10TH Ministerial Stakeholder Forum
The 10th Ministerial Stakeholder Forum took place on 26th February 2019 at the PanAfric Hotel, Nairobi. The Cabinet Secretary Health Hon. Sicily Kariuki chaired the meeting with the Chairman of Kenya Healthcare Federation, Dr. Amit N. Thakker as the co-chair. The forum took place immediately after Hon. Sicily Kariuki inaugurated the NHIF Reforms Expert Panel. In her opening remarks, the Cabinet Secretary (CS) welcomed the attendees emphasizing that the government still holds the vision of a more efficient, socially accountable and a transparent NHIF. The CS said, “As you are all aware, to kick-start the Universal Health Coverage Program, the President launched the UHC Pilot Programs on 13th December, 2018. Further to the pilot program and as part of the UHC agenda, His Excellency Uhuru Kenyatta directed the strengthening and reform of the National Hospital Insurance Fund (NHIF) and the Kenya Medical Supplies Authority (KEMSA).”
The CS informed the attendees that through intensive stakeholder engagement and expert review, the independent panel of experts would be required to develop an action plan for the key objectives of the panel. The panel of experts will focus on legal and regulatory reforms towards transforming NHIF to be a strategic purchaser of health services in the context of UHC, organisational and business process re-engineering reforms aiming at repositioning NHIF as a national social health insurance provider and strengthening fiscal and social accountability and sustainability. The Ministry of Health (MOH) will continuously engage the media to keep stakeholders updated. During the forum, the CS reiterated that MOH would continue working together with the private sector especially in strategizing towards achieving the UHC. She challenged the private sector to ensure implementation of action points discussed while being sensitive to timelines.
Dr. Amit N. Thakker congratulated the CS for inaugurating the NHIF Reforms Expert Panel noting the steps the MOH is taking toward reforms under the leadership of the CS. The KHF Chairman said, “The steps you have taken shows the public that you are serious about reforms. The 90 days timeline [for recommendations from the NHIF Reforms Expert Panel] will give good time to NHIF to make progress towards taking it the next level. It’s also great to hear that the same reforms process will be done for KEMSA”. Dr. Thakker advised the CS that the private sector would continue working with the pilot counties on three key focus areas. The first is the supply chain of medicines and non-medical health commodities where private sector will collaborate in ensuring that the supplies are available, affordable and of good quality. The products will include both locally produced and imported products. Secondly, the private sector will support in healthcare financing by expanding private medical insurance coverage to the pilot counties to complement UHC thereby enabling provision of wider coverage and higher quality of care. Lastly, on the matter of strengthening local referral systems, he informed the ministry that the private sector could help build local clinical capacity in the county referral hospitals effectively reducing the cases referred to Kenyatta National Hospital, Moi and Teaching Referral Hospital and other national referral hospitals. The KHF Chairman, Dr. Thakker, and the entire KHF fraternity congratulates our KHF director, Ms. Joyce Wanderi on her appointment into the NHIF Reforms Expert Panel by the Cabinet Secretary Health Hon. Sicily Kariuki.
The forth Speakers round table
Kenya Private Sector Alliance(KEPSA) held the forth speakers round table meeting at Leisure Lodge, Diani, Ukunda, on the 5th October 2018.The Speaker’s Roundtable (SRT) happened between the National Assembly and the Kenya Private Sector Alliance (KEPSA) and is one of the high level Public – Private Dialogue(PPDs) that was formed and formalized under the 10th Parliament. In her opening remarks, Ms. Carole Kariuki, KEPSA CEO, thanked the speaker and members of the National Assembly for the engagement with the private sector. She noted that KEPSA makes efforts to meet parliamentarians once elected, to enable them understand the private sector and continue engaging through parliamentary departmental committees to provide input into key policies and legislations.
Ms. Kariuki further noted the government’s focus on the Big 4 Agenda and emphasized on the need to work together to achieve the ambitious plan in the shortest time possible. She called for a change in tact and a need to re imagine Kenya through legislative partnership. She added that to spur manufacturing competitiveness, some of the underlying impediments that need to be resolved include; reducing energy costs, curbing proliferation of illicit trade and cheap imports, removal of IDF (Import Declaration Form Levy) and RDF (Railway Development Levy) on industrial input and machinery as well as enhancing prompt payments to suppliers. Through partnership with the National Assembly, she expressed optimism of achievement of the Big 4 Agenda.
