Why your referral hospital may not admit you when UHC takes effect

Patients unattended at a referral hospital. Only specialised cases will find their way to level six hospitals. [File, Standard]
Patients fond of self-referring to hospitals of choice will have to change their mode of seeking treatment once Universal Health Coverage (UHC) takes effect.

Under the UHC programme - to be rolled out on Thursday on a pilot basis in four counties - Kenyans will first seek treatment in dispensaries in their locality. The programme's success in the four counties will determine if its adopted across the 47 counties.

Referral of patients to healthcentres will be at the discretion of the dispensaries. The healthcentres in turn will refer patients to a county district hospital (sub-county), and if their cases are complicated, then they will be moved to a Level Five Hospital (county referral hospital).

Special cases

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Only special cases will find their way to Level Six hospitals, which are the national referral hospitals; Kenyatta National Hospital, Moi Teaching and Referral Hospitals, Mathari Mental Hospital and National Spinal Injury Hospital.

A breakdown, released by the ministry, of how the UHC will be implemented shows emphasis on strengthening primary healthcare as the basis of ensuring quality and access of all services.

“Kenyans are expected to first seek health services at dispensaries and health centres, especially for minor ailments, and be referred to county hospitals on need basis,” reads the Ministry’s UHC plan.

The plan outlines that Kenyans will be registered for UHC at household level by community health volunteers, who will be on monthly stipend of Sh2,000.

Unlike the National Health Insurance Fund (NHIF) where one needs just an identification card, on UHC, a letter from the chief will be required. This will prove that one hails from the said locality and is indeed a needy case.

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Health benefits

“A UHC card will be issued upon registration. Every household will be issued with a UHC card covering all the children under 18 years. Children above 18 years will get their own cards,” reads the ministry’s plan.

The UHC card will be used to identify one and their members of their household to the health facility.

Through UHC, the Government plans to strengthen primary healthcare by scaling up immunisation, antenatal and outpatient services which are part of the health benefits package.

However, there are also new services like mental health and emergency care services that have been included in the benefits package, which would be made available at dispensaries and health centres.

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Some of the public health services to be offered are distribution of mosquito nets, drainage of stagnant water and inspection of eateries, markets, and abattoirs.

Director of Medical Services Jackson Kioko acknowledged that Level One facilities (dispensaries) and Level Two (health centres) have been neglected for long.

“The issue here is that we need to offload our referral facility which are full of simple cases,” said Kioko.

Kioko added that there is already a policy that will ensure Kenya Medical Supplies Authority (Kemsa) equips lower tier facilities with drugs. This will go hand in hand with training community health volunteers.

He said the lower tier facilities will keep a record on patient visits, their age groups and the most common ailment, which will will facilitate interventions on health issues.

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The pilot phase of UHC will be rolled out on Thursday, if all goes according to plan. Countrywide roll out will be by December 2021.

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Universal Health CoverageReferral Hospitals