„Uatmu wa Afya“ – „the sweetness of health“ is written underneath Access Afya’s logo. During my public health exchange in Nairobi, Kenya, I worked with Access Afya for a month. And this trip has really showed me, how we should not take being healthy and more important having access to health care for granted.

Access Afya has multiple small clinics in the outer skirts and suburbs of Nairobi, providing healthcare and serving needs in low- income markets. I worked in their clinics Kisii and Kiambiu and was able to help with the Child Welfare Clinic, do online ultrasound sessions and attend the office hours and work together with their clinical officers. What I found surprising coming from Germany, the country with probably the most and most unnecessary bureaucracy, was how efficient and well-designed their digital patient system was. This made it so much easier to access patient data and look through their healthcare history.

While the clinics run from 9am until 8 pm every day and the team of clinical officers, nurses and lab technicians see and treat multiple patients a day, there are more people behind Access Afya who take care of deliveries, communicate with governmental facilities, manage the clinics and try to optimize their own processes.

The staff at Kiabiu clinic 

During my time in Nairobi, I worked on mainly one project. It was management of hypertensive Patients. I found out that across WHO regions, the prevalence of high blood pressure is the highest in Africa which surprised me. Access Afya is treating and monitoring a lot of high blood pressure (BP) patients, but they are also facing problems with the patient adherence and compliance to take their medication. On one of the online meetings we had every Thursday, I prepared a presentation for the team naming the risk factors of high BP and the problems the clinics are facing with non-adherent patients. We had a discussion about how we can solve the problem and what Access Afya should do to improve the compliance of their patients regarding high BP. Only two weeks later Joyce, the CME manager and I organized an information day for the patients, educating them on why treatment is important and offering discounts on medication. After their regular consultation they came to us and we answered all their questions about the medication, gave them advice about lifestyle changes that can help and we talked about risk factors and why it is so important to take the medication. I was surprised how quickly we managed to organize everything and that we got great feedback from the patients. The next thing I will do from Germany is to design an information sheet for the patients and have someone help me translate it to Swahili, while Joyce will find more options and days to give discounts on the medication.

I have to say I was surprised hearing that poorly adjusted high blood pressure is such a big problem in patients coming to Access Afya. But when Joyce showed me lists of patients that come in each day, I saw how many chronic patients they were treating. And speaking only to a few of them on the information day we organized, we realized how many questions the patients still have about their disease although a lot of them were eager to make the adjustments that were needed to improve their situation.

In the future, hopefully students can continue to benefit from the exchange and contribute ideas to the work of Access Afya and learn from their daily organizational life and ideas. The project could be further expanded, and the organization could also be supported with medical material if needed. Projects initiated in the future should continue to focus on patient education about and prevention of diseases.

I am very thankful to have worked together with Access Afya and to have learned a lot about projects and management of healthcare with lesser resources than we have in Germany. I hope to stay in contact with the team and hopefully be able to work with them on little projects in the future (maybe even back in Nairobi?!).

So thank you Access Afya for the warm welcome in the team and thanks to UFH to have given me the opportunity to go to Nairobi!