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The path towards achieving Universal Health Coverage

by Sharon Chepngetich

Access to needed health services is crucial for maintaining and improving health. At the same time, people need to be protected from being pushed into poverty because of the cost of health care.

Kenya has adopted Universal Health Coverage as one of the Big Four priority Agenda, under President Uhuru Kenyatta’s administration, with an aspiration that by 2022, all persons in Kenya will be able to use the essential services they need for health and well-being through a single unified benefit package without the risk of financial catastrophe.

The Constitution of Kenya, under the Bill of Rights, gives the citizens the right to the highest attainable standards of health in line with the World Health Organization (WHO) constitution which declares health a fundamental human right, thereby committing to ensuring the highest attainable level of health for all.

The health coverage scheme is rooted in the human rights framework with equitable access to resilient, people-centered health systems at its core and its implementation is touted to be for the future wellbeing of Kenyans and the economy.

Achieving UHC

Achieving universal health coverage has become a dominant global health policy preoccupation during the last decade, advocating ambitious health care coverage goals, increases in health funding and financial pooling mechanisms for social protection.

The goal of Universal Health System is to provide everyone with affordable access to health services.

Increasingly countries are building momentum towards improving access to Universal Health Coverage to provide quality health services that are equitable and affordable for all.

Kenyan health sector has an articulate and elaborate Kenya Health Policy (KHP 2014-2030) to assist the sector realign to new emerging issues to enable the country attain its long term Health goal sought by the country as outlined in the Kenya’s vision 2030 and the Kenyan constitution 2010.

The health sector is committed to contribute to ensuring Kenya becomes globally competitive, industrialized and prosperous middle income with high quality of life.

According to the Economic Survey 2017, over the last decade, Kenya’s strong economic growth has led to tripling of government expenditures across all sectors. With continued projected economic growth of above 5 per cent, Kenya has an opportunity to reform its health sector.

During the World Health Day 2018 event, the Cabinet Secretary for Health, Sicily Kariuki noted that the Universal Health Care goal aims at cushioning citizens against out of pocket expenditure on health services.

The Cabinet secretary revealed that almost one million Kenyans are pushed to poverty every year as a result of healthcare expenses thus Universal Health Coverage is a fundamental human rights issue.

The government targets Universal Health Coverage (UHC) for all households by 2022. This will guarantee access to quality and affordable health care for all Kenyans.

Pushing UHC

The proposed initiatives towards the realization of UHC agenda for Kenya include: Driving NHIF uptake through enlisting 37,000 banking sector agent network, leveraging on self-help groups and religious groups for advocacy; Enlisting 100,000 Community Health Volunteers to each recruit 20 households; Expansion of the ‘Linda Mama’ programme to mission hospitals; Legal reforms to align NHIF with the UHC; Adopt new health care financing models that include gradual increment of budgetary allocation to health from 7percent in 2017 to 10 percent in 2022, introduction of Robin-Hood taxes on Real Time Gross Settlements (RTGS), mobile money transfers, and airfares; and Adoption of new low cost service delivery model that leverage on technology such as eHealth for telemedicine, mHealth, and eHubs collection and dissemination of information this is according to the Budget Watch 2018.

According to the budget statement, FY. 2018/2019, H.E, the president has already launched a comprehensive NHIF medical scheme for secondary school students to insure them for all kinds of injuries and diseases, this will ease the financial burden of their parents.

This Universal Health Coverage has quickly gained traction in relative to the other pillars- enhancing manufacturing, food security and affordable housing. As they are still planning execution of the other three pillars, the Universal Health Coverage which was piloted in four counties namely; Kisumu, Nyeri, Isiolo and Machakos was launched by the president in December 2018.

Kenya has undertaken a number of health system and financing reforms to increase coverage for quality health services improve availability of essential medicines and reduce out-of-pocket payments, and one of the services which has really helped is the National Hospital Insurance Fund (NHIF).

NHIF has continued to implement social health strategies with a view to achieving Universal Health Coverage (UHC) for the benefit of all Kenyans.

Subsequently, the fund has over the last three years developed out new benefit packages as a means towards expanding excess to both the employed and self-employed sectors.

At the same time, the fund has stepped up its member recruitment and public education drives across the country with a view of covering many families thus cushioning them against catastrophic health care expenditure.

These among many other strategies continue to bear positive impact with many Kenyans responding well with increased product uptake.

According to the NHIF performance Report 2018, the fund has continued to expand its offerings in terms of health care benefit packages to all its members.

“The impatient services and the outpatient services has grown by 22 per cent and 48 per cent respectively,” says the report.

NHIF also supports local communities in informal settlements through free medical camps to identify health information to the community members.

The Kenyan experience has emphasized the key role that UHC plays in promoting private health sector growth. Private sector players recognize that increased insurance coverage among the population expands their market.

Being the largest health insurance provider in Kenya, there is now a general acceptance that the NHIF is the best placed to drive the UHC agenda. Strengthening the NHIF has been identified as an important priority by private sector providers with the recognition that a reformed NHIF is an important enabler for private sector development in Kenya.

The NHIF remains one of the most important institutions for realizing UHC in Kenya. Despite the challenges faced by the organization, there is a growing recognition that the organization is on the path to reform.



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