Kenya has reported several cases of Coronavirus disease (COVID-19) and the Government of Kenya has instituted a series of responses to curb the spread of the virus.
To complement Government efforts, Kenya Healthcare Federation (KHF) has constituted the KHF COVID-19 Response Team to coordinate activities by Private Sector Stakeholders in Health, to expedite detection and reduce transmission of the disease, because we believe that prevention is better than cure and that together we can reduce the overall number of cases that will occur in Kenya and beyond. This team is working closely with the Kenya Private Sector Alliance (KEPSA) and the Government to ensure a coordinated, consolidated and effective response.
KHF COVID19 Response Team Launch
Following the outbreak of Corona Virus Disease (COVID19) globally, the supply chain has been highly affected and impacted negatively on access to key medical products and health technologies.
In this regard, the Pharmacy and Poisons Board in line with it’s functions as stipulated under the pharmacy and Poisons Act, as amended by the Health Laws (Amendment) Act, 2019, is required to advise the Ministry of Health (MOH) on control, authorization and registration of medical products and health technologies during this period.
The PPB there reaches out to the specific organizations mentioned on the attached letter to furnish the board with the stock status of personal protective equipment(PPE’s) and essential medicines (as per the Kenya Essential Medicines List-2019 MoH) in your custody
The Kenya Essential Medicines List (KEML) is a key tool that should effectively be used to promote access to essential medicines, and through their correct selection, procurement, and use to achieve maximum therapeutic benefit and optimize patient outcomes as desired under Universal Health Coverage (UHC).
The KEML serves as a guide for the investment of healthcare funds to finance the most appropriate medicines to achieve therapeutic aims in response to prioritized public health needs.
It is also meant to guide health policy, focus attention and resources(time, financial, technical, and human) in areas and activities that support the above aims, such as training, quality assurance, financing and insurance, regulation and monitoring, appropriate use (including control of antimicrobial resistance), operational research and local production.
For an exclusive Kenya Essential Medicines List Please click HERE
Recognition and strengthening of neglected and specialized health cadres
The human resource for health (HRH) committee of Kenya Healthcare Federation (KHF) held it’s first quarterly committee meeting on 14th March 2019, at KHF offices, to set the 2019 focus areas. The meeting was chaired by Mr. Kennedy Auma, Committee Chair. The director representative for the committee, Dr. Elizabeth Wala, called upon the committee members to be meeting on a bi-monthly basis so as to ensure the focus areas are achieved. There was a unanimous agreement by the committee that there is need to address HRH issues proactively.
The first focus area for the committee in 2019 will be the establishment of a framework with the Ministry of Health (MOH) for the three specialized cadres: Community Health Volunteers (CHV), Health Record Information Officers (HRIOs) and Emergency Medical Technicians (EMT). The second focus area is the management and development of the HRH. This focus area will be implemented through stakeholder engagement through professional associations and unions, collection of data on the distribution of HRH in both public and private sector, performance management, innovative ways to overcome HRH gaps and strong leadership and governance structures. The third focus area will be on specialized cadres specifically recognition, regulation and establishment of a framework for their work with the MOH thereby enabling referral processes and availability of equipment to enable their work. Some examples of specialized cadres are Physiotherapy, Occupational Health, Oral health, specialized nurses and other medical specialties available in the diaspora.
The committee noted that HRH is a key pillar in Universal Health Coverage (UHC) and the Health Act 2017 therefore it is important to understand the legal framework therein and to monitor the implementation of the recommendations.From the three focus areas, three committees were formed to concentrate on their allocated focus areas to ensure that the committee achieves all focus areas by the close of the year.
What is the true cost of Healthcare? and what does it entail?
