How our strategic objectives drive system change 2/3
The following section highlights how PharmAccess advanced patient-centric care models in 2025.
Patient-Centric Care Models
Fragmented financing, limited trust, and disconnected data prevent health systems from functioning effectively.
PharmAccess develops practical models that demonstrate how these barriers can be overcome.
We advance patient-centered care by developing care pathways, digital tools, remote monitoring solutions, and data feedback loops that improve continuity of care and align incentives around better outcomes.
Our approach relies on health systems where citizens control their own data, and where data generated by patients serves their care, rather than serving external platforms. As well as requiring technology, from AI-assisted diagnostics to digitally enabled care pathways, this also requires governance models that ensure trust, transparency, and patient control. Maternal and child health, non-communicable diseases, and epidemic preparedness are the building blocks of this approach, contributing to inclusive healthcare financing.
In 2025, we took the first steps in setting up a data cooperative, we scaled our MomCare approach in Kisumu County, Zanzibar, and Lagos state, and we expanded our pandemic preparedness approach from Kenya to Nigeria.
Data Cooperative
As digital infrastructure expands across Africa, so does the reach of platforms whose data governance, incentives, and accountability structures lie far beyond the communities they serve. PharmAccess works to build an alternative: health data architectures in which patients are at the center, data is governed locally and with consent of its citizens, and the value generated by AI stays within the communities that created it. This is both a technical and institutional challenge — and one that connects Africa and Europe in ways that matter for both. An increase in European and Dutch investment in these approaches is a priority for ensuring sovereignty around the globe, which we prioritize in our work.
The data cooperative is being developed by trusted partners: PharmAccess, CarePay, AARinsurance, AARclinics and IFHA. CarePay already connects insurers, providers, and patients through claims and payment flows. Building onto this infrastructure, we are creating a consent-based data exchange and health management, where data can be translated into insights and guidance through AI. This is only possible by organizing data access through the individual, enabling consent-driven use of data across actors.
In parallel, the development of the data cooperative approach is carried out in collaboration with the Amsterdam health &
technology institute (ahti) and the city of Amsterdam. Together, we can develop and test approaches to personal data vaults, consent, and data use across different contexts.
In 2025, we developed the first use case for diabetes care. The service concept brings together multiple data sources into a data vault: claims data via CarePay, clinical and laboratory data from providers, and self-generated data through a diabetes management application (Clear.bio), including continuous glucose monitoring and lifestyle inputs. Patients can also add their own data, such as medical documents, test results, or lifestyle behavior.
All of this is brought together in a personal data vault, where the individual can access their data, receive structured summaries, and decide how and with whom to share information to support their care. As well as developing the first version of the personal data vault, we also established the necessary legal frameworks, governance structures, and contracting arrangements to enable a pilot in a real-world setting.
Next step: real-world testing With the groundwork laid in 2025, we will transition into real-world testing and iteration in 2026. The diabetes pilot will take a phased approach:
- Phase 1 — start with a small group of patients, focusing on how individuals access, understand, and use their data within the personal data vault.
- Phase 2 — the focus will shift to enabling providers to access and use consented patient data to support more personalized care delivery, including better follow-up, risk identification, and decision-making.
- Phase 3 — the model will extend towards enabling new, data-driven services and broader ecosystem use, where consented data can support innovation, research, and tailored service offerings for patients.
This phased approach allows us to learn step by step, while gradually expanding the functionality and value of the model. At the same time, continued development alongside the Amsterdam (ahti) use case will further refine the underlying architecture and governance model, enabling broader application over time.
Together, this work advances our longer-term vision of a health system where data can flow securely and responsibly, under the control of the individual, and where AI can be applied in a way that is both effective and trustworthy.
MomCare
Every day, about 830 women die due to preventable causes related to pregnancy and childbirth. Almost all (99%) of these deaths occur in developing countries, including in Sub-Saharan Africa.
MomCare is a value-based care program that uses data to improve quality of care and create transparency for patients, providers, and payers.
