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Universal health coverage will be a game-changer burden

COMMENTARY
By Sicily Kariuki | April 7th 2019

Every year on April 7, countries around the world celebrate World Health Day, drawing attention to important health issues and reaffirming commitments to improve the health and well-being of our populations. This year’s theme is “Universal health coverage: everyone, everywhere”.

Today, we celebrate the strides we have made under the leadership of the President in our journey towards attainment of Universal Health Coverage (UHC).

Health is a unique area where compassion, altruism and economics combine in a single cause. By saving lives and fighting morbidity, we help build more prosperous, productive communities.

UHC is therefore a critical component of sustainable development and poverty reduction. It is based on the principle that all individuals and communities should have access to quality, essential health services without suffering financial hardship. The government has prioritised the achievement of UHC, christened “Afya Care,” as part of its Big Four Agenda. The UHC pilot phase was launched by President Uhuru Kenyatta on December 13, 2018, in Kisumu, Machakos, Nyeri and Isiolo counties.

The Ministry of Health’s approach to achieving UHC is through removal of user fees at all public facilities, including levels 4 and 5 facilities, and ensuring commodity security through Kenya Medical Supplies Authority. The ministry is providing conditional grants to the four UHC pilot counties for health system strengthening and primary health care interventions. Notably, utilisation of health services has increased to 39 per cent.

Key reforms

The proposed next steps in the pilot phase of UHC will include: Increasing the uptake and utilisation of Community Health Volunteers’ services; investing in standardisation of diagnostics; prioritising the National Integrated Identity Management System programme for biometric registration of patients; monitoring of health facilities under the UHC pilot phase; strengthening health systems in the 43 non-pilot counties; and ensuring efficient and appropriate use of health funds.

While the goals of UHC are straightforward, implementing and realising UHC will be a far more complex process – and although we may easily recognise the “why” of UHC, we must also address the “how” of UHC. 

When people have to pay for health services out of pocket, the poor are often unable to obtain essential health services and even the rich are exposed to financial hardship when faced with severe or long-term illness. Pooling health funds through taxes, compulsory insurance contributions and voluntary health schemes helps to minimise the financial risk of illness across a population. 

Countries that have made significant progress towards UHC, such as such as Rwanda, Thailand and Japan have leveraged the power of national social health insurance programmes to reach vast populations with equitable, quality health care. In order to achieve UHC in Kenya, institutional reforms to the National Hospital Insurance Fund (NHIF) is therewith paramount. It is therefore for this reason that I instituted an expert panel to study the obtaining NHIF delivery mechanisms and propose reforms which will ultimately strengthen the capacity of NHIF to deliver UHC in an efficient, accountable, transparent and sustainable manner.

Similarly, Kemsa will be reformed and repositioned to ensure the uninterrupted supply of quality, affordable medicines and to build its technological and operational capacity to forecast needs and manage logistics.

Moreover, UHC is not a journey we take in isolation. We are grateful for the support of the Governments of Cuba and Thailand. We look forward to maintaining strong partnerships with the development partners, civil-society and faith-base organisations. And through the SDG Partnership Platform we look forward to bringing private sector along for financing and delivery of UHC.  

Where as government we remain committed to deliver on this critical agenda, it is the responsibility of every citizen to live a healthy lifestyle. Let us be proud today as a nation about the strides we have made towards UHC. And let us dedicate our time, goodwill and sacrifice to the achievement of UHC – for it is through UHC that livelihoods will be improved, while leading us towards economic prosperity! 

- The writer is Health CS

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