Eighth Ministerial Stakeholder Forum
The 8th ministerial stakeholder forum was held on 25th June 2018 at the Afya Annex, Kenyatta National Hospital from 11:00am – 3:00pm. The meeting brought together different health organizations including; Ministry of Health, Kenya Healthcare Federation, Faith based Organization and Kenya Private Sector Alliance, to discuss the Health Agenda.
The Cabinet Secretary for Health, Mrs. Sicily Kariuki chaired the meeting and in her opening remarks, she brought to light that the Presidential Round Table (PRT) meeting that took place in April 2018, showed that the H.E President Uhuru Muigai Kenyatta, wants concrete and tangible proposals, to show that the health sector is well planned.
She moreover said that the level of preparedness expected was not met. Therefore the next meeting must show that the health sector has planned and agreed upon tangible strategies.
“As Ministry of Health, we recognize the ambitious task ahead of us to achieve Universal Health Coverage and we know the requirements in terms of time and resources cannot come from government alone. Therefore, this is where the dialogue around Public – Private Partnership (PPP) is important and we should consider the future of PPPs in this sector. It is important that there is one side from the private sector. We have gazetted a Benefits Advisory Panel to come up with costs and packages. The role of the private sector will be stakeholder engagement. ”Mrs. Sicily Kariuki – Cabinet Secretary – Health.
Dr. Amit Thakker – Chairman Kenya Healthcare Federation Concurred with the CS where he emphasized that Inclusiveness is important as Ministerial Stakeholder Forum is made the epitome of Non-State Actors. “South Africa is in a similar policy position as Kenya where they want to achieve quality and affordable healthcare for all and they are very keen to learn from what we are doing.” Dr. Amit Thakker.
Dr. Elkana Onguti updated the attendees on the progress of Health Act 2017 Technical Working Groups, where he said that the roadmap for implementation of the Health Act 2017 will be produced in two weeks-time.
The Ministry of Health had asked the regulatory bodies to share their costs which seemed abit cumbersome because of the number of regulatory bodies. However, Dr. Thakker advised that there should be a comprehensive fee, which will be more efficient than paying each regulatory body and make it easier to operate in the counties. Moreover he emphasized that there are currently seven fees to be paid and this seems tedious.
“Multiplicity of the organizations in the Ministry of Health, requires different fees but this needs to be balanced with efficiency. The Health Act 2017, should address the element of time management through overarching regulatory bodies. We need to phase out operational bills to the exchequer so that we are only dealing with registration costs. However, this is not the only factors that are causing high costs in the sector and we need to be less inward thinking.” Mrs. Sicily Kariuki-Cabinet Secretary – Health.
“We need to think of the cost of drugs and the cost of medical devices.” Anne Wamae
Dr. Louis Machogu – Pharmaceutical Society of Kenya, brought out that in the last Presidential Round Table, the issue of fraud was discussed which increases the cost of pharmaceuticals products. He however suggested that there is need to discuss self-regulation for instance in terms of price mark-up control and ensuring that ‘quaks’ are tracked down. “PSK Kenya would like to report on self-regulation in this meeting and take responsibility.”
The CS applauded this where she said that the fraud is happening in genuine clinics there is need to deal with this, with a sense of urgency.
The CS concluded by asking the attendees to revisit the PRT slides and pullout what is operational and strategic. “Let’s take out the operational tasks. Tell us the HOW rather than the WHAT.” Mrs. Sicily Kariuki-Cabinet Secretary – Health.
She emphasized that the next presentation should reflect on; bringing the most value in the service delivery space, the changes should bring more jobs and investments, reflect the opportunities that will be unlocked with this particular action and identify the assistance need from Ministry of Health to make the tasks concrete.
The meeting was well attended by a total 30 people from Ministry of Health, Kenya Healthcare Federation (Private Health Sector), Faith based Organizations and Kenya Private Sector Alliance.
