Communique KHF 2018(Click to Download)
Communique – Kenya Health Forum 2018(Click to Download)
Kenya Healthcare Federation (KHF) holds the first Ministerial Stakeholders Forum (MSF) for the year 2018 with newly appointed Principal Secretary Mr Peter Tum
Principal Secretary (PS) for Health Kenya, Mr Peter K. Tum hosted his first Ministerial Stakeholders Forum (MSF) on 17th April 2018 at Afya Annex. The Forum which was co-chaired by Dr. Amit N. Thakker, Chairman of Kenya Healthcare Federation was well attended by Ministry of Health (MOH) officials, KHF Directors, KHF Committee Chairs, Faith Based Organizations (FBOs), Non-Governmental Organizations and Kenya Private Sector Alliance (KEPSA) coordinators.
The PS, in his opening remarks, acknowledged that engagement with the private sector is important due to the critical role it plays in all areas of Health, most importantly; policy development, supply chain of Health Commodities, Service Delivery in terms of facilities, Employment of Health workers, Patient Management , use of Technology, Research and Specialized Training. He noted that only by synergising the Public and Private Sector can we achieve Universal Healthcare Coverage (UHC).
Dr. Thakker, extended his appreciation to the Ministry of Health for recognising the role of the private sector as the engine of growth and creating an enabling environment. These conditions have led to significant growth of the private sector in Kenya that currently caters for half the health work force as well as 50% of the current facilities in Kenya. The current contribution to Gross Domestic Product (GDP) is slightly over 2.3%, which is well above the Sub-Saharan African Countries average of 1.7%.
Mr Stephen Macharia – Public Private Partnership (PPP Unit – MOH) gave a presentation that highlighted the key issues discussed in previous MSF meetings. He identified the significance of the private sector as it has the highest number of healthcare facilities contributing to 54%. In addition, he pointed out that there is need to focus on the lower income level of the population that are not covered by health insurance. There is therefore a huge market for the Private Health Insurance.
There were Seven emerging issues identified among the private sector as; Health Regulations, Healthcare Financing, Supply Chain, E-Health and Technology, Public Private Partnerships, Human Resources and Quality & Standards.
Dr Amit Thakker addressed the first issue as Health Regulations, where He offered KHF inclusion in the Health Act implementation committees and stressed the need to have a neutral regulatory body (Health Benefits Regulatory Authority),that will govern both the Private and Public financing Institutions as we embark on accelerating Coverage for Universal Healthcare (UHC).
Mr Isaac Nzyoka (Chair – KHF Healthcare Financing Committee) expressed support of the government’s agenda on UHC. In his presentation, he stated that there is need to strengthen the role of the private sector in terms of Health Care financing because it has a lot to offer. Private Insurers have over 200 financial distribution centres in the country that can be very useful. He noted that one of the biggest challenges in UHC is reaching the entire population. The Private Sector can achieve this through technology that can enroll members and manage overall process efficiency.
Dr Louis Machogu – Vice Chair KHF Supply Chain Committee, emphasized that the cost of care needs to be reduced and we can do so by promoting local manufacturers of medicine through appropriate incentives. Both sectors need to come together to utilize the 5000 registered private sector pharmacists to negotiate lower costs. VAT on medical devices are calculated on the patient bill and this ought to be reversed. Regulations need to be strengthened for control on parallel imports and influx of substandard products.
Ms. Daniella Munene (Member KHF e-Health Committee) spoke on E-health and Technology where She requested that the harmonized coding system at National Hospital and Insurance Fund (NHIF) be shared with the private sector which will result into a rich Data and innovation between the two sectors if they work together.
Ms. Joyce Wanderi – KHF Director & a member of KHF – PPP Committee proposed that the Public and Private Sector should organize a retreat to prioritize what the various pillars should be focusing on towards scaling up PPPs. She suggested greater transparency in the procurement process as well as looking at strengthening the PPP unit at MOH.
Mr. Ken Auma – Chair KHF Human Resource for Health Committee (HRH) Committee, Enlightened the members on the Multi Stakeholder Partnership (MSP) initiative under taken by KHF in regard to the 3 health cadres that need support which can play a role in UHC. He proposed that a unified curriculum be put in place for the 3 cadres and incentives be given to assist KMTC in the training process.
