Primary health care best bet for universal health coverage

Women at a maternity ward in Liberia. Primary Health Care is where people engage with the health system for the first time. Kenya is constrained by shortages of health workers. [File, Standard]

Kenya continues to make significant progress towards improving the health status of its people. Our efforts have resulted in a significant reduction of maternal and child mortality rates with a positive impact on health outcomes of our mothers, children and communities.

However, the country is now faced with the challenge of the double burden of communicable and non- communicable diseases, which the government is committed to ensure we achieve the goal of health for all.

Consequently, Universal Health Coverage (UHC) is now one of the ‘Big Four’ agenda in Kenya’s socio-economic transformation. In order to provide UHC to Kenyans, we will re-look at measures aimed at strengthening its health systems and shift its focus from the costly and often inaccessible curative services to preventive health services. Prevention is better than cure, as we all know it.

Primary Health Care (PHC) is where people engage with the health system for the first time, yet it has not been fully developed in this country. Kenya is constrained by shortages of health workers.

Less funds

Further, lack of adequate and sustained funding to support PHC services has been a challenge. In addressing these challenges, real long-term solutions are required so as to provide the best care for people in our communities, who are often living with complex long-term health issues. Hence the reason we need to embrace it.

In terms of funding, NHIF is already working on a PHC benefit package. It is our hope that development partners in the health sector will also align to PHC and direct their investments to its interventions so that we obtain adequate and sustained funding for PHC activities.

In tackling UHC, we shall also address issues of staff shortages, their skills and competencies to manage PHC. We shall ensure availability of essential medicines and improve the referral system, provide equipment and improve infrastructure. We shall also engage in cross-sectoral collaborations to improve access to safe water and address sanitation and other social determinants of health.

Already through the Medical Equipment Leasing program (MES), we are providing diagnostic and treatment equipment in 98 hospitals across the country.

To bridge the HRH gap and aid in skills transfer and service delivery, the government in the short-term will bring in 100 medical specialists through the recently signed Kenya-Cuba cooperative agreement.

Of these 100 specialists, 53 are family physicians a cadre of medical specialists who are expert general practitioners in primary care and work at county hospitals. Their orientation is towards preventive and promotive health services. They will be deployed to all our 47 counties.

The aim for this collaboration is knowledge and skills transfer while capacity building our health workers. As part of the agreement, 50 of our medical doctors will be trained in Cuba as Family Physicians. On return, they will be at the forefront in the strengthening of PHC by working very closely with the communities.

In addition, Cuba is offering technical support to Kenya Medical Training College (KMTC), for the training of clinical officers, nurses and community health workers in the field of family medicine.

As Kenya roles out UHC, Primary Health Care is now crucial than ever before to enable tackle the double burden of disease and lay a foundation for the sustainability of its health programs. The PHC is not just about tackling disease and caring for sick people. It focuses on promoting health, wellness, preventing disease and the underlying social determinants of ill-health.

Countries with well-functioning PHC programs like Cuba, Thailand and Brazil have better health outcomes at low cost. With the current political commitment through the inclusion of UHC in the ‘Big Four’ social economic agendas, and equitable distribution of resources through the devolution of health services, the country now has what it takes to show that PHC is the best path towards achieving the goal of Health for All.

Developed and developing countries like Cuba, have included a family physician in their primary health care model. Kenya needs family medicine and commit to training its health workers in this field through a model appropriate to our context.

Mrs Kariuki is the Cabinet Secretary, Ministry of Health