Eighth Presidential Round Table
Kenya private sector alliance held the 8th presidential round table at statehouse Nairobi on 10th May 2018, under the chairmanship of H.E President Uhuru Kenyatta. This was the first presidential round table for the year 2018. The major focus was on the BIG 4 Agenda with an objective of structuring the way forward to strengthen private sector participation. This being the second and last term for President Uhuru Kenyatta, provided and opportunity for the private sector, to align it’s business Agenda with the government Agenda to enhance collaboration towards common goals.
The meeting was moderated by Mr. Waita Nzioka, chief of Staff who welcomed both the private sector and the government for very informative and enlightening discussion. This was also reiterated by Cabinet Secretary, Ministry of Industry, Trade and Cooperatives Hon. Adan Mohamed.
Ms. Carole Kariuki – CEO KEPSA introduced KEPSA to the attendees where he highlighted the improvements achieved through the partnership with the government to improve the business environment and the path to ranking position 50 and below on the Ease of Doing Business from the current position 80. She however highlighted that the private sector has put a major focus on an economy led transformation towards realization of the Vision 2030 goals.
Ms. Kariuki mentioned that the BIG 4 Agenda presents numerous opportunities for private sector investment including SMEs and therefore the need to strengthen the engagement and partnership with the government through the various Public Private Dialogue (PPD) platforms towards unlocking these opportunities.
‘Implementation of BIG 4 Agenda, will see many job creation’ this was the presidents directive while vision casting the BIG 4 Agenda for his second and last term. Mr. Macharia – KEPSA Chair, ICT sector board presented overview of the Ajira Digital Project whose Vision is to create 1 million online jobs through training and mentorships owing to growing demand among the youth for online jobs. 7,168 youth had been trained on the Ajira Digital project in 2017. Mr. Macharia emphasized the need for partnership between the government and the private sector in developing the skills required for the BIG 4 and development of jobs with long term sustainability at the local level (Ajira Mashinani). He proposed creation of jobs portal for mapping available skills, job experience and the job markets to enhance linkages.
Ms. Flora Mutahi, chair – KAM highlighted the current situation of the manufacturing sector noting declining growth (at 3%) and low contribution to GDP which currently stands at 8.4%, low value addition, low cadre jobs creation. The main bottlenecks constraining manufacturing competitiveness include high energy costs, Import Declaration Fee (IDF) and Railway Development Levy (RDL) taxes on raw materials, low labour productivity, delayed payments, multiple charges, inefficient logistics and low access to affordable credit all which affect firm level competitiveness. In accessing markets, the main challenge is illicit trade and poor access to local markets, regional and global markets. At policy level, the main hindrance to manufacturers is the lack of predictability due to ad-hoc policies.
The meeting majorly focused on how to improve the manufacturing industry that will also see many job creation. Some of the proposed pointers for improving the manufacturing industry were; Provide Quality and Affordable Energy, Removal of IDF & RDL from raw materials, industrial input and machinery and increasing them imported finished goods, Low industry labour productivity, Delayed payments, Ad-hoc Policy Processes disrupting manufacturing, Global Market – create market access, Ensure trade flows as per EAC Protocol on Rules of Origin awaiting verification, Purchase minimum 40% & publicly report especially on Big Four Agenda contracts.
It was agreed that in the next PRT meeting, Affordable housing will be the main Agenda, hence all the key players to prepare their presentations. Affordable Healthcare will be discussed in the third PRT meeting while food security will be the last one.
Ms. Carole Kariuki – KEPSA CEO highlighted the five key areas that are of deep concern to the private sector in the implementation of the BIG 4. These include: Access to clean affordable and reliable energy; Governance (dealing with corruption, bribery, impunity and wastages); improving the business environment in Nairobi county which contributes 60% of the country’s GDP and sets the pace for other counties, enhancing access to affordable finance for businesses especially SMEs; comprehensive review of the PPP Act, and improving policy environment predictability. The CEO noted that resolving these issues would be a crucial enabler to enhance private sector participation in the BIG 4.
