Ruto banks on new legal regime to deliver healthcare to all Kenyans

President William Ruto speaks at Kiprugut Chumo Stadium during Mashujaa Day national celebrations on October 20, 2023. [PCS]

President William Ruto has reaffirmed his commitment to delivering quality healthcare to all Kenyans through the implementation of newly enacted laws that anchor Universal Health Coverage (UHC).

The laws, according to the President, will strengthen primary health care in the country compared to curative services that continue to put much weight on running the country's healthcare system.

Speaking during this year's Mashujaa Day celebration in Kericho on Friday, October 20, 2023, Ruto said though the Constitution guarantees Kenyans the right to the highest standards of health, previous governments were unable to deliver the same due to a lack of laws and policies.

“Access to healthcare will no longer be based on the ability to pay; It will be based on the health needs of every Kenyan,” said Ruto.

The new laws are the Primary Healthcare Act 2023, the Facility Improvement Financing Act 2023, the Digital Health Act 2023 and the Social Health Insurance Act 2023.

The Social Health Insurance Act, 2023 provides for the formation of a Social Health Authority (SHA) which will replace the current National Health Insurance Fund.

SHA will comprise of a publicly financed Primary Health Fund, a fully publicly financed Chronic, Emergency and Critical Illness Fund and the Social Health Insurance Fund.

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Under the law, the government will pay for unemployed individuals to enable them to access care.

“Every Kenyan will pay, as per their earning, and those without pay, the government will pay for them. Everyone will have SHA card, either paid by self, or by the government,” added Ruto.

According to the Social Health Insurance Act 2023, all Kenyans will access free care at Level 1, 2 and 3 hospitals, whereas the medical cover will enable them to access care at Level 4, 5 and 6 hospitals.

“We are implementing a per-household payment system, where a flat rate applies to everyone, regardless of their income,” said the President.

The president also announced that no Kenyan will be turned away at any public health facility for lack of money or having reached the limit for their medical cover.

"Every Kenyan shall access healthcare at public hospitals of all levels. The story of going to the hospital and you are told you can't be served because your card has been depleted, the new card shall not have such limitations," said President Ruto.

According to the president, the Social Health Insurance Fund signifies a shift to increased use of domestic resources for health financing and a sustainable approach, especially at a time when resources from donors and development partners are dwindling.

“The healthcare system in Kenya is largely focused on curative services at the expense of preventive and promotive services,” said the president.

Banking on curative services, according to the government, has occasioned inequity in financing, which has disadvantaged primary healthcare uptake and promotion.

“The Government’s mission is to build a progressive, responsive and sustainable healthcare system for accelerated attainment of the highest standard of health for all Kenyans,” he said.

Under the new law, individuals with chronic diseases like cancer and diabetes who exhaust their premiums as per treatment requirements according to the framework will be able to receive care using Chronic, Critical and Emergency Fund, under the SHA without extra costs.

"That new card will make sure if the limit is reached, then, the chronic and illness fund will kick in and every Kenyan will be attended to. No Kenyan will be turned away because of payments," said Ruto.

This is in contrast to the NHIF covers which require patients to make further top-ups or pay in cash once they deplete their allocation for them to continue accessing the services.

The President further said that incidents of sick Kenyans being turned away will be a thing of the past due to lack of medical cover.

"When Kenyans have emergencies or accidents, they go to hospital and are told they don't have medical cards(insurance). From now on, emergencies, chronic illnesses and accidents shall be treated without being questioned. All lives are important," said Ruto.

The Facility Improvement Financing Act, 2023 will boost revenue collection in hospitals, that have substantially reduced over the years.

He noted that money collected at hospitals are currently directed to the County Revenue Fund and is rarely re-invested into the facilities.

“The government notes that lack of autonomy in public health facility management and financial control has led to increasing fragmentation, poor service delivery, deteriorating health outcomes, and reduced efficiency,” said the president.

Additionally, the law will structure the process and guide the counties on how to provide for retention, management and use of revenue, derived from health-related services rendered at public health facilities.

Also assented was the Digital Health Act, of 2023, which will be leveraging technology to enhance the implementation of digital products and services.

The law will guarantee the collection, use and storage of data including that of patients and day-to-day operation of health.

Previously, patients' data was stored manually in hospital health records, making it difficult for patients to access services, in regions where they were not initially attended to by a physician.

With the technology, Community Health Promoters (CHPs) will also key data from the household they are serving, to the nearest Level 1, 2 or 3 hospitals where they are linked to.

“The Digital Health Act provides the legal basis for the development of a comprehensive and integrated health information system. These systems will enable end-to-end access, equity, financial risk protection, transparency, and accountability,” said Ruto.

He added, “The enactment and implementation of the Act and the digitisation agenda will deliver on the promise to integrate ICT to enhance telemedicine and health management information systems,” said Ruto.

Further, he emphasised Kenya Kwanza's health agenda to build a function which entails having an adequately motivated health workforce, and infrastructure.

Mr Ruto added that community health promoters are key in having the country attain UHC.

During the celebration, he commissioned 100,000 CHPs to spearhead preventive and promotive health across the county.

The workers will be paid a stipend of Sh5,000 by both the county and national government, equally at 50:50.

[Additional reporting by Julius Chepkwony and Nikko Tanui]