Anthony Jaccodul Vice – Chair KHF Quality & Standards Committee presented on quality and standards where He stressed on the need to include the Private Sector in the process of making Kenya Quality Model for Health (KQMH) the minimum standards certifying tool in Kenya as well as introducing a harmonized national coding system to enable data share.
Ms. Pauline Irungu, Vice Chair – Health NGOs Network (HENNET) emphasised that UHC needs to feature Quality of Care much more prominently.
Dr. Sam Mwenda, Chair – Christian Health Association of Kenya (CHAK) reiterated that Kenyans need to be empowered to access facilities that they have not been able to, this will enhance the change.
The meeting was very productive with the hope of good collaboration in the Health sector towards achieving quality and affordable healthcare for all Kenyans.
Multi Stakeholder Partnership (MSP) meets to strategize on how to fill the identified gaps in the pre -identified specialized cadres.
On January 26th 2018, the MSP carried out an introductory meeting where three specialized cadres were shortlisted namely; Health Records and Information Officers (HRIOs), Community Health volunteers (CHVs) and Emergency Care Professionals (ECPs). Since then, these Cadres have had several meetings to a lay foundation on how they will be strengthened.
On the 23rd March 2018, the MSP organized the second large stakeholder meeting at Four Points Hotel by Sheraton – Hurlingham to highlight the gaps within the three specialized cadres and agree on a way forward to fill those gaps.
“Lack of qualified professionals and machinery to institute emergency care, contributes to a major cause of deaths in Kenya where 54% of the annual deaths can be addressed by establishing pre-hospital and emergency care” Dr. Benjamin Wachira – Emergency Medicine Kenya Foundation.
A case study in nyamira county shows that there is no emergency care attention at county level, therefore patients have to either be airlifted to Nairobi or travel by bus, to seek emergency medical care. The Emergency Medical Care policy draft has been completed and the government intends to release it this year.
CHVs in Kenya are very important in teaching the community how to improve healthcare and change behavior at a household level which will inturn prevent illnesses. Moreover, CHVs are a major link between health systems and the consumer.
It was noted that there is no associations available for CHVs. Dr Amit Thakker – Chairman – Kenya Healthcare Federation, explained that there is no regulators concerned with the scope of work of CHVs and further recommended that there is need to bring this regulations on board.
HRIOs are very vital in health record keeping and the data should be correctly captured because it should give a clear picture on the healthcare position in terms of progress. “Life begins and ends with health records and information officers” said Mr. Kennedy Auma – Association of Professional Coders/Chair – KHF Human Resource for Health Committee.
It was noted that the Health Records and Information Managers Act 2016, has been approved but not implemented and the Act includes establishing a Health Records and Information Managers Board.
An observation from Kiprono Chepkok – CEC, Health Elgeyo Marakwet, shows that Health records and data should be accurate, the existing data is incorrect since it has been derived from the Ministry of Health and not from the county directly.
Moreover; “there is need for easy access to health information and care in all counties to avoid/reduce medical travel within the nation” Ruth Koech – CEC Health, Nandi County.
There are training gaps and opportunities within the three cadres where Kenya Medical Training College (KMTC) has been the main trainer of most health care workers in the country. There are 148 health training institutions accredited by the health regulatory agencies as at 2015 to train various health professionals to meet the growing demand for quality healthcare in the country. He futher said that training is important because competency based training leads to access to quality healthcare.
There are training institutions distributed in 36 counties out of 47 counties in Kenya and out of these 36 health training institutions, only 14 are government sponsored colleges.
It was noted that there is lack of curriculum standardization and the Private Sector can help the Training Institutions e.g. KMTC to review their curricula, because there is need to saturate the market with Trained Professionals in order to prevent brain drain.
Dr. Amit Thakker shed light on Health Regulatory Bodies and Associations in Kenya. He stressed on the need for cadres to have Regulatory Bodies and form Associations. Moreover, this is a requirement by the Act of Parliament to establish the Regulatory Board (HRIOs).