Amref Health Africa in partnership with Kenya Healthcare Federation (KHF) held a forum on cost of healthcare on 12th February 2019, at Sarova Pan-Afric Hotel. In order to unpack the areas where costs lie in healthcare, the following guiding questions were asked: What is the true cost of care? How can healthcare be made affordable to all? The forum was well attended by the private sector, civil society organizations, health regulatory bodies, insurance providers and representatives from the Ministry of Health. In his opening remarks, Dr. Amit N. Thakker, chairman, KHF, emphasized on the need for Universal Health Coverage (UHC) and its linkage to preventing catastrophic health expenses leading Kenyans into poverty. He encouraged frank and open dialogue on: commercialisation of medicine, remuneration of human resources for health, understanding public perceptions of cost in the private sector, specifically, the perception of providers (doctors and facilities), insurers and manufacturers and governance of practice.
Mr. Nathaniel Otoo, Executive Director, Strategic Purchasing Africa Resource Centre (SPARC) reiterated that achieving UHC calls for the right capacity and collaboration between public and private sector to fill in the gaps. He took the forum through the Ghana UHC journey focusing on financing strategies. Ghana moved from passive to strategic purchasing with monitoring of quality, performance, and pricing. The National Health Insurance Scheme in Ghana moved from a price taker to a price setter. Along their journey they noted that private sector is not always a marker of efficiency. Mr. Otoo offered to support KHF in its move to tackle the cost of healthcare through capacity building in strategic purchasing, and improving of efficiency and quality of services.
The panel discussions revolved around fraud, supply chain, human resources for health and lack of robust health information systems. As a summary of the meeting, the following priority focus areas were outlined: supply chain management – regulation, distribution, purchasing, prescription; local manufacturing of key products, methods to determine true cost of healthcare at provider, distributor, manufacturing and payer levels; operational efficiencies – equipment sharing, centralised ambulance services, utility costs, models of healthcare worker remuneration; enforcement of professional standards; governance including guidelines or protocols on management of costs; self regulation; patient behaviour change and right of choice; data generation, analysis, and governance; and finally healthcare financing including increasing the risk pool which calls innovative insurance models and social health insurance to capture a larger population, and incorporation of the prevention aspects of healthcare into our current insurance models
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 African Leadership Meeting
The African Leadership Meeting was held in Ethiopia on 9th February 2019.The main agenda was “commitments for investments in the health sector across the continent with an emphasy on the importance of partnerships in order to grow the healthsector. The leadership meeting was co-organized by Africa Health Business.” Dr. Amit N. Thakker, Chairman Africa Healthcare Federation, emphasized that deepening private sector integration within the African health system is non-negotiable. He urged the government leaders to embrace the private sector and improve both Public-Private Dialogue and engagement in the respective African countries through the Ministries of Health. Countries that practice this openly have already shown positive results Dr. Thakker said this while moderating a panel session themed “Domestic Financing for Health, Effective Partnerships and Private Sector Engagement”
H.E President Uhuru Kenyatta, President of Kenya, acknowledged that investments in health were integral to achieving the social economic agenda and that it was necessary to build partnerships to achieve Universal Health Coverage. The Kenyan President urged other leaders to create an enabling environment for the private sector in order to build confidence and attract investments into health systems.
It was stressed that the health sector is a viable investment area where the return on investment is substantial such that investors can expect between 9 – 20 times the level of investment. The meeting led to increased commitments of US$200 million from both public and private health sector and donor governments (Higherlife Foundation, The Government of Ireland and the Government of France), to end epidemics and achieve Universal Health Coverage.H.E. President Sahle-Work Zewde, President of Ethiopia, called on the African leaders to bring hope and opportunities to the people of Africa through transformational leadership Investments in healthcare would improve the quality of life across the continent and allow African populations to lead full, productive and prosperous lives. She emphasized that investments in healthcare underpin national development. Mr. Bill Gates, Co-Chair of the Bill and Melinda Gates Foundation, urged immediate action in order to end epidemics and meet health targets.
It was suggested that African Ministers of Health should meet more frequently to work together on the health status in the continent and report their progress to the AU Heads of State and Government Summit. In this way, African governments can learn from initiatives across the continent, identify synergies that unlock efficiencies and collaborate in relation to continental priorities. African leaders urged their counterparts to focus on improved efficiency in order to strengthen national health systems. For the private health sector, the meeting was received as a key step towards acknowledging sustainability and private sector efforts towards health outcomes. The meeting was an important platform to build on Public Private Dialogue, create awareness and commitments in relation to investments in healthcare in Africa and urge the African leadership to create an enabling environment for business. This shall lead to a stronger private health sector which can further contribute to economic development and goals towards achieving Universal Health Coverage in an efficient and affordable manner.