Tanzania: scaling MomCare in Zanzibar
The Zanzibar government has adopted the MomCare approach, and through the Matibabu card, we can identify the pregnant women with the greatest financial need. These women qualify for pregnancy cover provided by the Zanzibar Health Services Fund. So far, we have enrolled about 2,200 women in Kaskazini B and Micheweni District. At the same time we are improving quality of care through SafeCare and screening for mental healthcare. We have laid the groundwork for the Zanzibar government to continue financial coverage for the most vulnerable women through the HEF in the future. The impact is already visible: mothers’ attendance at four or more antenatal visits has increased from 15% to 52%.
Kenya: progress on the hybrid care model
We are working on a hybrid care model that combines various types of care, aiming to keep mothers consistently connected to their care providers and create seamless care journeys. This will improve outcomes while reducing the costs arising from inefficiencies (estimated at 20-40% globally) and complications, making it easier to finance high-quality pregnancy care through public or private insurance schemes.
In 2025, we started seeing the benefits of care coordination between physical clinic visits and tele-consultations. A foundation of trust has been established between patients, healthcare providers, and telehealth provider HealthX Africa. Preliminary results suggest an 80% increase in overall contact moments.
In addition, our screening shows that 25% of women in the program are struggling with mental health challenges. We are increasing touch points for mental health screening and follow ups, and we are already observing increased trust and outreach from the women in the program.
There is also opportunity for us to increase adherence to care journeys. PharmAccess partnered with Penda Health and Turn.IO on a pilot patient engagement project at two medical centers in Nairobi. Through WhatsApp, patients received real-time, AI-simplified health information during their medical center visits. The key finding was that patients do want access to their own health information, especially when it is relevant, timely, and easy to understand.
Kenya: scaling MomCare principles and creating a digital ecosystem
Our MomCare approach has also been adopted by the County Government of Kisumu, branded as SafeMamaTech. Public and Private providers are connected and sharing healthcare information on pregnant women, creating an integrated, outcome-driven maternal care network.
In 2025:
- The program expanded from 8 to 23 public and private health facilities.
- The program enrolled 2,512 mothers.
- 1,602 mothers attended their first antenatal visit before 22 weeks of gestation, a key indicator of early care.
- 1,261 deliveries were recorded across the network, and each documented and reviewed through continuous quality improvement processes.
Another significant advance in 2025 was the introduction of AI-assisted ultrasound through BabyChecker in partnership with Dutch company Delft Imaging. In total, 1,089 scans were conducted and 109 high-risk pregnancies were identified; these could have been cases that went undetected until complications arose. The BabyChecker integration demonstrates that AI diagnostics can operate within the infrastructure to generate actionable clinical intelligence at the point of care. This work is part of the Dutch government’s Combi Track.
Advocacy on quality resulted in a county directive allocating 5% of public health facility budgets to quality improvement in facilities. These incentives are awarded based on the SafeCare Maternity Rating tool (read more in here).
SafeMamaTech is clearly taking root in the local health system, and local actors are advocating for it: the project was presented and discussed by county and partner voices in 2025, including at the Global Digital Health Forum in Nairobi and the ICHOM conference in Dublin, Ireland.
Using the SafeCare framework, facilities improved their quality: surgery readiness rose from 13% to 100%, lab diagnostics from 23% to 73%, and medication management from 29% to 67%.
Nigeria: scaling MomCare
The costs of pregnancy care are skyrocketing and creating sustainability challenges in Lagos, Nigeria, with very few antenatal visits and C-section rates of up to 60%. For the Lagos State Social Health Insurer (LASHMA), financing maternal and child care is a major challenge: they need to increase the number of mothers accessing early care as well as improving the quality of that care, while aligning financial incentives for providers. The aim is to ensure high quality pregnancy journeys with better outcomes and fewer preventable costs, using proven interventions.
LASHMA has already committed to financing quality of care, with differentiated tariffs based on SafeCare levels. In 2025, we shaped our partnership with digital and mobile health company mDoc for digital pregnancy coaching and with Ingress for community engagement, with the aim to connect digital care to the healthcare providers, resulting in increased journey adherence.
