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.
Kenya Healthcare Federation (KHF) holds it’s second Members meeting at Four Point Hotel by Sheraton – Hurlingham
Kenya Healthcare Federation held its second members meeting on 22 march 2018, at Four Points Hotel by Sheraton in Hurlingham. The meeting was chaired by Dr. Amit Thakker -Chairman KHF, in his opening remarks, he advised the members to pay key attention on various presentations so as to obtain the ‘HOW’ to unlock partnership with the Counties. This is because counties have been allocated Ksh. 191Million and 88% of it is allocated to Healthcare. He further emphasized that each county is to present a Business Case for Healthcare which should be used by the year 2020 and tripled thereafter.
The meeting majorly focused on updating the members on the Kenya Coordination Mechanism (KCM) progress with the Global Fund (GF). GF has been working with Kenya Coordination Mechanism (KCM) whose mandate is to mobilize funds from the GF for HIV/AIDS, Tuberculosis & Malaria programmes & to coordinate and evaluate implementation of the global fund grants. HIV /AIDS, Tuberculosis (TB), and Malaria are three major global Public Health threats that undermine development in many countries worldwide. Close to five million people die every year of these illnesses with substantial humanitarian, economic and social impact.
GF as a financial institution, provides support to countries in response to these three diseases. However, it’s main purpose is to increase resources to fight these diseases and to direct those resources to areas of greatest need.
GF granted Kenya towards fighting these diseases or bring them under control. From this grant, the 2017 – 2022 strategy was drafted which will majorly focus on maximizing impact against HIV,TB and Malaria, build resilient and sustainable systems for Health, promote & protect human rights & gender equality and mobilize increased resources.
Kenya has made a great effort towards fighting these diseases. In that, The Ministry of Health (MOH) has prioritized the fight against, these diseases and remarkably, has continued to meet its obligation of GF co – financing requirement of 20% more to this, patients are able to access diagnostic treatment & prevention services and commodities for these diseases at no cost. The National Government has allocated Ksh. 10.2 Billion to support intervention of these diseases in Kenya for the year 2018 – 2021.
KHF Committees updated the members on their progress where they presented their progress since laying down the strategy during their 1st meeting of the year. The Human Resource for Health (HRH) Committee emphasised on strengthening the HRH because “Strong workforce will be the driving power to achieving quality and affordable Healthcare” Kennedy Auma – KHF – HRH Committee Chair. However, the committee will focus on Harmonizing and recognizing professional bodies in Kenya,Outline clear schemes of services, for both standardization and stuffing norms, for development and approval stages for all the cadres, Work with Multi Stakeholder Partnership to acquire data on specialized/neglected cadres (not recognised by ministry) focussing on Emergency Medical Care (EMC),Health Records and Information Officers (HRIOs),Community Health Volunteers (CHVs) and Develop a good relationship with the Council of Governors (COG)
The ICT and Mobile Health Committee will majorly focus on ensuring that Healthcare ICT space is an enabling environment for solutions, Understanding regulation i.e. educate stakeholders, create awareness of the existing regulations and share available data, Engage the regulators, associations, insurers, providers and suppliers, Analyse e-Health strategy policy guidelines by MOH – ICT unit and participate in the Health Act 2017 implementation process. More to that, the committee will make access to information easier, Increase access to health using ICT and approaching the MOH as an organized group representing the private sector voice.
The Public Private Partnership (PPP) Committee will prioritize identifying suitable PPP models, Engagement in PPP Act to understand indepth what PPP entails and pursue an Engagement with County Health Government.
The Healthcare Financing Committee (HFC) will major on Universal Health Coverage, Capacity building and Payer provider relationship. The committee will ensure that under Universal Health Coverage, All people and communities have access to quality essential Healthcare services that is affordable without financial strain.
The supply chain will venture more effort on pushing the support of Local Pharmaceutical Manufacturers. “Non Communicable Diseases are on the rise and majority of the patients are not able to keep up with the medication because they are costly Kenya has capacity to produce good quality medicine but still imports more than 80% of medicine at high prices. This imports are of sub-standard quality. Local manufacturing is one of the presidents big 4 Agenda and this local medicine will be 5 times cheaper than imported medicine and of better quality. However, Public hospitals import branded instead of generic products yet Local Manufacturing is the solution to make medicine cheaper in Kenya.” Rolando Sateke – CEO Cosmos.