TERUMO BCT opens a branch office in Kenya
TERUMO BCT a global leader in blood management, blood safety, therapeutic apheresis, cell therapy and cell collections. Terumo, opened its first office in Sub-Saharan Africa in Gigiri, Kenya on 7th February 2019. This happened after the company was recently listed in a recent industry report as among the world’s top players in the blood bank market. Dr. Jackson Kioko, Director for Medical Services (DMS), Ministry of Health, who also officially opened the new company, graced the ceremony. The Cabinet Secretary, Ministry of Health (Kenya) Mrs. Sicily Kariuki in her speech that was read by the DMS, Dr. Kioko, applauded TERUMO BCT for the great achievement and for choosing Kenya as their base in Sub-Saharan Africa. She further said that the partnership is very timely as Kenya is working on making Universal Health Coverage a reality and blood and blood products are key.
Officials from the Japanese Government and TERUMO BCT emphasized that their decision on choosing Kenya was informed by Kenya being a high recipient of Official Development Assistance (ODA), an agreement that was signed during Sixth Tokyo International Conference on African Development (TICAD6). The conference focused on “Advancing Africa’s Sustainable Development Agenda – with a major theme as promoting resilient health system for quality of life.” Kenya’s prioritization of healthcare by driving the health agenda as reflected in the BIG 4 Agenda further incentivized their move.
As a company, TERUMO BCT will apply three strategies through it’s partnership in Kenya: Create awareness, Capacity building and training of blood bank technologists and professionals and Use of advanced technology & systems. The company officials emphasize that they will proudly share their knowledge and experience in blood safety and blood bank.
Through sharing of knowledge and expertise, the company will contribute towards saving lives especially mother and child, achieving Universal Health Coverage and achieving Sustainable Development Goals (SDG).
Kenya Healthcare Federation engagement with Meru County
Kenya Healthcare Federation held the initial county stakeholder engagement with Meru County Health Officials to discuss the establishment of Meru Medical Care. The meeting was held on 10th January 2019 at KHF offices. The engagement with the county was very timely because KHF has set a goal to establish county stakeholder engagements. The Governor, Meru County, has laid a plan to establish Meru Care that will ensure all households have medical cover. The cost of Meru Care is proposed to be ksh. 2,000 per household annually.
Meru County has a population of 1.56million people with 2000 health workers, which gives a ratio of health workers to population at 1:780. Meru Level 5 Hospital is the main teaching and referral hospital and has specialists. The county has one Level 5 hospital, 15 Level 4 hospitals, 25 Health Centres, 157 Dispensaries and 76 Pharmacies.
Dr.Githu Wachira from the Ministry of Health-Non-Communicable Disease Unit, Meru County, said that Meru County is leading in the burden of NCDs with Gastrointestinal Tract (GIT) cancer being very common. He further said that research is ongoing to determine the trigger factors for the GIT cancers. Trauma is the second leading cause of NCD morbidity with a major cause being assaults. Dr Lillian Karoki, Director of Medical Services, Meru County informed the meeting that the total county health budget received from treasury is Ksh. 3.2 billion. She further said that 85% of the total population can afford to pay National Hospital Insurance Fund (NHIF) subscription; the challenge is they do not keep up with the monthly contributions thus bringing the current active NHIF membership to as low as 7%.
KHF was pleased with the vision of Meru County as regards their health agenda. KHF advised that the County should explore ways to increase revenue for the health facilities to make them self-sustaining. Commodity management is important in ensuring that limited resources are used appropriately and loss through pilferage is minimized. Given that 85% of the population can afford NHIF, the County could establish the Meru Care to target the medical needs for the needy. KHF further advised the County to consider licensing Meru Care as an official scheme with transparency in revenue collection, revenue allocation, benefits, beneficiaries and provider management. This would enable the scheme to purchase healthcare services and products competitively. It was also proposed that the County share their proposal for Meru Care with KHF who can assess the benefits package for validity and sustainability. KHF expressed willingness to assist Meru County with advocacy and lobbying to justify the budget for Meru Care and to bring the vision into fruition.
