Failure to invest in preventive healthcare is taking a heavy toll on Kenyans, says a report.
The report by the African Institute for Development Policy (Afidep) says preventive healthcare, which can lower diseases such as diabetes, hypertension and cancer, has been receiving the lowest chunk of the budget, yet it is the most critical.
Afidep country head Rose Oronje called for more investment in health at the community level, and not simply waiting for people to show up in hospital.
Low investment in Universal Healthcare, misplaced spending and corruption have worsened the situation such that if you are poor, you are likely to die of a manageable disease or be impoverished.
"It means sensitising individuals on health risks, healthy diets, and lifestyles, and helping them live a holistic lifestyle to prevent disease burden. It also means the government is looking at healthcare as a multi-sectoral investment," Dr Oronje said.
Over 44 years ago, Kenya pledged to align with the principles of Primary Health Care which focus on promoting health, wellness, preventing disease and the underlying social determinants of ill-health.
And in the 2010 Constitution, Kenya also adopted the principles of UHC, declaring health a fundamental human right, including access to quality health services, without out of pocket expenditures.
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Kenya also committed to the Abuja Declaration which requires countries to put in 15 per cent as the bare minimum of the national budgetary allocation to health. Yet the highest health budget allocation the country has ever had is 11.1 per cent in the 2022/2023 Financial Year. Before devolution, it used to oscillate around 7.8 per cent.
"Although the health budget has been growing, it has not matched the rapidly growing population. Allocation to Primary Health Care (PHC) remains minimal despite PHC's criticality to health outcomes," said Oronje.
The low budget allocation, Oronje said, means that Kenyans don't have access to quality health services. It also means Kenyans have to dig deep into their pockets to pay for healthcare. Out of pocket expenditure, according to the report, was at 24 per cent.
"Out of pocket expenditures end up sinking Kenyans further down the poverty hole and they also mean those who can't afford end up dying," Oronje said.
The report also said that the 11.1 per cent of budget allocation is not being used where it can have maximum impact.
Over 86 per cent of the budget is spent on curative services and running health facilities and organisations such as Kenya Medical Research Institute), Kenya Medical Supplies Authority, Kenya Medical Training College, with quite a bit of it ending mismanaged.
"There are pointers to mismanagement too, a case in point is where government hospital workers receive salaries yet don't go to work as expected," she said.
The report recommended additional domestic finances for health and increased resource allocations to prioritise critical, but neglected preventive, promotive, reproductive, maternal, child and adolescent health.
It also called on stakeholders to address hurdles in policy that hinder private sector investments and expansion and uptake of insurance schemes.
"The government should also address inefficiencies and wastage in health budget expenditure. There's a need to make people and processes in the healthcare sector more accountable," says report.