The Chairman appreciated the government led by His Excellency for meeting the private sector for the 8th Presidential Roundtable to resolve the business issues that may hinder private sector participation in the BIG 4. He took note of previous engagements with the President and MSFs that had led to great success in resolving issues presented in the NBA-II. He called for more collaboration and partnership in implementing the third NBA and the BIG 4 Agenda. Addressing corruption which is the biggest challenge at present, policy reforms to improve the business environment to position 50 and below, digitization of government systems, adoption of modern technologies (Block chain, Artificial Intelligence, etc.), addressing the obstacles to business competiveness such as access to reliable, clean and affordable energy, access to financing and market linkages are some of the areas that need to be prioritized. The chairman proposed that MSFs be held every 4-6 weeks and not more than eight weeks to resolve various business issues.
In his closing remarks, president noted that the leaders present at the PRT were the only ones with the capacity to make a difference for the rest of the Kenyans. He noted that the government cannot achieve its objectives alone but rather with the support of the private sector.
The president emphasized on the need for collaboration in fighting corruption, and inaction by leaders. “it is up to the government and the private sector to say we have reached an end to this problem” he said.
He urged everyone to avoid shortcuts, expressed his government’s commitment to creating an enabling environment for genuine business to thrive and urged everyone to report all incidences of corruption through the hotline “0791333222” which he committed to personally follow up and act.
President Uhuru asked the leaders to help the government in facilitating the private sector to help grow the country and achieve the BIG 4 agenda.
He noted that the 8th PRT was a start; continuous engagement will focus on finding solutions to getting manufacturing contribution to GDP to 15% from the current 8.4%. The Cabinet Secretaries and other government leaders were reminded that they were entrusted with running their offices on behalf of the government and any failure would not be tolerated.
The meeting was well attended by Cabinet Secretaries, Chief Administrative Secretaries, Principal Secretaries, leaders of State Agencies and private sector representatives.
HEALTHCARE FINANCING COMMITTEE CONTRIVES ON DELIVERING UNIVERSAL HEALTH COVERAGE
The healthcare financing committee held a dinner meeting on 31st May 2018, at Pride Inn Hotel to strategize on how to deliver UHC from the Private health sector perspective. The committee strategy is also under the BAF project that was granted to KHF for advocacy. The dinner meeting being chaired by Dr. Walter Obita, took three hours and was very intense and informative. In his opening remarks, he highlighted that the committee has been tasked to lead universal health coverage within KHF.
Dr. Obita reminded the attendees that Universal healthcare basically looks at quality healthcare, accessibility and reduction of out of pocket expenses while accessing health services. He further reiterated that KHF fully supports UHC which is part of H.E President Uhuru Kenyatta’s BIG 4 Agenda number 4, Affordable Healthcare. KHF’s approach is to have both private and public health providers to be able to offer this care because there will be cross – referrals and the patients should be able to access this care. There was a suggestion on an engagement on risk pooling mechanisms to ensure agreement on the type of what mixed methods that can be used in order to reduce exposure on both public and private insurance insurance companies.
One of the agendas floated was to have the private Insurers be the first to insure claims for the patients to access care followed by National Hospital Insurance Fund(NHIF). KHF agreed that there should be a benefit package that should be used by the patients when they seek care. This provides an opportunity for the private insurance companies to assess the gaps within NHIF so as to develop a benefit package that addresses these gaps. There was also a suggestion that we should have a health benefits regulatory body that can provide an oversight for both NHIF and private insurers. This will provide an enabling environment for both public and private insurance, increase accountability and have transparency.
This intitiative will enable innovations to look into health financing that can be introduced in the counties, and enable citizens to access healthcare at an affordable rates. For example Makueni County Healthcover where each house hold is supposed to pay Ksh.500.00 to access care with no additional cost. The benefit package should also concentrate on primary healthcare.
Dr. Amit Thakker – KHF Chairman highlighted that KHF has started County Stakeholder forum which is under the BAF project and is focusing on healthcare financing towards achieving UHC. So far KHF has covered two counties successfully and has a plan to cover seven counties. There was an agreement that NHIF should be advised to pay first key focus on the poor in the society.
The meeting was well attended by Amref healthcare, Fountain Healthcare, Carepay, Business Advocacy Fund, Access Afya, Association of professional coders, Health store east Africa, The Nairobi Hospital, Jubilee Insurance and KHF secretariat.
Kenya Healthcare Federation (KHF) 3rd Bi-Monthly Members Meeting.
