Business and policymakers have an increasingly important role to play in improving healthcare provision in Africa, by helping to educate and empower local communities to identify their own healthcare needs, says Liza Kimbo, chief executive officer of the Viva Afya chain of healthcare clinics in Kenya. But what is the best way of achieving this aim? Ms Kimbo spoke with Andrea Chipman, author of a recent Economist Intelligence Unit report sponsored by Janssen, "The future of healthcare in Africa: progress on five healthcare scenarios".

Andrea Chipman (AC): Where are businesses and other external groups playing the biggest role in community healthcare provision in Kenya, and how should this role evolve?

Liza Kimbo (LK): Non-governmental organisations (NGOs) are often involved in primary care and many are focused on hygiene, food security and the provision of clean water, all of which have a very significant impact on public-health outcomes.

Larger businesses, especially those operating at a national level, such as sugar- and tea-packing companies, are usually more involved in healthcare, possibly because these industries are labour intensive. Many have set up in-house clinics to address primary-healthcare needs and are involved with social outreach and other initiatives. A few flower-farming companies in Naivasha, Kenya, have come together to set up a women’s hospital.

Every employer can and should engage in improving healthcare for their workforce and families. It is a worthwhile investment that improves the bottom line through better attendance and productivity. There is also a need to extend healthcare to the wider community by establishing clinics and hospitals or by supporting existing public-health infrastructure, as the government cannot address these needs on its own. Businesses should also extend their existing health education efforts to address the growth of chronic diseases such as hypertension and diabetes, for example by showing people how to improve their diets, monitor their blood sugar and measure blood pressure.

AC: How can outside decision makers help to empower communities?

LK: Our biggest problem is education and the low levels of basic knowledge about healthcare, as exemplified by the Ebola crisis. A lack of education and awareness and the reluctance to seek help for health problems kills more people than anything else.

Part of this is ignorance: people may have very limited variety in their diets; they may not necessarily seek medical attention at the first sign of symptoms; or they might not consider that the conditions they have are treatable. Another influencing factor is cultural beliefs, which leads people to consult traditional healers or misread symptoms. As a result, people delay getting their health needs attended to, and preventable conditions become expensive to treat.

Health educators can help us make better use of the limited health resources available. Businesses and NGOs can play a big part in showing people what they can do to protect their health in the long term by taking a few preventive measures, such as monitoring their blood-pressure and sugar levels. When one NGO spent a weekend in a rural area of Kenya screening for prostate cancer hundreds came out to be checked.

There is also a need to help communities form their own localised health insurance schemes, whereby they pool their resources into a community fund, much like employers do for their employees.

AC: How crucial is local autonomy in healthcare decisions?

LK: The more locally managed the healthcare, the more in tune it will be with the needs of the community. In Kenya, we are now seeing the benefits of devolution, with increased policymaking at county level. Meru County is focusing on technology for improving malaria diagnosis; by training staff to use readers for rapid diagnostic tests, the county has sharply reduced prescriptions for malaria medication and improved fever management.

Kiambu County has tried to fulfill both training- and data-collection needs by training community health workers and equipping them with basic reporting tools on mobile phones.

Strengthening local health-management structures and bringing them closer to the community allows for better management of the workforce and of the limited resources available, based on actual community needs. Improved management of community health data could be used by counties to employ relevant specialists according to disease burden.

Business input and community empowerment is one of the themes discussed in a new report, "The future of healthcare in Africa: progress on five healthcare scenarios", written by The Economist Intelligence Unit and sponsored by Janssen.

The future of healthcare in Africa will also be discussed at an upcoming conference, Health Care in Africa 2014: fast-tracking to the future.