Ruto set to launch ambitious health care programme

President William Ruto (centre) signs Universal Health Care Bills at State House, Nairobi. [PCS] Kenya today rolls out the ambitious Universal Health Coverage (UHC) programme that seeks to ensure affordable health care for all. President William Ruto will launch UHC during Mashujaa Day celebrations in Kericho. Since independence, Kenya has had a challenging task of delivering healthcare for citizens but the road to its implementation has been slippery. Former presidents Mwai Kibaki and Uhuru Kenyatta made attempts to deliver affordable healthcare but it came a cropper, with the most recent attempt being three years ago where the government piloted UHC in Kisumu, Nyeri, Isiolo and Machakos counties. Today, under the Rutocare, the president is beginning an arduous task where global attempts apart from the United Kingdom's NHS have failed including former US President Barrack Obama's Obamacare. "Our national healthcare journey has been long and at times painful. Indeed, most Kenyans have always insisted that healthcare is the public service they want the most; it is the priority. Today, we have made a significant step towards making healthcare universal for all Kenyans," said President Ruto on Thursday. A prelude of the unveiling, on Thursday the Head of State signed into law the Primary Health Care Bill, 2023; the Digital Health Bill, 2023; the Facility Improvement Financing Bill, 2023; and the new Social Health Insurance Bill, 2023 - to provide the legal and institutional framework for a new dawn in our healthcare system Under Rutocare, through the Community Health Policy and Primary Health Care and Health Financing strategies, the president seeks to lay the foundation for the biggest change in the healthcare system since independence. "These laws will transform healthcare in Kenya; they will save lives, empower communities and make us a stronger and healthier nation," he said. Quality healthcare Ruto said for long, Kenyans have collectively aspired for quality, affordable and accessible healthcare system. "Since independence, significant efforts have been made, but we have never quite got where we've wanted; that, changes today," he said. "We have reached a pivotal moment in our quest to reshape our healthcare delivery system. Today, four crucial Bills for the implementation of Universal Health Care have become law," he added. The Head of State said the Kenya Kwanza manifesto committed to achieving UHC through a fully financed primary healthcare mechanism, comprising preventive, promotive, curative, palliative, and rehabilitative services. Under the Rutocare, the government will ring-fence healthcare funds, through the facility improvement legislation at the national and county government levels under the Facility Improvement Financing Act, 2023 where every institution will keep part of the cash they collect from their operations. The Act will counter the decrease in funding for public health facilities, which often lack the requisite levels of investment, leading to lack of autonomy, fragmented services and poor outcomes. The law will entrench financial and managerial autonomy to enhance decision-making, efficiency and community involvement at these facilities. "The Act provides guidelines to ensure a unified approach to facilitate autonomy, enabling them to independently retain and manage funds, ultimately improving resource availability, quality of services, efficiency and delivery," said Ruto. Other exciting attributes of the law signed by the president include the setting up an emergency medical treatment fund to cater for emergency, cancer treatment, referrals and other chronic ailments. Kenyans have been forced to raise funds and sell property to seek medicare for kin in and out of the country and the emergency medical treatment fund will address this. With health insurance coverage at a low of 26 per cent nationally, out-of-pocket costs are burdening families and keeping sick Kenyans away from treatment. The new Social Health Insurance Act, Ruto said will now address financial barriers to healthcare and the existing challenges faced by NHIF by establishing the Social Health Authority. The signing of the Social Health Insurance Act into law immediately repealed the current National Health Insurance Fund and established three new funds including, the Primary Healthcare Fund, Social Health Insurance Fund, Emergency, Chronic and Critical Illness Fund. These funds will ensure publicly funded primary healthcare, emergency care and universal health insurance while promoting equitable access to quality health services. The Primary Healthcare Fund will finance services from health facilities at levels 1 to 3, while the Social Health Insurance Fund will cover services at levels 4 to 6 facilities. The Emergency, Chronic and Critical Illness Fund will fund emergency and chronic illness costs, once social health insurance is depleted. This fulfils the express wishes of Article 43 (2) of the Constitution, which provides that no Kenyan should be denied emergency medical treatment. The Primary Healthcare Act addresses the current healthcare imbalance in Kenya by emphasising preventive and promotive health services. The Act introduces a framework for the effective delivery of primary healthcare services through networks that include all healthcare providers, whether public, private or faith- based. Immediately after the launch of UHC, Ruto is expected to deploy 100,000 community health promoters, a month after he flagged off the kits for use in all our counties. Each community health promoter will be responsible for 100 households and are expected to have kits and phones to enable them to work effectively in the Rutocare programme where the national and county governments will share the responsibility of stipends for the promoters. According to the president, the goal is to bring healthcare to the doorstep of Kenyans, significantly improving accessibility and affordability. Under the Digital Health Act, the law will streamline the adoption of technology in the health sector, enabling improved data sharing and resource utilisation thus addressing the existing legal and regulatory gaps in the framework for the eHealth ecosystem. It will also enable the development of standards for the provision of mobile health, telemedicine and e-learning in healthcare with the potential to personalise patient care, improve quality andempower communities. A command centre would be set up in Kenyatta National hospital which would be linked to all the level three, four and five hospitals across the country. The command centre would allow a doctor to access information online on any patient who has visited a hospital.

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