Creating more transparency in malaria program funds: a business case for Connected Diagnostics in Kenya

Abstract Background International vertical (disease specific) health financing programs risk functioning in parallel with existing domestic funding in low- and middle-income countries (LMIC)s, leading to inefficient service delivery and concomitant poor health outcomes. There is a need to reduce these inefficiencies and create new public-private opportunities to bundle health system funds. In this paper we aim to assess the opportunities offered by digitalized diagnostics to target and monitor health funds to those in need objectively and transparently. We named this Connected Diagnostics (ConnDx). Methods In this study we used the malaria case to demonstrate the ConnDx process codeveloped with the local Department of Health of Kisumu, Kenya. We used ConnDx quantitative data to demonstrate how an ConnDxapproach can contribute to manage malaria health funds with markedly increased transparency. We also calculate the costs for ConnDx and standard care to assess potential cost reductions. Results ConnDx was rolled out in five private healthcare facilities and detected 2,199 malaria cases among 11,689 patients with fever. ConnDx allowed for the identification of malaria hotspots, semi-real-time assessment of patient health seeking behavior across facilities, and insights in doctor’s prescription behavior, vis a vis National Guidelines. Based on these insights, we demonstrate that a 25% reduction in costs can be realized, while simultaneously better-quality indicators can be monitored and put into quality improvement action. Conclusion The concept of ConnDx can in principle be used for any medical condition that can be diagnosed in a digital manner and linked to mobile payment systems. This can help decision makers in LMICs to channel disease-specific funds to the right patients for the right disease at the right time, which can potentially accelerate the way to universal health coverage.