Universal health coverage dream is not a destination but process
President Uhuru Kenyatta launched the Universal Healthcare Coverage (UHC) pilot phase in Kisumu County in December, 2018 as part of a grand plan to transform Kenya into a newly industrialised middle-income country by 2030.
The other counties in the pilot phase are Isiolo, Nyeri and Machakos. The four were selected as they represent unique characteristics: Isiolo (frontier county with mainly nomadic and semi-nomadic population); Kisumu (high burden of infectious diseases); Machakos (high burden of road traffic accidents); and Nyeri (high burden of non-communicable diseases).
A year into the pilot phase, the government is set to scale up UHC to the other 43 counties. Given the cost implications, it is important to start off knowing it is a journey to be finalised some day.
According to the World Health Organisation (WHO), UHC connotes that people and communities can access the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while ensuring that the use of these services does not expose the user to financial hardship through out-of-pocket expenses.
The UHC agenda has been a success story in some parts of the world, for instance Thailand. In Africa, Rwanda and Ghana have embraced it. Its success is hinged on efficiency and effectiveness of the healthcare system and a competent and motivated Human Resources for Health (HRH) pool.
UHC underscores the government’s commitment to meeting various constitutional provisions, including the right, in Article 43(1)(a), “to the highest attainable standard of health, which includes the right to healthcare services, including reproductive healthcare”. It is also in line with Sustainable Development Goal (SDG) 3.8, to “achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all”.
As a ‘Big Four Agenda’ pillar, UHC is expected to herald the transformation of the health sector and benefit those hitherto unable to access healthcare or lack medical insurance.
Further, UHC will boost access to medical and minor surgical services, maternal and child health services through the support of elaborate public health education. It will also enhance the cancer, HIV, tuberculosis and malaria treatment programme in Kenya.
Last September, the President and the Ministry of Health received the UHC political leadership award from Access Challenge and the African Union. This demonstrates commitment to delivery of UHC. It is also commendable that the 47 governors have committed to support UHC.
To realise the benefits of UHC, the government has been undertaking reforms at the National Hospital Insurance Fund (NHIF), Kenya Medical Supplies Agency (Kemsa), the national referral hospital system, health workers training and the Healthcare Regulatory Framework since their efficiency and effectiveness will be critical.
It is instructive that national referral facilities and county hospitals, as well as the private sector, harmonise and align their actions and interventions to inform the success of UHC.
Once UHC is scaled up across the country, Kenyans should take responsibility for their own health by going for check-ups and early screening, immunisation of their children and all preventive measures.
In the words of the WHO director-general, Dr Tedros Ghebreyesus, while on a visit to Kenya in January 2018, “Kenya is blazing a trail as a regional leader and that success of UHC here could have a ripple effect throughout the region”.
Kenyans should view UHC not as a destination but, rather, a continuous process towards improving access to quality and affordable healthcare. Overall, its success will improve the health and welfare of citizens and be a guarantee for economic growth and competitiveness by ensuring a healthy and productive population.
Dr Aruasa is the chief executive officer of Moi Teaching and Referral Hospital (MTRH), a Level 6B facility. [email protected]