The Health Regulations and Quality Standards Committee (HRQS) emphasised that there has been a misunderstanding between accreditation and certification of an organization. Kenya Healthcare Federation aims to clarify this while ensuring that Health services offered are of good quality as recommended. Through Doris from Kenya National Accreditation Service(KENAS), HRQS was able to clarify on the functions of the two bodies as; accreditation ensures that and 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.
There was a joint agreement on improving and strengthening insurance especially NHIF to ensure all citizens are covered irrespective of their geographical location and financial status. Moreover, members suggested that there should be equal distribution of medial specialist in all 47 counties, this is because many specialist doctors are concentrated in Nairobi County hence the patients have to travel to Nairobi to seek specialist medical attention and better medical investigation such as X-rays and Laboratory.
Many patients are not able to access specialised medical attention because the medical specialist are concentrated within Nairobi. This becomes strainous because they have to travel and incur a lot of expenses moreover, there are less medical equipments for X-rays and Laboratory, this forces the patients to travel to Nairobi for better diagnosis.
The meeting was well attended by 77 members, who included KHF member, CECs and Development partners.
5TH Annual Devolution Conference 2018
The 5th Annual Devolution Conference – 2018 took place at Kakamega High School in Kakamega County from 23rd to 27th April 2018.The conference was hosted by the Council of Governors in partnership with the Ministry of Devolution and Arid & Semi-Arid Land(ASAL), the Senate, the County Assemblies Forum and other stakeholders .The conference brought together 6,000 people from different sectors such as; Health, Trade, Agriculture, Urban Planning & Infrastructure, Private Sector, National and County Government representatives and Members of the Public.
The Conference also focused on the president’s Big four Agenda where there were break out session to
Discuss more on Health, Trade, Agriculture and Urban Planning & Infrastructure where there was impactful contribution from the members of the Public, and Private Sector. All sessions were chaired by the Cabinet Secretaries (CS) or Principal Secretaries (PS) from the various Sectors. In attendance was the CS Ministry of Trade, Industries and Cooperatives Mr. Adan Mohamed, CS Ministry of Energy Mr. Charles Keter, PS Housing and Urban Development Mr. Charles Mwaura, the PS Crop Development, Dr. Richard Lesiyampe, PS Irrigation Fred Sigor, the PS ASAL Mr. Michael Powon, the PS Devolution Mr. Nelson Marwa, the Chief Administrative Secretary Ministry of Health Dr. Rashid Aman and the PS Health Mr. Peter Tum among many others.
There were plenary sessions which Portrayed strong political will, to ensure that the Big 4 National Agenda is achieved and to demonstrate the political commitment to Devolution. Deputy President, William Ruto emphasized the importance of the Big 4 Development Agenda which will transform Kenya. The Big 4 agenda will also help deepen Devolution and benefit all Kenyans. He reiterated that partnership will be very key in achieving the big 4 Agenda.
The President in his speech emphasized that Health is very key in the big four Agenda “We aim, by 2022, to give every family in the Republic access to Affordable Healthcare. Again, this is no small task and it will require a reimagining of the status quo. In defining this aspiration, I recognize that County governments are at the closest point of inflection when it comes to the provision of Health services at the grassroots.
There will be the hard work of financing this dream and restructuring all the institutions critical to its success. We will have to improve the quality of our facilities and manage the cost and quality of drugs; we will also have to train and recruit more Doctors and Nurses. Equally, all of us will have to work together to fit existing programmes into the new plan. Still, the work will be well worth it. A win in Healthcare today is a decisive win for generations to come.”
The PS for Health Peter Tum expressed an overarching vision of affordable Healthcare as captured in the Kenya Health Policy 2014 – 2030. He emphasized that the Ministry of Health has scaled up their interventions in order to be able to achieve the goals set out in the policy. Already, such interventions have led to reductions in maternal deaths. He briefly reminded the attendees that the Universal Healthcare Coverage pilot program would be held in 4 Counties, namely, Nyeri, Kisumu, Machakos and Isiolo. The lessons from this will determine the way forward in relation to the Universal Healthcare Coverage Agenda.
