January 2021 marked the exciting start of the latest term for PSI’s Board of Directors. So began the tenure of four new and returning talented Board members and new Board Chair Carolyn Brehm. We are conducting interviews with the Board members, delving into their backgrounds, personal and professional journeys, as well as their call to PSI and its mission to deliver consumer-powered healthcare.
Below, we welcome Dr. Angela Gichaga, Chief Executive Officer for the Financing Alliance for Health, to the PSI Board of Directors.
PSI: TELL ME ABOUT YOUR BACKGROUND, YOUR AREAS OF EXPERTISE AND YOUR PROFESSIONAL JOURNEY.
Dr. Angela Gichaga: I have spent my entire career in public sector strengthening. I started my career as a frontline clinician for Kenya’s Ministry of Health (MOH), before transitioning to health facilities administration and later the national MOH headquarters to work on strategy and policy. I served at different levels within the MOH because at that time I had moved from being a medical doctor to qualifying as a health economist. That was when I got great exposure to this interface between the worlds of health and finance.
When I was working at the national level in the Kenyan Government, I would meet people from Ministries of Health and Finance from across the continent, and I realized we were battling similar challenges of limited human and financial resources. So, I started to think about how I could solve for these challenges not just at my country level but at a continent level. That was one of my motivations for joining McKinsey.
When McKinsey & Co. asked me to join their new Africa Delivery Hub, I jumped on the opportunity to be their second local external hire of the East Africa office, to serve both government and social sector clients across Africa. I spent a number of years with McKinsey, living for about a year in Sierra Leone, Ethiopia, and another six months in South Africa, working on health, education, energy, tourism and economic development projects . Living and working across the continent was really important in truly understanding the challenges, compared to the perspective you get when you fly in and fly out.
But as time went on, I really began to miss one of my key passions, which is health finance. When (former) Heads of States and global health leaders said they wanted to set up a health financing unit that would support African governments with their health financing strategies, I jumped at the chance. I joined them as the first full-time equivalent and inaugural CEO and grew the effort into what we are now—an advisory firm that serves with Ministries of Health and Finance supporting their healthcare financing strategies in Africa.
Since 2015, we have engaged 12 countries, most across the continent, we have had cumulatively ~30 staff, and a growing geographical and service package footprint. We are offering end to end services, which include helping the government develop a healthcare finance strategy for primary and community health, costing that strategy, developing the investment case, and then mobilizing resources for the strategy, which includes existing resources and designing innovative financing instruments and approaches for governments to deploy in country.
This has been the career journey to date!
PSI: WHAT INSPIRED YOU TO JOIN THE PSI BOARD AND WHAT MOTIVATES YOU ABOUT PSI’S MISSION TO MAKE IT EASIER FOR ALL PEOPLE TO LEAD HEALTHIER LIVES AND PLAN THE FAMILIES THEY DESIRE?
Gichaga: I became acquainted with PSI Kenya when I was still in government more than 10 years ago, so here are 10 reasons why this Board role with PSI appeals to me:
- PSI is focused on the right goals. Not everyone in the global health space is focused on the right goals. Quality, affordable, accessible basic healthcare for all, and alignment to Universal Health Coverage and the Sustainable Development Goals. PSI is a systems-change agent, working in the interface of understanding primary healthcare but also understanding that many others have a role to play, like the private sector and government. PSI is a not a standalone silo but a systems change agent.
- PSI focuses on impact, both the scale and the depth. Scale you can see in the more than 46 countries where it works and depth of impact through the evidence-based programming. PSI has done the research and so it knows how it is doing the programs.
- PSI has staying power. Not many entities can talk about being in the space for 50+ years. That means you’re doing something right. Over time PSI has seen a lot, grown a lot, changed a lot, adapted a lot, and knows a lot, therefore PSI has a lot to offer.
- PSI is flexible and adaptable. 10 years ago, PSI focused only on reproductive health. But I’ve seen growth in the plurality of services that PSI has been offering in different countries; that growth shows that PSI realizes their consumer is a whole and complex person, who comes needing more than just reproductive health services—but of course PSI stills maintains that first, important service it offered at the beginning.
