Kenya’s health system is broken, UHC can fix it.

The Covid-19 pandemic has shown us, that we are not prepared as a Country to take proper care of its citizens in moments of a health crisis. The reality is that our health system is fragmented and if anybody falls sick, regardless of social status receiving health care services in Kenya places many families in debt because of lack of a social protection system that covers health. If this alone is not enough, Kenya is well below childhood immunization rates and maternal health even as we battle cholera outbreaks due to inadequate sanitation.

Achieving Universal Health Care (UHC) means that all Kenyans from all walks of life can access the highest level of quality of care without exposing financial hardship. But there is a way out and we don’t need to look far. Rwanda has succeeded in implementing a social health care system that is working perfectly. But first, some background. Historically Rwanda’s healthcare had been supported by UNICEF and WHO until the 1994 genocide which crippled the entire healthcare system alongside the economy. Post genocide, Rwanda had an uphill climb to restore its health systems by investing 9.7% of national expenditure to build one of the best healthcare systems in Africa.

Health insurance became mandatory for all Rwandese citizens by devolving the financing and management of healthcare to local communities through a system of health insurance providers. Under the scheme, the rate varies on a sliding scale according to wealth. In comparison, Kenya should be well ahead of its neighbouring counterpart with National Health Policies outlining UHC as the priority for the year 2018-2022 to increase health insurance, increase access to essential health service, and reduce out-of-pocket household expenditure.

Sadly, we haven’t fixed our health systems. To begin with, we spend approximately 4% on health care, this is way below the Abuja declaration of 15% and this could be the heart of the problem.

So how can UHC fix Kenya’s broken health care system is perhaps the question in our minds during this pandemic and health crisis. One is by allocating resources towards healthcare to increase accreditation of health care providers. Secondly is by providing adequate training of health workers to increase the ratio of health worker to patient ratio which currently stands at 1:1000 against the WHO recommended ratio of doctor to patient ratio in the country at one to 17,000

Thirdly is that the Government’s focus should be on preventative as well as curative measures to healthcare working closely with County Governments to play a bigger role in building hospitals in order to attract and retain highly skilled health workers. Finally, working closely with key players in the private health sector to lower the cost of private health care in addition to increasing manufacturing of pharmaceutical supplies and medical equipment are proven ways to build a strong health care system.

Like Rwanda, healthcare insurance should be mandatory for all Kenyans, the National Government through the NHIF should finance UHC to reduce the high burden of infectious diseases to provide preventative treatments for all illnesses for its citizens. Taxation measures at the National and County levels should be able to finance UHC by making it mandatory that all Kenyan have healthcare Insurance.

In the context of providing UHC for all Kenyans, a bigger push for local manufacturing of pharmaceutical drugs should lead to cheaper and adequate provision of both branded and generic essential medicine especially for cancer patients who pay up to five times more than they should for their cancer treatments locally.

But there is hope, the NHIF has actually made a big difference in increasing access to care to Kenyans who were previously dying prematurely due to non-communicable diseases. Increasing NHIF’s mandate of providing UHC will require collaboration between the National government, County governments, and the private sector to enhance Private-Public Partnerships (PPPs). This requires goodwill from all the health sector players, with the goal to ensure that Kenya’s population is healthy and productive.

The writer is a healthcare and management consultant.

gordon@gordonodundo.com

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