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Buy food for the family or pay to see a doctor?

Buying food for the whole family or paying for a doctor to see one child? Paying for your children to use a toilet facility or buying much needed medicines for yourself? These are some of the choices facing mothers living in Kenya’s slums. Susan Mbula and her husband cradle their newest addition to the family – Peace. She is the couple’s fourth child and together they live in Sinai, a slum in Nairobi.

Their home is one room divided in two by a single sofa. It’s neatly organised and, compared to others in the neighbourhood, it’s in decent condition. The slum has no running water and sanitation comes at a premium.

The priority each day is to find enough water for the family; healthcare is viewed as a luxury. About 25 per cent of Kenyans are covered by some form of health insurance, the rest pay as they go, leading a lot of people into poverty, says the Kenya Healthcare Federation. For many, saving or pre-paying for healthcare is not possible.

Peace is the first of Susan’s four children to have received vaccinations, thanks to a health fund she has on her mobile phone. “With my other babies I really suffered due to financial problems. I couldn’t afford any hospital bills,” says Susan.

“I would go to the clinic late, like a few months from giving birth, and I would not have as many tests, but when I got pregnant with my child Peace I managed to visit the clinic due to my savings,” she says.

The service she benefited from is called M-Tiba – essentially a health e-wallet that runs on M-Pesa, Safaricom’s mobile money payment system that has more than 19 million active users.

“Most Kenyans when they have a health emergency either try to raise funds from friends and families or have to sell what little assets they have,” says Safaricom chief executive, Bob Collymore. Safaricom developed M-Tiba in partnership with healthcare payment companies Carepay and Pharmaccess.

There’s no additional cost to use M-Tiba as it’s built into the medical treatment price, but there is a 0.5 per cent fee on every M-Pesa transaction. In the past decade, mobile operator Safaricom has both revolutionised and, some would say, monopolised the market as most Kenyans do not have bank accounts. Josephine Suleiman gave up a job in banking to set up Olive Link, a health clinic in the Sinai slum.

When it opened in 2013 it treated 1,200 patients. “Before, people were coming to the clinic and were not able to afford treatments,” says Josephine. Last year the clinic treated 12,800 patients.

Josephine and her staff have been encouraging patients to enroll in M-Tiba and save little by little. The service has enabled mothers like Susan to think about prevention rather than cure when it comes to vaccinations and antenatal care. – BBC

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