Kenya can lead the way in Providing Equitable Health Care

The Covid-19 pandemic has shown us that Kenya is not adequately prepared to manage a health crisis. Our health care system is disjointed and not able to provide care to its citizens and there continues to be systemic discrimination in the provision of healthcare in Kenya between the affluent and those who live below the poverty line.

Despite policy efforts and the launch of the Universal Health Coverage (UHC) scheme to promote affordable and quality health services in key counties, equitable health still remains unachieved.

Eliminating health disparities and pursuing equitable health means that the level of care should not vary based on gender, ethnic group, or social-economic status. It also means that every Kenyan Citizen can receive the care they need when they need it. Health inequalities have been further compounded by the division of the levels of care into primary care, secondary care, tertiary care, and quaternary care with each level of care related to the complexity of the medical cases being treated as well as the skills and specialities of the health care providers. This is skewed to favour large urban centres like Nairobi, Mombasa, Nakuru, Kisumu and Eldoret leading to the exclusion of a large majority of Kenyans.

Access to health care services is a fundamental right set out in the Constitution of Kenya and a core objective of the Kenya Health Policy 2012–2030. Achieving equitable health care can only be achieved by removing obstacles to health, eliminating poverty and eradicating all forms of discrimination. The Government’s mandate should focus on enhancing at the primary care level screening, early intervention and preventive measures as this would cost less in the long term. The provision of chronic care, surgical interventions as well as other specialized treatments should be well thought out and implemented across all Counties in the Country through the allocation of adequate human resources, supply of medical equipment, pharmaceuticals and sustainably funded to enable access to both public and private facilities. In doing so, all citizens will be able to receive health services when needed in government, private hospitals and faith-based organisations that meet set standards of quality and are cost-effective. Kenya’s UHC approach should aim at reducing health inequities particularly in chronic illness such as cancer, diabetics and renal diseases. If a large segment of the Kenyan population is uninsured medically, they have to rely on out of pocket payments making UHC a daunting task.

Kenya can lead the way in improving health access by taking a multisectoral approach that involves nutrition through food security, affordable housing, safe sanitation, as well as local investment in manufacturing, medical equipment and pharmaceutical supplies. More can be done in infrastructure development in terms of transport to connect patients to medical facilities and telecommunications to encourage local innovations in telemedicine that would address inadequacies in remote locations and have a wider provision of mobile clinics with assured frequency especially in rural areas and informal settlements. Greater partnerships should be encouraged between the private sector providers and County Governments to establish healthcare facilities that are appropriate for the local community’s needs.

The novel Covid-19 provides a great opportunity for Kenyans to re-evaluate their healthcare system and actually implement one that will give Kenyans from all walks of life the opportunity to reach their full health potential.

The writer is a healthcare and management consultant.

gordon@gordonodundo.com