Kiran Nyotta – KHF legal and policy expert, explained how the Health Act could impact specialized health cadres where the Health Act 2017, was enacted to consolidate the Kenyan health system and includes provisions to regulate healthcare service delivery and providers.
She reiterated that the Kenya Health HR Advisory Council (The ‘Council’), will be formed under Part V of the Act which will deal with establishing norms and standards for healthcare professionals and will maintain a master register of all health practitioners in the counties.
The Council’s Board will include 2 representatives from Health Professional Associations who are not regulated or registered by any regulatory body. Therefore, the specialised heath cadres can take advantage of this provision by forming an Associations so that they can contribute to the Council deliberations.
Kiprono Chepkok – CEC Health Elgeyo Marakwet put forward that there is no direct link between the counties and Regulatory Bodies and the link is very important. Ruth Koech – CEC Heath Nandi County emphasized on the need to establish a body that can accredit all the ignored cadres.
A consensus was reached on the three cadres in that the Emergency Care Professionals should be recognized and increased access to training with excellent curriculums will strengthen the cadre in the health workforce. It was further agreed that any future steps should be aligned to the ECP policy which has been launched by the Ministry of Health.
It’s important to enhance and update the HRIOs curriculum structure whereby advocacy for the implementation of the Health Records and Information Managers Act 2016 shall strengthen the cadre.
More advocacy and discussion on the CHVs renumeration should be done at a policy level in order to strengthen the cadre moreover, formation/strengthening of an Association or training incetives could motivate this work force.
Kenya Healthcare Federation(KHF) Leadership Team First Meeting with the Cabinet Secretary Ministry of Health
The Kenya Healthcare Federation (KHF) Leadership Team and Ministry of Health(MOH) had a courtesy call with the Cabinet Secretary of Health Mrs. Sicily Kariuki to plan for the upcoming Ministerial Stakeholders Forum (MSF).
KHF and MOH officials briefed the CS on the past six MSF engagements and the progress achieved in the past years. The Health Bill 2016 that subsequently become an act in 2017 and is currently under implementation is one of the success cases where KHF has worked with the Ministry through the MSF. Taxation waiver on imported pharmaceutical raw materials, implementation on the Joint Inspection Checklist and discussions on VAT on medical devices are some of the industry healthcare matters discussed within MSF in 2017.
This year the private sector plans to work with the Ministry to accelerate healthcare access by encouraging local manufacturing of medicines with commitment towards quality and affordability, Promoting the concept of UHC in partnership with county governments towards achieving affordable healthcare for all in keeping with the Big 4 agenda, interface with the government on problem solving opportunities within the ICT sector through data sharing and interoperability, Educating the counties on PPP acts guided under the national PPP framework is also key as KHF is now working closely and directly with the county governments to achieve deepen affordable healthcare for all.
The Cabinet Secretary urged KHF on the need to invest more on health to deliver on UHC with pooled investments. She commended the private sector efficiency and innovation in delivering healthcare within satisfactory timelines and commits the governments’ interest to work with private sector and achieve quality and accessible healthcare. She advised KHF to continue working with the Governor of Isiolo County Hon Mohamed Kuti as he is a very resourceful towards demand driven engagements.
There are great investments opportunities in the healthcare sector in Kenya from all over the world that needs clear definition of partnership structures with value add towards achieving UHC. KHF and MOH will hence work together and evaluate tangible impact in unlocking these opportunities.
Kenya Healthcare Federation (KHF) engagement with Healthcare Regulatory Bodies
In Kenya today, it can be overwhelming to know and understand which regulatory body in the health care industry is mandated to regulate specific healthcare cadres and standards. KHF aims to engage and partner with the regulatory bodies to understand their specific roles in order to strengthen the health system by shedding light in the health sector on the specific roles of the regulatory bodies.
Regulation plays a major role in the health care industry and health care insurance coverage. The various regulatory bodies in Kenya protect the public from a number of health risks and provide numerous programs for public health and welfare. Healthcare regulations and standards are necessary to ensure compliance and to provide safe healthcare to every individual who access the system.