Kenya Healthcare Federation held the third bi-monthly member’s meeting on 30th May 2018 at Kenya Private Sector Alliance – Shelter Afrique Building, Nairobi, from 2:00pm to 4:00pm.The chairman Dr. Amit Thakker, started off the meeting by welcoming all the member, new KHF members, guests and partners to the meeting.
The meeting reported on active Mininsterial Stakeholder Forum(MSF) involvement following the 2018 focus areas. KHF has officially been include KHF in the Health Act 2017 Implementation Committees and an introduction of overarching regulatory authority for medical plans (Health Benefits Regulatory Authority).
A major focus was put on presidential round table (PRT), where Dr. Thakker updated the attendees on the current position of Presidential Round Table(PRT). KEPSA has held three Presidential Round Tables focusing was on the BIG 4 Agenda, the private sector presented on their key role they’ve been mandated concerning the big four agenda. There was an emphasy that corruption is a major setback while delivering the big four agenda and this needs to be addressed and H.E President Uhuru Kenyatta reiterated that he is not going to spare any details on the BIG 4 agenda because that’s his major focus for social economic till 2022.Manufacturing was first pillar that was discussed where it was given much time and attention .one of the key areas that will be focused on in manufacturing is regulations.
It was agreed that affordable housing will be the second one, Affordable healthcare will be third and food security will be the last one. While focusing on Public-Private Partnership, it was noted that there has been a mismatch on the role of government and private sector where both sectors don’t have a clear understanding of their functions. This has been a major setback for growth and function of Public Private Partnership and hinders the growth of GDP. Dr. Thakker emphasized that the major gap while enhancing PPP growth is the lack talent in both sectors. Dr. Thakker however, informed the attendees that he had a discussion with the Health CS Mrs. Sicily Kariuki where he suggested that the communication strategy should be revised because the current one is very weak.
There was a clarification on the health agenda where it has been mistook that the health agenda states “Achieving universal Healthcare” but the correct one is “affordable healthcare for all” where the ministry of health looks at scaling up NHIF in order to reduce out of pocket by Kenyans while accessing quality and affordable healthcare. KEPSA highlighted that it’s important to put the poor at the fore front while strategizing and delivering quality and affordable healthcare. Kenya Healthcare Federation was asked to prepare and present a strategy on how the private health sector will contribute towards achieving Universal Healthcare.
(KEPSA) has put together five key areas to focus on while preparing for the next PRT as follows, the private sector must speak with a unified voice as it pushes its agenda at the Presidential Round Table(PRT), Ministerial Stakeholder Forums(MSF) and other Public Private Dialogues(PPD) platforms. KEPSA leaders to support and engage in the BIG 4 pillars in the preparatory activities so as to get tangible business priority issues tabled at the roundtable. The key Public-Private Dialogue Engagements that KEPSA has prioritized within the next month that all feed into PRT include: Judiciary Roundtable, Speakers’ Roundtable and Council of Governors.
The structure of the next PRT presentations to mirror the BIG 4 McKinsey document already prepared by the government, Identify specific industries that will deliver on the agenda. What private sector will deliver, Specific challenges, the interventions we are seeking from government, the impact on jobs, sector growth projection, enterprises to be created and a quantum of additional investments.
KHF has organized County Stakeholder Forum (CSF) for Health that will engage seven counties namely: Kirinyaga, Mombasa, Nairobi, Uasingishu, Kisumu, Makueni and Isiolo.The aim of the forum is advocacy towards achieving Universal Health Coverage, where KHF is directly engaging the CECs to advise on what should be put in place inorder to achieve UHC. During the county engagement, it was well noted that the counties have been focusing on primary Health Care. Dr. Amit Thakker highlighted that if the County Stakeholder forum is well implemented there will be an improvement in the delivery of quality and affordable healthcare.
The Nation Media Group presented on upcoming National Leadership Forum Themed: Universal Health Care, which will take place on 5th July at University of Nairobi Auditorium. Mr. David Aduda from Nation Media Group highlighted on the importance of KHF participating in the Forum in order to present a unified voice of the private health sector.