‘Health regulations will be key focus in the Universal Health Coverage’
The health regulation and quality standards committee, of Kenya Healthcare Federation, held it’s first quarterly meeting for the year 2019, on 16th March 2019, at KHF offices, to outline 2019 focus areas. The meeting was chaired by Dr. Elizabeth Wala, federation vice chair, and the director representative for the committee. In her opening remarks, Dr. Wala reiterated that 2019 focus areas on regulations to be key in the Universal Healthcare Coverage (UHC)agenda. She noted that the Health Act and its implementation process was very slow in 2018, because it was overtaken by the UHC agenda and the supply chain concerns. In addition, she noted that efforts towards quality in 2018 focused more on the Kenya Quality Model for Health (KQMH) as a framework, yet other existing models that could be applicable in the health sector. She concluded by saying that this year this committee must set three achievable focus areas.
It was agreed that given that the Ministry of Health (MOH) is substantially mandated with the regulatory role, the committee should seek the ministerial input through the Ministerial Stakeholder Forum (MSF) meetings. Through the Business Advocacy Fund () grant, the committee agreed that prevailing challenges on quality and accreditation would be added to the BAF fund as key focus areas in advocacy. The committee’s key focus areas in 2019 include:Drafting a position paper on private sector’s position on Universal Healthcare Coverage (UHC)(This will ensure that the quality component is well defined implemented in UHC), rolling out of the KQMH, advocating on Kenya Accreditation Service (KENAS) accreditation process and spread the communication on Health Act Implementation.
Private health sector advocates for quality healthcare services and patient safety
Healthcare regulations and quality standards are aimed at ensuring that health services are safe, effective and of good quality, and that they are provided in accredited healthcare facilities by duly qualified health professionals.
The Kenya Healthcare Federation (KHF) health regulations and quality standards committee held a breakfast meeting at KHF offices on 16th August 2018. The meeting was chaired by the committee chair, Ms. Millicent Olulo. In their previous meeting, the committee had engaged Ms. Doris Mueni, Deputy Director, Kenya Accreditation Services (KENAS), to clarify on the functions of accreditation and certification bodies. She advised that accreditation ensures an organization is competent to perform specific functions in a reliable, credible and accurate manner, while certification is provided to mark compliance with a standard or specification. There are major benefits of accreditation such as quality improvement in internal operations, safeguarding credibility of results from conformity assessment activities, and improved market image.
There has been much engagement between Ministry of Health (MoH), Kenya Bureau of Standards (KEBS) and the Kenya Accreditation Service (KENAS) to see how to adopt the Kenya Quality Model for Health (KQMH) as national standards for quality and patient safety. It was noted that KQMH has been revised and piloted in four counties and that the next steps as outlined in the tool are roll out of adequate human resources for health, definition of the private sector’s and counties’ roles, establishment of clear road maps based on the pilot and assessment, making a sustainability plan, and identifying public – private partnership (PPP) opportunities for the private sector in implementing KQMH.
It was also noted that there should be discussions with MoH on the Universal Health Coverage (UHC) agenda, particularly on the following aspects: Whether it is prudent to solely rely on the National Health Insurance Fund (NHIF) to deliver UHC for Kenyans – would this compromise quality of care? Secondly, there needs to be a focus on quality assurance and a reliable supply chain. Ms. Faith Muigai urged KHF to have a strong position on quality of care. Ms. Muigai will develop a position statement to advocate for quality of care for UHC which will be presented to the Parliamentary health committee. There was a suggestion that Dr. Charles Kandie and Dr. Jared Nyakiba who deal with quality and safety policies at MoH be invited to the next committee meeting to enrich further discussions on accreditation of hospitals and patient safety.
The committee held elections of officials for a new term. Ms. Millicent Olulo and Mr. Antony Jaccodul were re-elected as chair and vice chair respectively. This was the first committee meeting under the directorship of the newly elected vice chair, Dr. Elizabeth Wala, and Director, Ms. Faith Muigai.
Health Regulations and Quality Standards Committee (HR&QS) engagement with Kenya Accreditation Service (KENAS)
In order to ensure delivery of quality and affordable Healthcare, a Healthcare Organization should be assessed and qualify for certification and accreditation. There has been a misunderstanding between accreditation and certification of an organization. Most Kenyans are not very sure on where to go for specific healthcare services, because once a Health Centre bares an accreditation or certification label only, does it indicate that it’s fully qualified to offer specific services? HR&QS Committee aims to clarify this while ensuring that Health services offered are of good quality as recommended.
This first committee meeting was graced by Ms Doris Mueni – Deputy Director KENAS, who clarify on the functions of the two bodies as; accreditation ensures that an organization is competent to perform specific functions in a reliable, credible and accurate manner, while certification means compliance with a standard or specification. There are major benefits of Accreditation such as quality improvement in internal operations, safeguard credibility of results from conformity assessment activities and improved market image.
Doris further clarified that KENAS does not accredit hospitals directly, but accredits certifiers of Hospitals e.g. Pharm Access offers certifications through the Safe care Programme, KENAS also does a conformity assessment test to vouch for competence on specific departments in different facilities thus do not accredit all departments. Below are some of the KENAS accredited facilities; 32 Medical laboratories (Government, Private, FBOs), 45 Testing and Calibration Laboratories, 7 Inspection bodies and 3 Certification bodies. KENAS also accredits these models to offer certification services as an assurance for quality and patient safety.
There has been a lot of engagements going on between Ministry of Health (MoH), Kenya Bureau of Standards (KEBS) and Kenya Accreditation Service (KENAS) to see how to adopt Kenya Quality Model for Health (KQMH) as a national standards for Quality and Patients safety. Doris clarified that National Hospital Insurance Fund (NHIF) certification is supported by the Medical board and Pharmacy and Poisons Board (PPB), using the KQMH standard and It’s best if certification is done by Independent bodies since NHIF certification is for rebates. Moreover, NHIF is not accredited by KENAS but can be certified by law.
A close out program on joint inspection was done on 26th February 2018 where a total of 2138 facilities both Public and Private were visited and inspected for the last one year during pilot phase. The Lessons learnt from this exercise, will inform Universal Healthcare Coverage. Patient perspective on quality will be incorporated in the next document to be developed. It was however noted that more inspectors will be needed and trained for the national roll out.
The Health Act 2017 key goal is to create a unified health system that aligns with the Constitution, by spearheading regulatory changes and coordinating the interrelationship between the National and County Government. This committee will represent the private sector on, Legislation &Regulations and Promotion & Advancement of Public Health/Lactation Stations.
The meeting was well attended by committee members namely; HUQAS, AAR Healthcare, Health Store EA, PSK and KENAS.