- PSI is localized. There is something to be said about closeness and credibility to the markets you serve. The fact that PSI has entities in all these countries has helped its staying power. Its people are based in those local entities, and local people are hired, who are highly professional, and understand the context.
- PSI is innovative. PSI saw the private sector’s role in primary healthcare before it was sexy – everyone else is just jumping on this bandwagon. PSI was among the first and that couldn’t have been easy, so that shows the entity is willing to push the thinking and try new things even before the momentum is built.
- PSI is very collaborative. You can see this from the different stakeholders that it engages.
- PSI applies a youth and gender lens. I am obsessed with gender issues and youth engagement.
- PSI has such an impressive Board. The individuals on our Board offer a great mix of skills, exposures, and experiences, which I thought would make for a rich interaction. This is my first global Board role and I thought this would be an excellent platform to learn from and hopefully bring value to.
- I like the idea of experiential philanthropy. A lot of people invest and support initiatives but never really get to experience them. It is one thing to read impact reports and another thing to actually see the work on the ground; the more and more we do that, the more and more we make the case for increased investment, which is really needed in health.
PSI: WHAT DOES CONSUMER-POWERED HEALTHCARE MEAN TO YOU AND HOW DO YOU SEE IT MAKING CHANGE FOR THE PEOPLE PSI SERVES?
Gichaga: It means putting the consumer at the center of everything you do. It is more than buzz words; it is a mentality. The consumer is not just a beneficiary of the services you are offering, but active participants in their own health journey. That needs to be recognized. In practice, that means the consumer deserves to have knowledge about what kind of health services they need, ask questions and be part of the service provision. That is where my passion for community health comes in. For a long time, it was a situation of “others doing for”— this is what we think the problem is, this is what we think the solution is, and that is what you need to do. But now it is putting yourself in the consumer’s place and walking the journey with them.
PSI: WHAT ARE YOU LOOKING FORWARD TO IN 2021?
Gichaga: There is an African proverb I love: “When the rhythm of the drumbeat changes, the dance steps must adapt.” For me, 2021 is about adaptability. 2020 was challenging and we will continue to feel the ramifications for a number of years to come. 2021 is about adapting how we work, what we do, what we focus on and how we do. Building back bigger, better, stronger than before. There is global momentum around health and its financing because of the pandemic, but the truth is that development assistance to health has been declining; plateauing at best. The population and illnesses are increasing, so there is a mismatch there. The global economy has shrunk, the traditional funders of health are no longer going to be driving it. What is our plan around that?
We must recognize that more of the funding for entities like mine – the Financing Alliance for Health – and for PSI will shift in terms of the proportion and there will be a bigger role by non traditional players and leveraging government, consumers. So then how do we put systems in place to facilitate that so that it doesn’t affect access and utilization of health services, or the quality and the availability of health services. That adaptation will be critical and necessary.
PSI: ANY FINAL FUN OR INTERESTING FACTS ABOUT YOURSELF THAT YOU’D LIKE TO SHARE?
Gichaga: I am obsessed with supporting women and youth to achieve their potential. I have been codifying a “Pathway to Parity” program since 2015. The goal of the program is to recognize that the reason we are still not achieving gender equity is because we are trying to help women direct one part of their life, yet they are not [supported] in other parts of their life (i.e. in the workplace but not in their own home and in society). This is a holistic program and approach that recognizes that building women and young people’s skills to achieve their goals is not just in a vacuum, it is an ecosystem.
There are three parts of the program, the first is focused on young and adolescent girls, because that is when limiting beliefs are put into someone’s mind. How do we tell girls at that age that they can do whatever they want to? The program aims to give them the tools to take power for themselves, so they actually want to assume leadership roles in the future.
The next phase is around supporting high potential mid-career women in the workplace through mentorship, coaching, sponsorship, all aimed at thinking about what they need to do to get to the next level.
And the third part of the program is around creating safe spaces: targeting top leadership executives and helping them to create safe spaces for women to thrive in the workplace. Those are psychological spaces within organizational culture, and physical spaces at the table as well. What role does this play in elevating women in the workplace to take up leadership roles? If you want workplaces to be safe spaces for women, you have to be part of forming the culture and be intentional about it.