Kenya Healthcare Federation met with the Clinical Officers Council of Kenya, on 14th March 2018 at Blue Violet Plaza building on Kindaruma road – Nairobi and Public Health Officers and Technicians Council of Kenya, on 7th March 2018 at Kenya Medical Training College – Nairobi, to introduce the Federation to the two councils and set ground for a strong partnership.
The meeting was led by Faith Muigai – KHF Director, Dr. Amit Thakker – Chairman and Puja Tank – Executive Coordinator. The partnership will see good working relation hence enhance, more job creation by the council moreover, the federation will work with the council through enabling policies that maximize the contribution of the private sector.
Having a strong and effective Public Private Partnership in Health, will spur a higher Small and Medium Enterprise (SME) growth more over in the next phase, also this will ensure that the Human Resource for Health is strengthened.
The meetings were well attended by the Federation’s secretariat and the two council’s official’s.
KHF holds its first 2018 Members Meeting in an Exclusive Lunch Event at Radisson Blu Hotel on 26th January 2018
Kenya Healthcare Federation (KHF) recently held its first members meeting for the year 2018 on 26th January 2018 at Radisson Blu Hotel Westlands. KHF has in the year 2017 worked with the Healthcare agencies, NGOs, FBOs and Ministry of Health to address quality, affordable and accessible healthcare, in a bid to transform the sector for enhanced efficiency and sustainability. The meeting which was well attended with members, guests and development partners was graced by Dr. Andrew Mulwa Chairman of County Executives Committee (CEC) for Health and Mr. Stephen Macharia, Head of PPP unit in the Ministry of Health.
The meeting was supported by the Multi Stakeholder Partnership Kenya (MSP-K) who shared a presentation on what can Kenya do to meet the growing HRH need with a special focus on specialized health cadres. MSP strives to engage intense advocacy, quality training and deployment of specialized carders. MSP is collaboration between AMREF Health Kenya, Malteser International and Kenya Healthcare Federation (KHF) established to stimulate the strengthening of health systems services in Kenya through the inclusion of specialized services.
The members meeting was chaired by Dr. Amit N. Thakker and attended by over 70 members and guests, deliberated on various priority areas for the federation for the year 2018. Partnerships with key stakeholders like FBOs, KEPSA, SRT, NGOs, MOH and County Governments is key this year for a productive membership value. Other major activities highlighted included projects, bi-monthly members meetings, annual national and regional and International conferences e.g. The Kenya Medical Association Annual Scientific conference and the EAHF conference, regular healthcare workshops and the KHF Annual General Meeting.
The KHF six committees which has this year attracted massive membership participation presented the below focus areas for this year.
Focusing on its mission “an enabling environment that supports quality affordable healthcare for all” KHF will in 2018 strengthen the health systems through various advocacy channels to deliver better healthcare policies and regulations to its members. KHF is wishing you a healthy month and year ahead as we look forward to more updates in the month of May 2018 with KHF Newsletter.
“Your daily peek behind the health scenes at KHF, with exclusive sustainability news resources, tips and more”
Kenya Healthcare Federation (KHF) Supply Chain Delegation to COSMOS Pharmaceuticals Limited
KHF supply chain team visited COSMOS Pharmaceuticals Limited on 8th February 2018 towards promoting the newly introduced member integration programme. The high cost of medical care in Kenya is partly due to the high cost of medication which makes up an average of 45% of patients’ hospital bills. COSMOS limited one of the Kenyan local pharmaceutical manufacturers strives to reduce the cost of healthcare and inturn contribute to Universal Healthcare Coverage.
From the presentation by COSMOS limited during the visit indicated that public and private expenditure on imported units once converted to local manufacturing prices, could lead to a potential savings of Ksh. 800 million per year based on the leading molecules, benefiting patients and insurers. Public sector spend 4.5 times more buying expensive medicines, while private sector spend 3.8 times more buying expensive medicines instead of using quality generic brands.
Unregulated trade margins have led to selling of expensive drugs. According to WHO Guideline on country pharmaceutical pricing policies and strategies, countries should consider regulating distribution chain mark-ups for distributors and wholesalers and retail chain mark-ups and fees for pharmacies, dispensing doctors and dispensaries. If mark-ups are regulated, countries should consider using regressive mark-ups (lower mark-up for higher-priced products) rather than fixed percentage markups, given the incentive that the latter provides for higher-priced products to receive a higher net margin.