Prof. Khama Rogo from the World Bank stated that for interventions to be successful, the difference must be made at County Level. For instance, we should allow training for Human Resources for Health to be implemented at county level. He emphasised that Universal Healthcare Coverage will be achieved when we capitalise Devolution.
Kenya Healthcare Federation (KHF) represented the private Health sector through the attendance of Dr. Amit Thakker – Chairman, Dr. Jacqueline Kitulu – Director, Ms. Faith Muigai – Director, and Dr. Peter Kamunyo – Director.
There was a session on ‘Critical Enablers for Optimizing Health Sector Performance’ where Dr. Amit Thakker – Chairman – KHF was part of ‘’ panel in this session. In his remarks, he highlighted that the private sector contributes a lot in the Healthcare and will continue to advance the Health Sector in Financing; Innovations such as Telemedicine; Stakeholder engagement and Healthcare service delivery. Sanda Ojiambo from Safaricom added that the Big 4 agenda provides great opportunities for transforming Business.
There were booths where the attendees displayed their products and services. Moreover the KHF members who showcased the organization’s products and services at the booths were; Management Science for Health, Pharm Access Foundation, AMREF and Philips.
The Devolution Conference was well attended and gave all the relevant stakeholders a platform to engage on important issues in relation to key sectors. KHF was able to engage with Government officials and showcase the importance of private sector contributions to the Kenyan Health sector.
The Deputy President Willam Ruto closed the meeting by appreciating the attendees for their unified effort towards Devolution. “I would like to pay tribute to all of you for your devotion to the success of Devolution. Rest assured, you have a strong supporter of Devolution in this Administration. Let us all define our leadership through service, work, and delivery. The magic of Devolution, after all, is in service delivery. That is what Kenya needs; that is what our people need. By the time this leadership term is over, we will be celebrating 60 years of self-rule. We are the ones with the power to ensure that we have something to show for that time.”
UNIVERSAL HEALTHCARE CONFERENCE IN MAKUENI
There is precedent for moving Kenya towards Universal Healthcare Coverage. The Kenyan Constitution states that every Kenyan has a right to quality and affordable health care and recognizes the role of the government in removing barriers to access. This was recently affirmed in Sessional Paper No. 7 of 2012 on Universal Healthcare Coverage. The Government‘s commitment to providing Healthcare for all of its citizens is clearly moving in the right direction.
From researches conducted on Healthcare provision in Kenya, it has been pointed out that provision of Universal Health Care Coverage has its challenges such as; shortage of government budgetary resources, corruption, weak Health Systems, high poverty levels, reaching vulnerable people, selecting the right package of benefits, Integration of the informal sector and poor distribution of Human Resources for Health.
Makueni County held a two day conference on achieving Universal Healthcare Coverage from 4th to 5th April 2018 in Wote – Makueni.
The conference brought together different Health Sector Stake Holders to address this challenges and to strategize on a firm structure that will be implemented and adopted in all the counties towards achieving affordable and quality Healthcare for all Kenyans (President’s big four Agenda).
“Kenya Healthcare Systems needs to restrategize because the population is growing at high rate, this means that if the Healthcare systems and Human Resources for Health is not revisited and strengthened, Kenya may not be able to access Quality and affordable Healthcare.
He reiterated that the Government should strongly embrace Preventive (Immunization) Health care other than Curative Healthcare. He also emphasized that community Health Workers play a major role in Primary Health care especially in preventive care therefore, they should be recognized and strengthened while revisiting the Health Systems in Kenya.’’ Siddharth Chatterjee – United Nations Development Development Programme resident representative to Kenya.
Dr. Amit Thakker – Chairman Kenya Healthcare Federation reaffirmed that Strengthening Health Cadres especially Community Health Workers will be very key in achieving Universal Health Care. However, He said that the private sector is ready to work with the counties especially offering pro-bono services to support putting up structures that will see implementation of Universal Health Care.
Professor Kibutha Kibwana – Governer Makueni County, affirmed the attendees that change of mindset and being optimistic that with the right structures and support from the Health Stakeholders, UHC can be achieved. If this is implemented in Makueni County, then this can be adopted to other Counties and in the National Government.
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.