The Speakers’ Round Table, under the leadership of the Speaker Hon. Justin Muturi, had some key areas of focus ranging from policy to revenue management to engagement with the private sector engagement. To note a few, the agenda included outlining recommendations and strategy for the conclusion of the list of policies, laws and regulations in the areas of revenue generation, debt management and effective taxation. They also sought to enhance the quality of policy and governance to facilitate a conducive business environment to create jobs and wealth in order to bring inclusive prosperity. Further, the Speakers’ Roundtable aimed to increase uptake and adoption by parliament of key private sector recommendations on the legislative agenda as identified by private sector and to increase coordination between the legislature and private sector on legislative agenda needed to drive the Big Four development agenda and to unlock private sector investments.
The National Assembly Speaker Hon. Justin Muturi applauded the crucial role played by the private sector in the economy as the engine of growth, creating jobs, paying taxes and providing essential goods and services. He said that interactive planning and decision making processes would be needed to support the private sector participation in development and foster partnerships strategies that combine skills, resources and ideas to stimulate the economy, enabling it to respond innovatively to national and global economic changes.
The speaker noted KEPSA’s continued provision of a unified voice for the private sector and maintaining focused efforts to create impact on wealth creation and social economic development. On the other hand, the SRT would provide an opportunity to highlight the key issues affecting public and private relationship and give the National Assembly a chance to identify areas of intervention to create an enabling environment for private sector development and increased investment. It would also act to enhance oversight of the executive to ensure all budgetary proposals are scrutinized and implemented as approved with ensure integrity, ethical values and the rule of law as well as promoting action-based best practices like corporate social responsibility, conservation and protection through prudent use of the country’s natural resources
During the breakout sessions, there were major discussions on universal health coverage (UHC) conducted by Hon. Sabina Chege, the chairperson of the Health Parliamentary Departmental Committee. Kenya Healthcare Federation was represented by Mr. Anthony Jaccodul, Vice Chair of the Health Regulations, Quality and Standards Committee. In his remarks he said that provision of universal health care in Kenya will not only accelerate progress towards vision 2030, but will also lead to realization of Sustainable Development Goal 3 of ensuring healthy lives and promotion of well- being for all the ages. There is therefore need for a whole systems’ approach in the delivery of UHC Mr. Jaccodul also presented KHF’s position statement on which includes; UHC should be implemented and monitored basing on quality indicators that can be measured by accredited Health Standards for Quality, Facilities to adopt both nationally and international accepted patient safety and quality standards e.g. Kenya Quality Model for Health (KQMH), Safecare, Joint Commission International (JCI),The sole government agency handling quality that is KENAS needs to be brought on board to ensure quality of care conversation does not get lost, KENAS would accredit conformity assessment bodies to implement various standards available in the industry, This would also provide a space for continuous quality Improvement, National Hospital Insurance Fund(NHIF)restructuring regulations to various sections of the Health Act 2017 should be drafted and guidelines adopted to ensure this moves in tandem with UHC.
The discussions were rich, informed, and resulted in several recommendations. There is need for a holistic approach to Universal Health Coverage. In addition to financing , we should focus on human capital, better health infrastructure, value chain efficiency, lower cost of medical equipment, standards for health services delivery and enhanced access to quality healthcare, policy on harmonization of pricing of health services to be developed and a review of work schedules in public hospitals to tackle the problem of shortages. There would also be need to evaluate of the Managed Equipment Service Program by the MOH to establish reasons why some of the critical equipment are lying idle and that the NHIF coverage in schools should be standardized to cover all students in both public and private schools including issuance of the NHIF card. The Hospital referral system should be strengthened to the lower tier county run hospitals to reduce burden on Kenyatta National Hospital and Moi Teaching and Referral Hospital. It’s important to strengthen the private sector for curative healthcare while public sector focus on preventive and promote health services. A health summit for all the health leaders including the Health Parliamentary Departmental Committee, Governors, County Executive Members and the private sector was proposed.
The legislative recommended the fast tracking of the Health Laws Amendment Bill 2018 ,by the house business Committee to the committee of the whole house. This bill will promote local manufacturing of pharmaceuticals and medical equipment to tackle influx of illicit trade in Kenya. National Hospital Insurance Fund (NHIF) Bill to be brought to Parliament soonest so as to address governance issues i.e. separate accreditation and financing role of NHIF, Issues of quality management should be assigned to Kenya National Accreditation Service (KENAS) to accredit healthcare facilities and Ministry of Health MOH to oversight policy, Ministry of Health to fully operationalize the Health Act, Review Insurance Regulatory Act to increase uptake of private insurance in addition to the National Hospital Insurance Fund (NHIF) and Finance Committee to review the public finance management Act to ensure that health finances are ring-fenced exclusively for health services only and avert diversion.
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.