AAR Health Services [formerly African Air Rescue] : Kenya -- final evaluation report, July 1995-July 1997

Specifically, the subproject was to help AAR Health Services, a private company that already markets prepaid health services to employers in the area, to provide FP services through a system of outpatient and outreach clinics, and to integrate managed care principles into its operations. As regards the planned clinic system, a large outpatient clinic -- Odyssey Plaza Medical Center -- opened in 9/95. However, due to limitations in the real estate market, only one of the 3 planned outreach clinics was opened, and this, at Kariobangi, many months behind schedule. This affected the FP outcome, since it was envisioned that the outreach clinics would be key providers of FP services. A second outreach clinic in Kangemi is scheduled to open in the first quarter of 1998. Many of the subproject's other objectives were reached, however. In 1/96, AAR began offering FP services to its members at no additional cost. AAR staff were trained in managed care concepts, FP counseling and delivery, and IEC campaigns, and received TA in marketing AAR services. AAR membership has increased over 68% -- from 9,600 to 16,130 members -- although the goal of increasing number of lower income members has not been met. AAR has been able to generate record profits while maintaining stable premiums for its members. The total number of FP clients has been low, however. With the opening of additional outreach clinics and an intensive promotion effort planned for the next year, use of AAR's FP services should increase. Overall, however, AAR achieved an important goal of expanding health care services: the Odyssey Plaza Medical Center serves 20,000 members, and the Kariobangi outreach clinic provides minor curative and FP services, as well as maternal and child health services, including immunizations and vaccinations; it also treats sexually transmitted diseases and HIV/AIDS and provides health education. Three lessons were learned. (1) Employers in the industrial area of Nairobi are increasingly willing to pay for high-quality health services for their employees. (2) A private, well-managed, and entrepreneurial company has the ability to take risks, act quickly, and produce quick results. (3) Even if a health care plan offers FP services, there must be specific incentives to ensure that it is financially advantageous to promote FP usage. (Author abstract, modified)