Remuneration or mark-up regulation if considered can provide incentives for supplying specific medicines (generics, low volume medicines, reimbursable medicines) or to protect specific patients or population groups (e.g., vulnerable groups, remote populations).
One way to improve both availability and accessibility is to produce medicines locally. Which will decrease dependence on foreign suppliers (70% of total consumption) hence provide employment. Local production could also give greater control to Kenyan regulators, which are fighting against low quality drugs, sometimes made in far-off factories that are difficult to monitor.
The delegation witnessed an all-round production facility with five manufacturing blocks with over 180 API and over 6000 SKU’s. The factory which is equipped with marketing & administration offices, also harbor on site finished goods and works in a 24 hour operation. For the tablets manufacturing section, the facility runs 4 Granulation Suites, 6 Compression Rooms, 1 Capsulation Room, 3 Coating Rooms, 6 Blister Packing Lines and 1 Bulk Packing Line. The facility also operates 4 Dry Powder Filling Lines, 2 Ointment & Cream Filling Lines and 2 Liquid Bottle Filling.
With the aims to develop at least 5 highly effective products per year which comply to either British or United States Pharmacopeias, COSMOS practice good manufacturing according to WHO and GMP standards and all formulations are locally developed, following USP and BP. They are accredited manufacturers by USAID and PICS and receive regular PPB inspections leading quality standards roadmap goals. For ARV production COSMOS receive voluntary license from GSK and BI and count with state-of-the-art laboratory with well-trained and qualified staff.
KHF members gracing the delegation included Access Afya, Good Life Pharmacy, Pharm Access Foundation, F&S Scientific, Health Aid Chemist, Karen Hospital and Pharmaceutical Society of Kenya (PSK). A token of appreciation from KHF was presented to COSMOS by Dr. Robert Miano of PSK. Dr. Miano also read a speech from the KHF supply chain leadership team, which reiterated the big 4 agenda laid by President Uhuru Kenyatta. In his speech, Dr Louis Machogu pledges PSK’s total alignment of the sectors aspirations and opportunities into the Pharmacy Priority Agenda (PPA) 2018-2010.
Millions of Kenyan citizens still have limited access to quality-assured and affordable medicines to date. Even today, with increasing expansion of NHIF coverage, many people have to pay for their medicines out-of-pocket but lack the necessary financial resources to do so. With the rising burden of NCD and the reduction of donor funding’s, healthcare expenditures will become more expensive for the population, public and private health insurances and the public budget. KHF strives to promote local manufacturing through creating a better policy environment and strengthening public awareness and in turn reduce the cost of healthcare in Kenya.
The 5th Africa Healthcare Summit 2017 in London – Africa’s Largest Healthcare Event in Europe
The Oliver Kinross organized the 5th Africa Healthcare Summit which was held at Olympia London – United Kingdom, from 6th March – 7th March 2018. This business event provides high-level discussion and meetings into the investment opportunities and technology procurement requirements of Africa’s healthcare industry.
The event examined the latest healthcare developments across Africa, assessing current reform measures, and examining the impact of the huge investment boom that is currently forecast in Africa’s healthcare sector.
The event being the largest high level healthcare event in Europe, was well attended by more than 400 global leaders, senior level healthcare professionals, Distributors, Ministries of Health, Hospitals, Healthcare Providers, Solution Providers and decision makers from across Africa and around the world to gather and discuss on various crucial topics of the subject.
The summit held the Africa healthcare awards that recognizes excellence and achievements in the field of Africa Healthcare and dental provision. Moreover, the judges also awarded organizations that have made major contributions to the industry with new international solutions and technologies that have the potential to create innovation and catalyze development in Africa.
Dr. Amit N. Thakker, chairman of the Africa Healthcare Federation (AHF) and Kenya Healthcare Federation, received the award on behalf of AHF, for the most outstanding contribution to the African Health Industry.
In his remarks “Exactly 10 years after I founded Avenue Healthcare, I realized that the only way to optimize the role of the private sector is to have an institutionalized mechanism to engage government and promote robust public – private partnership programmes.”
