We don’t know what good healthcare looks like

This may well be my shortest blogpost this year. It is late at night as I quickly jot it down and I have had a long day – and another tough one is waiting for me tomorrow. I was having a strategic conversation about public hospitals in Kenya and in Africa and how they have a bad reputation. No one wants to go to them because, well, legend has it that you could die waiting for care. I know I say that legend has it as if it isn’t true, yet it all to often is. There have been many stories of patients dying in Emergency rooms while waiting to be attended to by severely overworked and under resourced doctors and nurses. Forget pay. the medics often have the worst working conditions of many professions.

In my conversation, we veered to the growing idea of Universal Health Coverage, which according to the World Health Organisation “means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.“ Discussions abound about this idea and the many obstacles to it – how could it be paid for, would it mean more taxation, isn’t it an inherently utopian (and therefore impossible to achieve) idea by goody-two-shoe socialist NGO-types who have no real idea about the economics of health?

Here’s the thing, I think that the real obstacle to Universal Health Coverage is that in Africa, we all do not have a mental model of a working hospital that is clean, well resourced, adequately staffed with people who are not struggling to make a living s much that they have to take locums (side jobs) to survive. Human beings need mental models to fuel their imaginations. So if we ever saw an African public hopsital system working then maybe we would actually work to build one.

The question is this. How do we fuel new mental models in our citizens so that they can demand for better care?