January 22nd, 2024

According to the Kenya Household Health Expenditure and Utilisation Survey (KHHEUS) 2018, the cost of healthcare services, distance to facilities, and the quality of care are the main barriers to seeking healthcare by women and households in Kenya. This is particularly the case for lower-income Kenyans, especially women.

Overall, women earn less than men, have limited mobility and shoulder most of the healthcare burden at the household level. Additionally, some issues such as maternal health are unique to women.

For at least one out of every 10 Kenyans (13.2%)^[1], the local pharmacy is the first point of contact with the healthcare system. The pharmacists provide both consultation and medication to those around them. Yet, most of the smaller pharmacies are not able to stock the right types and quality of healthcare products because they cannot access appropriate financing.

FSD Kenya has partnered with Kasha, a platform for last-mile access to health and household goods, to research, design and test a trade credit solution. The solution is expected to enable small pharmacies to stock the right quality and quantity of products to meet women’s and households’ health needs. The pilot started in April 2023. By the end of December 2023, 55 pharmacies in lower-income residential areas of Nairobi and its environs were using the trade credit facility. About 390 orders equivalent to KShs 8.7m had been serviced, with a repayment rate of 70% – the difference being largely the timing of the payments.

Based on the pilot and the qualitative research undertaken, buying on credit is common in the industry, particularly among the larger urban pharmacy segment. This has led to laxity in adherence to the credit terms and a general demand for even longer credit terms. The credit tenor is currently 60-90 days, with demand for up to 120 days.

Kasha’s trade credit solution has been most valuable to the smaller pharmacy segment which has limited access to credit from the larger medical and health products suppliers. Many of these smaller pharmacies would ordinarily either pay on cash-on-delivery terms or very short credit terms. Kasha’s 30-45 days solution has enabled them to stock quality products. The trade-credit facility makes it possible to order based on demand. The short turn-around period made it possible to closely align the orders to demand.

According to the pharmacies, Kasha delivers quality and even supplies some of the products that were not available from other providers e.g. microgynon, a contraceptive. This enabled the pharmacies to meet their customers’ healthcare needs. Furthermore, Kasha negotiates for better prices with the suppliers and manufacturers and passes on this benefit to the pharmacies.

Only 38% of the small pharmacies that used Kasha’s trade credit solution were owned or managed by women. Based on the research, the female owners/managers are generally cautious about credit and tend to get their products from a few suppliers with whom they have built relationships over time. Despite their smaller order sizes, they were better payers than the men. They are also more likely to revert to cash purchases when business is low as they have limited alternative sources of income. Moreover, they tend to finance business from family and friends where there is less pressure to repay.

Based on the pilot, the female-managed pharmacies are more patronised by women when it comes to sexual and reproductive health needs as opposed to men who tend to seek care from their fellow men.

Kasha plans to employ the lessons from this pilot to expand the pilot outside of Nairobi. The focus will be the small pharmacies with no access to a trade credit facility. The aim will be to test the viability of this business model which is central to its business.

^[1] Kenya Household Health Expenditure and Utilization Survey (KHHEUS) 2018

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