Non-communicable diseases: a silent epidemic with mounting costs
Hypertension and diabetes are no longer diseases of the affluent and elderly. They are spreading rapidly across Sub-Saharan Africa (SSA), striking working-age adults in urban and rural communities alike, and increasingly overwhelming health systems that were designed for an era of infectious disease. Non-communicable diseases (NCDs) are already projected to account for nearly half of all deaths in SSA by 2030, as the region undergoes a demographic and epidemiological transition without the health system capacity to match it.
Hypertension: widespread, poorly controlled, and expensive
Hypertension is the most prevalent NCD in Sub-Saharan Africa (SSA), affecting roughly one in four adults — a rate comparable to that in high-income countries, but with strikingly worse outcomes.[1] What makes the SSA situation uniquely dangerous is not the prevalence alone, but the near-total absence of control.[2]
Uncontrolled hypertension is a leading driver of stroke, heart failure, and kidney disease. These complications are largely preventable with consistent medication and follow-up, but they become catastrophically expensive once they develop. The economic burden falls mainly on patients: medication costs for hypertension management in Sub-Saharan Africa range from $1.70 to $97 per patient per month out of pocket, with costs rising sharply when comorbidities like diabetes are present.[3]
Diabetes: rapid growth, late diagnosis, and a looming cost crisis
Diabetes presents a different but equally serious challenge. While prevalence in Sub-Saharan Africa currently stands at around 5-6% of adults, the trajectory is alarming: the number of people with diabetes in the region is projected to reach 60 million people by 2050.[4]
The most striking feature of diabetes in SSA is not how many people have it, but how many do not know about their condition. Three in four adults living with diabetes in SSA are undiagnosed, the highest proportion of any region in the world.[5] This means that by the time most patients enter the health system, they do so with advanced disease that requires intensive, expensive care. Late presentation is not a failure of individual behavior; it is a systemic failure of detection infrastructure.
The economic consequences are substantial, and worsening. Diabetes is estimated to have cost Sub-Saharan Africa over $11 billion in total economic losses.[6]
The causes and costs of patients dropping out
The fundamental challenge of both conditions is not detection — it is retention. Hypertension and diabetes require patients to remain engaged in their care indefinitely: taking medication daily, attending follow-up visits, adjusting behavior, and monitoring their own vitals. In resource-constrained environments with limited follow-up infrastructure, long distances to facilities, and no financial protection, adherence is fragile. Non-adherence is among the most expensive problems in NCD management. Patients who drop out of care deteriorate silently, and they eventually re-enter the health system with complications — kidney failure, stroke, blindness, diabetic foot amputation — that are exponentially more costly to treat than the conditions that preceded them. The cost of inaction compounds over time in ways that make early investment in retention not just clinically sound, but economically essential.
A data-driven vision with the patient at the center
Our digitally enabled NCD approach aims to:
- Detect and diagnose earlier, before complications set in.
- Improve adherence through timely, personalized follow-up and patient support.
- Predict which patients are most at risk of dropping out or deteriorating, enabling proactive intervention.
- Generate the clinical evidence that value-based financing requires — rewarding providers for health outcomes, not just visit volumes.
- Make insurance viable by reducing the unpredictability and catastrophic cost of NCD care.
Zanzibar: community infrastructure as the foundation for data
In Zanzibar, the NCD program expanded significantly in 2025, growing from 32 patient support groups and 1,215 patients in December 2024 to 52 active patient groups with 1,876 patients across 30 facilities in 10 (out of 11) districts a year later. The Patient Group Module was integrated into the government's Zanzibar Electronic Medical Records system (ZanEMR). This addressed a long-standing problem of data fragmentation. By embedding patient group tracking within ZanEMR, the program has improved continuity of care, enabled timely clinical follow-up, and created a data layer that makes it possible to monitor patient outcomes at scale.
