President William Ruto has signed into effect four acts which will steer the implementation of Universal Health Coverage (UHC) in Kenya. The laws include Primary Health Care, Facility Improvement Financing, Digital Health, and Social Health Insurance acts.
Primary Healthcare, which health CS Susan Nakhumicha says is at the heart of UHC implementation, is defined by the World Health Organisation (WHO) as a strategy that will ensure that healthcare is delivered in a way that is centred on people's needs and respects their preferences.
"Primary healthcare (PHC) enables health systems to support a person's health needs – from health promotion to disease prevention, treatment, rehabilitation, palliative care and more," states the WHO website.
Nakhumicha says PHC will ensure every Kenyan - whether in an urban area or a remote village - can access high-quality healthcare services when needed most. It places the well-being of our citizens at the forefront of our healthcare system.
"It marks a shift from merely treating illnesses to actively promoting wellness at the community level. The goal is to bring healthcare closer to homes, creating a web of healthcare support extending from basic community facilities to advanced medical centres," she says.
Key to implementing this act is a trained and equipped workforce, to which the government has made plans to hire over 100,000 paid Community Health Promoters.
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"To this end, we are expanding training opportunities, prioritising the employment of healthcare workers, and enhancing working conditions to attract and retain skilled healthcare professionals," says Nakhumicha.
Facility Improvement financing
The health sector has been plagued by chronic fund misallocations and misappropriation, which cripple service delivery in public hospitals.
This law will ensure that all revenue collected, retained, planned for and used by public health facilities and units is channelled and appropriated to provide an efficient, secure and accountable mechanism. It aims to achieve this through providing a unified system to guide financial management in public health facilities, which will improve transparency, efficiency and effectiveness.
Ruto said this legislation would curtail fund mismanagement to protect the money collected from healthcare facilities from building unnecessary infrastructure such as gates and pavements and ensure improvement of priority areas and service delivery.
The digitalisation of the healthcare system in Kenya aims to establish and maintain a comprehensive, integrated health information system to promote transparency and data privacy and make sense of data to inform policies and provide targeted healthcare.
"To streamline healthcare services and enhance accessibility, we are consolidating all medical services onto a single digital platform. This innovative approach empowers Kenyan citizens to access their health records and essential services easily. By embracing digital solutions such as telemedicine and electronic health records, we simplify healthcare delivery and improve the overall patient experience," says Nakhumicha.
"Health records are in all manner of shapes, in pieces of paper, full scarps, exercise books, but now with these laws, you just need to identify yourself, and the doctor can pull out your health records to review your history through ICT," said Ruto.
Social Health Insurance
This act is a health finance mechanism aimed at overcoming equity issues. It's a common phrase that most Kenyans are one illness away from utter poverty.
Under this act, the government will set up a prepaid mechanism for funding the healthcare system to avoid unpredictable out-of-pocket expenditures for ailing Kenyans at the point of care.
Speaking during the ongoing UHC conference in Kericho, the Ministry of Health Acting Director General Dr Patrick Amoth said, "The Social Health Authority will have the rich support the poor, while young individuals will support the elderly. Healthy people will pay premiums and support the sick who have chronic diseases. This is how to protect us from more expenditure. The changes will ensure the protection of everybody."
With the law now in place, every individual above the age of 18 years will pay an amount yet to be agreed upon in Regulations to the Social Health Insurance Fund while the government will set aside money for the Primary Healthcare Fund and the Emergency, Chronic and Critical Illness Fund.
The president said there will be follow-through with regulations that will underpin and straighten some of the specific items of the pieces of legislation to ensure the public and other stakeholders have a say and are brought on board to ensure the success of UHC.