New plans on achieving Universal Health Coverage
Kenya Healthcare Federation(KHF) Healthcare Financing committee held it’s last quarterly meeting at KHF offices on 7th December 2018 the meeting was chaired by the committee chair Dr. Njoki Fernandes. The key agenda for the discussions were: Universal Health Coverage, Doctor’s price guidelines and NHIF amendment Bill. Dr. Walter Obita, director representative for the committee updated the committee on the discussion around Universal Health Coverage that has been going on at the ministerial level and the last engagement between the Ministry of Health led by the cabinet secretary Mrs. Sicily Kariuki and the private Health Sector.
Healthcare Financing Committee has been leading all the discussions around Universal Health Coverage where the committee has also been engaging with the government at the technical working committees(TWCs) set by the national government. Dr. Obita has been representing KHF healthcare financing committee in the TWCs.
From the UHC discussions in the ministry of health ,the current position shows that the government is not going to use the social insurance schemes to roll out UHC. Hence it plans on directly procuring or paying for commodities through Kenya Medical Supplies Authority( KEMSA).The counties will therefore have to roll down the payments made to KEMSA by directly making orders to KEMSA where KEMSA will make the deliveries. Inadditional,the government is going to allocate some resources to the public health activities,community health activities and 80% will be used for commodities and supplies to KEMSA.
The counties have been tasked with a role in ensuring that all other health systems are built through allocation of finances to each of the activities which include:Human Resource recruitment, deployment and management, Strengthening of governance structures and management of data, information and technologies .
Dr. Fernandes brought to the attention of members the NHIF amendement Bill with a major focus on section 2a) part II which states that there shall be paid into the fund the employer contributions matching employee’s contribution, Part III. such monies as may be appropriated by the National Assembly out of the Consolidated Fund, for persons certified by the Board to be unable to pay the contributions, Part iv. Gifts, grants or donations, Part v. Funds from the National Government, County Governments or employers for the administration of employee benefits and section five ,Part vi ,to administer employee benefits on behalf of the national government, the county governments and employers in respect of their employees. KHF’s recommendations included: should discuss this bill with the parliamentary Health Committee, Lobby in, Federation of Kenya Employer(FKE) and KEPSA and Healthcare Financing Committee to be involved in all the discussions.
There was a parliamentary directive that the Doctor’s rate should be taken back to 2006 price guidelines that were abandoned two years ago with the adoption of the current rates. The National Assembly’s Health committee further requested the Cabinet Secretary, Ministry of Health, Mrs. Sicily Kariuki to replace the existing Medical Practitioners and Dentists Rules 2016 with the second edition of the Professional Fees Rules and Guidelines of 2006, which prescribe cheaper rates for various medical services and procedures.
KHF’s recommendations as a way forward for the doctor’s price guidelines include: KHF should get more involved in costing and also learn from the successes of other countries and professionals, KHF should engage more health experts especially health economist to join in the discussion to guide in making more sound decision, Healthcare Financing should be more engaged in the discussions so as to deter NHIF from charging high rates ,the medical board should consider setting up maximum rates instead of minimum and there should be maximum margins set for pharmaceuticals and supplies which will also bring about price regulations.
Other issue as discussed was the quality of care which has been compromised and the public is not well informed on where to seek care from. Therefore the committee suggested that there should be edu-information and sensitization done to the public on who to go for care. There should also be regulations on healthcare providers at all levels in which they should have the right qualifications and experience.
The committee agreed on the focus areas for the year 2019 as: NHIF Amendment Bill, Doctor’s Price Regulations, Pricing Quality and Regulations ( this will focus on care services and medications) and engaging the media in Agenda setting.