Ghana: scaling NCD care
In Ghana, our value-based care (VBC) approach for hypertension is now embedded within the National Health Insurance Authority (NHIA) and delivered through the Christian Health Association of Ghana (CHAG) network across 22 facilities in six regions.
The program operates across three interlocking workstreams: structured doctor-patient consultations focused on care quality and continuity; peer patient support groups guided by health workers; and a digital remote monitoring component that enables patients to measure and share vitals from home, allowing virtual follow-up between facility visits. Together, these are designed to keep patients continuously engaged.
The results are striking: NCD control rates improved from 48% at baseline to 55% by mid-2025. Patients enrolled in the digital remote monitoring component achieved 59% improvement in controlled outcomes after one year — significantly higher than the national average of 6%.
Nigeria: when detection is not enough
The KampeCare pilot in Nigeria — a pharmacy-first NCD model run with AXA across 21 pharmacies — reached approximately 4,400 clients and identified 464 unique NCD patients between July 2024 and September 2025. It confirmed that community pharmacies are accessible, trusted entry points for NCD detection. But it also exposed a critical gap: approximately 60% of hypertension patients did not return after their first visit, and only 13.8% had a repeat blood pressure check.
At the conclusion of the pilot, the program was discontinued. The learnings remain valuable inputs for future program design.
Epidemic Preparedness (EpiPrep): turning frontline care into real-time epidemic intelligence
EpiPrep focuses on strengthening how health systems detect, understand, and respond to infectious disease threats. In many African settings, the majority of patients first seek care from private providers, pharmacies, or community health workers. While this helps them access care, it means that the critical frontline data generated often remains invisible to public systems. This creates blind spots that delay outbreak detection and response.
We are closing this gap by connecting frontline providers to digital tools that support better diagnosis, real-time data capture, and decision-making. By combining rapid diagnostics, mobile technology, and AI-driven analytics, our approach enables the earlier detection of outbreaks and improve the quality of care for individual patients. This complements public surveillance systems and strengthens collaboration between private and public sectors, translating everyday patient interactions into actionable epidemic intelligence.
Activating technology in the community
In 2025, our work in Kisumu, Kenya demonstrated how digitally connected diagnostics for one specific disease, malaria, can drive system-level change. By equipping community health promoters, pharmacies, and private facilities with tools to test, digitize, and report malaria cases in real time, we created a more complete and timely picture of malaria disease patterns.
Over 26,000 malaria rapid diagnostic tests were conducted and digitized across community and private providers, generating real-time insights for decision-making. AI-supported diagnostics achieved high accuracy (87.7% sensitivity, 97.6% specificity), improving trust in frontline testing. Community-based providers detected higher malaria positivity rates than formal facilities, demonstrating the value of bringing care closer to patients.
By connecting the private sector, health authorities were able to respond faster and more precisely.
Epidemic monitoring in Africa is performed through (versions of) the WHO Integrated Disease Surveillance and Response (IDSR) system — a list of infectious diseases that need regular surveillance, which is used by most public health systems. The data in these systems, which are often paper-based, are incomplete and lagging. PharmAccess digitalized the Kenyan IDSR system and connected 25 hospitals in Kisumu (encompassing almost 40% of the population) in semi-real time (supported by DIDIDA). The dashboard monitors about 40 diseases; in 2025, we recorded 490,980 IDSR events — an average of 9,430 per week. We were able to identify a single mPox outbreak in Kisumu City as well as a local outbreak of cholera. On request of the Kisumu Department of Health (DoH), we created a specific digital cholera tool, which contributed to the timely ring-fencing and containment of the epidemic.
> Read an anonymized report on the DIDIDA website
EpiPrep in 2026
In 2026, we will expand pharmacy- and community-based fever management models to Nigeria, including supporting the development and implementation of an improved version of the EpiPrep tool, to strengthen real-time data systems that connect frontline providers to national surveillance and decision-making. We will also advance the use of AI for predictive modelling and early warning systems, enabling more proactive responses to outbreaks.