12 hours a day, 7 days a week, and 6 of our branches are open 24 hours a day. They never close, so that we can be available for those who work odd hours, and for families who experience emergencies overnight. Although you can make an appointment to see a clinician at Penda, while 99% of our patients are walk-ins, and our average total visit time (including waiting time, lab, pharmacy, and billing) is under one hour,” she explains.
The high scores that each of the medical centres has achieved echo the positive patient experience based on trust that Stephanie and her team has relied on to grow the company over the years, adding that their evidence-based approach to dealing with a huge breadth of medical problems, has also been one of the key success factors.
“Until recently, it was next to impossible to provide guideline-based care for the hundreds of different conditions that are commonly encountered in primary care. We are at a very special moment in the digital health journey as Penda Health to deliver evidence-based recommendations to our clinicians at the point of care across hundreds of common primary care conditions. That clinical decision support, coupled with advanced data analytics, allows us to consistently deliver the highest quality primary care experience to tens of thousands of patients every month – and to refer them to specialists when necessary,” she elucidates.
TECHNOLOGY DRIVES THE BUSINESS
Stephanie discloses that Penda Health provides high-quality, accessible, and affordable primary healthcare services at 20% of the cost of competitors, with the tech-enabled quality improvement loop for its lower-cost mid-level providers (clinical officers) being at the core of its innovation.
The tech-enabled loop is based on point-of-care clinical decision support that enables accurate diagnosis and treatment, integrated into the firm’s electronic medical record (EMR).
Further, Penda Health has a robust physical and e-learning platform for onboarding and training its healthcare workforce in delivering international standards of healthcare, while its real-time automated quality measurement using structured EMR data and advanced analytics is used to understand population-level health metrics that guide decision-making at all levels of the organization.
She adds that data-driven feedback loop facilitates providers to further inform training needs and quality improvement initiatives at the company.
Stephanie reiterates how technology has been critical to their growth and success. “As Penda grew from 2 to 21more facilities, our EMR standardized and gave us visibility on every aspect of the patient’s interaction. This helped us deliver the same level of service across all the centres,” she informs us. “Our call center and automated WhatsApp interactions provide timely assistance to patients remotely. This has helped us ensure we support patients anytime, anywhere, as we grew.”
Adopting digital tools has enabled the firm to face and adapt to disruptive changes in the healthcare industry. “Our strategy is extremely patient centric and we believe in integrating the cutting edge of technology that will help patient experience and differentiate ourselves. We will continue to leverage that data to make improvements in patient retention, clinical decision making and operational excellence. We are actively incorporating predictive models to reduce patient churn and improve operations.”
She explains that they will further leverage their digital front door to provide a seamless, blended healthcare experience to their patients by utilising tele-medicine, digital payments and digital health records. “Our clinical decision support is well ahead of the curve in primary healthcare in ensuring patient safety and quality. We will continue to build on this effort through rapid iterations.”
Additionally, the team is working at improving service delivery everyday, working towards efficiency and effectiveness in its operations and ensuring that they deliver best quality at the least cost possible, while they review parameters regularly to ensure that they are getting better.
COVID-19 LESSONS AND STRATEGIES
Stephanie is truly appreciative of the great work and resilience of its staff in the face of challenges that rose during the Covid-19 pandemic. “The Covid-19 crisis has certainly been a challenging experience not just for Penda Health but the entire health system. However, working closely with our stakeholders – patients, staff, donors, investors and Government – we have continued to ensure our patients and staff remain safe by strictly adhering to the laid down health protocols.”
“We strongly value the role of our staff as frontline health workers in the fight against Covid- 19. We have provided Personal Protective Equipment (PPEs) to our employees as part of measures to ensure a safe working environment.” She adds that she is proud of the hard work from their procurement team, which ensured that even at the start of the crisis, they were able to access PPEs and other essential supplies, when disrupted supply chains and sudden surge in demand led to severe shortages, not only in Kenya but globally as well.
The company has used the pandemic to rejig its list of offerings to ensure minimal disruption to its services while keeping its patients and staff safe, with new digital health services coming into the fore. “Our new free telemedicine service “Pigia Penda” has enabled us to stay connected to our patients and guide them through acess to essential vaccinations, antenatal care and care for Non-Communicable Disease (NCD) care. We have also been running a digital patient engagement and education campaign dubbed #youcancountonPendaHealth to emphasize the importance of taking care of one’s health during the Covid-19 pandemic.”
Stephanie reveals that as the pandemic’s effects became clear, they embarked on re-aligning their organizational structure to become a leaner, cost-effective, stable and sustainable health care provider, a process that affected several staff members as the organization consolidated roles, outsourced some functions and reviewed skill sets required to perform certain functions. “All these measures were aimed at enhancing organizational efficiency, focusing on our core business to achieve higher reach and impact, while responding effectively to the prevailing realities of Covid-19.”
During the pandemic, they worked closely with the Ministry of Health to ensure that five of its centers stayed open for 24 hours and more importantly, past curfew hours, to ensure emergency cases were well handled, even in the middle of the restrictions on movement brought by the pandemic. “For these and other measures, some of our medical centres were awarded SafeCare Level 4 Accreditation validating our deep commitment to patient safety and healthcare quality.”
The firm’s medical centres have been appointed to offer Covid-19 vaccination, an achievement that Stephanie is extremely proud of, for its impact on the communities they serve – and the recognition that this brings to the health care provider as a critical part of the healthcare delivery system in Kenya About 1 out of every 50 doses in Nairobi have been given at a Penda medical centre.
OPPORTUNITIES, TRENDS AND THE FUTURE
Stephanie believes that there are more opportunities to grow the company in Kenya and even into Africa in future and therefore they are ready to partner with like-minded partners to deliver on their ambitious goals.
The firm is funbdraising investment 1 to invest in its technology strategy for scale and then to begin to expand to other parts of Kenya, with plans to set up up three more branches in Nairobi and build five others in the Coastal, Central, Eastern and Rift regions, bringing to 30 the total number of outlets by the end of 2022.
“We are an organization that really believes in trying to reach all of Africa. Today we are in Kenya – we chose Nairobi to be our starting point, that’s my home and it’s a place I really love – but in future, we would love to go all over Africa. We are always looking for a connecting partner to help us in our growth.”
For better impact, Stephanie advises that she would like to see more affordable healthcare insurance options in Kenya, adding that the insurance sector and healthcare providers must work hand in hand to do so.
“If one sector works and the other one doesn’t, the healthcare sector will not achieve its goal of care for the health of the citizens. The insurance sector is critical to patients’ ability to access quality care. With economic stress in the country today, it is good to see insurance providers creating more affordable health insurance options. We work with several innovative insurance providers in the sector to create sustainable, affordable options.”
The healthcare provider has recently signed a partnership with leading insurance provider Britam that will deliver maternal tele-medicine to its customers by providing medical consultation and wellness support for free from their homes.
She adds that out of Covid-19 pandemic, the adoption of healthcare technology is booming as well as the personalization of healthcare will continue to increase in the future. However, as much as there is a lot of growth in digital trends, she argues that primary health must be strengthened by the government. “Primary healthcare is the frontline of the health sector – making sure that babies are getting immunized, making sure that mums have better pregnancy experiences, etc.”
As Penda Health seeks more partnership and growth opportunities, we look forward to celebrating the 10 million patient milestone soon and to another 10 years of impact, not only in Kenya and Africa as well!!
This feature appeared in the February 2022 issue of HealthCare Africa. You can read this and the entire magazine HERE
