How do we know if healthcare is truly making a difference?
For many years, health systems have measured success by activity—how many patients were seen, how many procedures were performed, or how many services were delivered. But these measures tell only part of the story.
During ISQua’s latest African Community of Practice (AfCOP) webinar, “Value Over Volume: The Future of Healthcare in Africa?”, speakers Elizabeth Opondo, Project Lead in Value-Based Healthcare at Infospective Research (Kenya), and Joel Lehmann, Executive Director of EQUAM Stiftung and Co-founder of Infospective Research, explored why healthcare systems need to shift their focus from volume to value.
Their message was clear: delivering more care does not necessarily mean delivering better care.
What is Value-Based Healthcare?
Value-Based Healthcare (VBHC) places patients at the centre of healthcare delivery. Rather than rewarding the quantity of services provided, it asks a different question:
Are we achieving the outcomes that matter most to patients, while making the best use of available resources?
As Elizabeth Opondo explained, value is created when healthcare improves the health and wellbeing of patients in ways that are meaningful to them—not simply by increasing the number of consultations, tests or treatments.
This means understanding what patients hope to achieve through their care, measuring those outcomes, and continually improving services based on that information.
Why This Matters for Africa
Across Africa, healthcare leaders face a common challenge: improving quality while working within limited financial and human resources.
The speakers highlighted that this challenge also presents an opportunity.
Rather than replicating models developed elsewhere, African countries can build Value-Based Healthcare approaches that respond to local realities, community priorities and patient needs. Innovation does not always require significant new investment—it often begins by asking better questions, using existing data more effectively, and involving patients in decisions about their care.
Examples shared during the webinar demonstrated how healthcare organisations are already beginning to reduce unnecessary interventions, improve coordination of care, and use data to support better clinical decision-making.
Measuring What Matters
A recurring theme throughout the webinar was measurement.
Traditional health system indicators often focus on activity—appointments completed, admissions, or procedures performed. While these remain important, they do not always reveal whether patients are healthier, functioning better, or experiencing a better quality of life.
Value-Based Healthcare encourages organisations to measure outcomes that matter to patients, alongside the resources used to achieve them.
This includes considering questions such as:
- Did the patient achieve the health outcome they were hoping for?
- Has their quality of life improved?
- Did the care experience meet their needs and expectations?
- Could the same or better outcome have been achieved more efficiently?
By collecting and using this information, healthcare organisations can identify waste, improve services, and direct resources where they have the greatest impact.
Starting Small
One of the strongest messages from the discussion was that organisations do not need to wait for large-scale national reforms before embracing Value-Based Healthcare.
Instead, participants were encouraged to begin with small, practical improvements.
This might involve identifying one patient group, asking patients what outcomes matter most to them, introducing a simple outcome measure, or using existing quality improvement methods to evaluate changes in care.
As moderator Rhoda Kobia concluded, every healthcare facility can begin by asking: “How do we know we are delivering value to our patients?”
Creating an African Model of Value-Based Healthcare
Elizabeth Opondo encouraged participants not to view Value-Based Healthcare as a rigid international framework, but as an approach that can evolve to reflect African health systems and priorities.
Rather than following a textbook definition, healthcare professionals across the continent have an opportunity to develop and document their own innovations, demonstrating how Value-Based Healthcare can improve equity, quality and patient outcomes in diverse settings.
This collaborative approach reflects the strength of the AfCOP network, where healthcare professionals learn from one another, share experiences, and adapt successful ideas across different countries and health systems.
Continuing the Conversation
The lively discussion and extended question-and-answer session demonstrated the growing interest in Value-Based Healthcare across Africa. Participants explored practical implementation challenges, the importance of patient-reported outcomes, leadership, data, and quality improvement, while exchanging experiences from their own organisations.
The webinar concluded with a clear call to action: start measuring what matters to patients, begin with achievable improvements, and continue building a community committed to delivering better value in healthcare.
As healthcare systems continue to evolve, success will increasingly be measured not by how much care is delivered, but by how much difference that care makes in people’s lives.
If you missed the live session, a recording is available through ISQua’s resource library – https://login.isqua.org/resources/afcop-value-over-volume-the-future-of-healthcare-in-africa. Please note that you must log in as an ISQua Guest or Member to access.