Dr. Amit and Dr. David Parinyetwa, Minister of Health Zimbabwe during the awards.
East Africa Community Holds It’s 1ST Summit on investment in Health Sector
The East Africa Community held the 1st summit on investment on Health Sector in Kampala Uganda on the 21st February 2018, followed by Heads of state retreat on 22nd February 2018, which aimed at accelerating attainment of the objectives of the EAC development strategy, agenda 2063 and the sustainable development goals in the infrastructure and health sector.
The Summit discussed the Health Sector Investment Priority Framework (2018 – 2028) that was the product of a process of ministerial consensus. From the summit introduction by ministries of health in east africa countries, The hosting Minister, Hon Sarah Opendi, the State Minister of Health for General Duties, spoke of the importance of collaboration and shared commitments to achieve the ambitious targets in relation to HIV Aids, Tuberculosis and Malaria in the region. There is a historical view of treating health like a social goal, but it is an economic goal and therefore deliberate efforts must be made to improve quality and efficiency under the overarching goal to progressively attain universal health coverage.
The Cabinet Secretary for Health from Kenya, Hon. Sicily K. Kariuki highlighted the government’s commitment to scale up universal health coverage in Kenya during the term of the President (2018 – 2222) and beyond. She highlighted the opportunities in the health sector created by this vision ranging from technology to local manufacturing. The CS reminded attendees about importance of the health sector for the economy. Not only does the health sector affects all sectors by ensuring that there is a healthy workforce, the health sector can also attract local, regional and international investors to Kenya and the region. Hon Patrick Ndimubanzi, the State Minister of Public and Primary Healthcare of Rwanda touched on the importance of quality human resources for health and quality medicines and supply chain. Given the triple burden of diseases, Hon Ndimubanzi stated that the region would have to collaborate with the private sector to attain the region’s goals.
Hon Ummy Mwalimu, the Minister of Health, Community Development, Gender, Elderly and Children of Tanzania highlighted that maternal mortality rates remain unacceptably high in the region. Dr. Riek Gai Kok, the Minister of Health of South Sudan reminded the attendees that South Sudan was a young country which required additional support to be able to attain any of the goals set out in the priority framework.
The EAC Head of States Retreat
The East African Community Heads of State, their Excellences’ President Yoweri Kaguta Museveni of the Republic of Uganda, President Uhuru Kenyatta of the Republic of Kenya, President Salva Kiir Mayardit of the Republic of South Sudan, President Dr. John Magufuli of the United Republic of Tanzania, First Vice President Gaston Sindimwo of the Republic of Burundi, Hon. James Musoni and Minister of Infrastructure Republic of Rwanda representing President Paul Kagame held the Joint EAC Heads of State Retreat on Infrastructure and Health Financing and Development.
This was the first time, regional health sector priorities were discussed. The Framework is aligned with the E.A Vision 2040, the Sustainable Development Goals and AU 2063 commitments in relation to innovation, medical tourism, job creation, innovation and improved GDP through health investments. Dr. Delanyo Dovlo (World Health Organization) recognized the imminent need for these discussions since the cost of ill health is USD 2.5 trillion in East Africa in terms of loss of productivity. This can be cut by half if the SDGs are met.
Dr Amit N. Thakker (chairman Kenyan Healthcare Federation), addressed the EA Presidents to show areas where private sector investments could accelerate realisation of the priorities. He showed that a mix of infrastructure and workforce investments are required to reach the regional goals. Dr. Thakker stressed that universal health coverage should not be narrowed to insurance as this would exclude opportunities to include innovate medical plans such as risk pooling. A case study of the Health Act 2017 and medical plans in Kenya was used to illustrate what can be implemented to create an enabling environment for private sector engagement.
He recognized the imminent need to deal with beaurocracy to remove impediments to trade. His Excellency, President Museveni acknowledged that private sector involvement is increasingly important as the middle class continues to grow in the region. The Framework discussed and assented at the EAC Health Summit and Head of States Retreat show the political will to include the private sector in efforts to advance the regional health sector. A greater understanding of the priorities set out in the framework will allow Kenya Healthcare Members to align with the regional health policies.