KHF Supply chain committee to engage KEMSA on UHC pilot supply chain
The supply chain committee of Kenya Healthcare Federation met on 19th March 2019 at KHF offices to outline the 2019 focus areas. The meeting was chaired the committee vice chair, Dr. Chris Masila and the committee director Dr. Anastacia Nyalita. In her opening remarks, Dr. Nyalita updated the committee that the Pharmacy and Poisons Board (PPB) has submitted the draft rules on regulation of parallel importation to the Ministry of Health (MoH) The Supply Chain Committee through Ministerial Stakeholder Forum has been advocating for the promotion of local manufacturers. This discussion has been taken up by Dr. Fred Matiangi’s team working under Kenya Private Sector Alliance (KEPSA) and together with Kenya Association of Manufacturers (KAM), there has been much progress made although the outcome of the discussions have not been released.
During the supply chain committee discussions, it emerged that the exact role of supply chain in the Universal Health Coverage (UHC) pilot counties was not clear, therefore the committee agreed to schedule a meeting with Kenya Medical Supply Authority (KEMSA) to gain insights into KEMSA’s role. Dr Nyalita updated the committee of the move by National Quality Control Laboratory This move will create monopoly in analysis leading to lack of efficiencies and cost effectiveness.
Mr. Kevin Saola from Nestle Kenya informed the meeting that international trade has been experiencing barriers especially in the East Africa. “an example of current trade barrier between Kenya and Tanzania where locally manufactured products must undergo bureaucratic, Tanzania Bureau of Standards (TBS) regulations. This has marked an increase in costs leading to poor competition.” Mr. Kevin Saola, Nestle.The committee’s focus areas for the year 2019 include: engaging KEMSA on UHC pilot counties’ supply chain, engage the NCQL board and the Ministry of Health on regulation and importation and engage the Ministry of Trade and EAC on export restrictions of Kenyan products Tanzania Bureau of standards.
Enhancing safety in the working environment
Kenya Healthcare Federation held the second members meeting at ParkInn hotel in Westlands, on 21st March 2019.The meeting was sponsored by Global Fund/Kenya Coordinating Mechanism(KCM).The goal of Global Fund/KCM is to dramatically increase resources to fight three of the world’s most devastating diseases(Tuberculosis, HIV &AIDS and Malaria)and to direct those resources to areas of greatest need The themes for the Global Fund strategy are: Innovative approaches to meet diverse country needs, strengthening systems for health is critical to attain universal health coverage and to accelerate the end of the epidemics, Increased programmatic and financial resources from diverse sources are needed to accelerate the end of the epidemics and Promoting and protecting human rights and gender equality is required to accelerate the end of the epidemics
The Key goal of KCM is to mobilize funds from The Global Fund for HIV/AIDS, Tuberculosis and Malaria programmes and to coordinate and evaluate implementation of the Global Fund grants. With the support of the Global Fund and other Partners, the MoH initiated and sustained over 1million adults and children living with HIV on ARVs. Global fund prides itself in the remarkable achievements including: Over 15 million Long Lasting Insecticide Treated Bed Nets distributed & Malaria Case Management supported, Reduction in malaria prevalence from 11% in 2010 to 8% in 2015, TB Medicines provided to over 900,000 Patients and Services for HIV, TB and Malaria are provided to all Kenyans at no cost in all Public Health Facilities.
The meeting was also graced by Mr. Antony Wahome, chairman, national gun owners association of Kenya, his major focus was to inform and sensitize the health workers on how to handle armed patients to protect themselves and the patients as well. He emphasized on internalizing the law of fire arms and how to safely handle fire arms. Dr. Amit N. Thakker, chairman, Kenya Healthcare Federation, emphasized on a call from the cabinet secretary, ministry of health, Mrs. Sicily Kariuki, for joint efforts with the private sector towards fighting corruption and fraud in the health sector especially in the supply chain, with a major focus on pharmaceuticals.
The ICT and Mobile health committee takes lead in establishing healthcare coding systems
The ICT Committee held it’s first quarterly meeting at Kenya Healthcare Federation offices (KHF) on 24th January 2019 to outline the focus areas for 2019. The meeting was chaired by Dr. Torooti Mwirigi (Carepay Limited). The focus areas outlined included: data exchange, data regulation and governance, active participation in the Health Act 2017 technical working groups (TWGs) and Universal Health Coverage (UHC) committees at the Ministry of Health (MOH), and, partnerships. Mr. Joel Lehman (Infospective) updated the group that at the last Ministerial Stakeholder Forum (MSF) it was agreed that standardization of coding of persons, facilities, practitioners, procedures and diagnoses was a priority in the health sector. The Pharmacy and Poisons Board (PPB), with the help of consultant Prof. Francis Ndemo of the University of Nairobi and chair of PPB Practice Committee will take a lead in introducing standard codes for pharmaceuticals. The recommendation of Pharmaeutical Society of Kenya (PSK) and KHF, is to use the globally used ATC codes with a suffix unique to the specific brand registered in Kenya. The Kenya Medical Practitioners and Dentists Board (KMPDB) will take the lead in adoption of standard codes for procedures and diagnoses.
The data – exchange sub-committee was mandated to structure a framework for a data exchange. The sub-committee agreed that key considerations for this framework include standard codes e.g. ICD10, ACT, CPT, RADLEX etc., health information exchange standards e.g. HL7, clinical pathways and formularies. To achieve this, stakeholder mapping is necessary to pick up on best practice. Establishment of a good relationship between the subcommittee and the Nursing Council of Kenya, the Kenya Medical Laboratory and Technician Board and, the Kenya Medical Practitioners and Dentist Board is also necessary to give an opportunity for supporting these boards on the best coding systems considering global best practices.
After the framework is created it will be floated to KHF member for endorsement, a milestone to be achieved by mid-2019. Similarly, ICT and mobile health committee will make policy proposals on data governance and regulation and present to KHF membership for endorsement. KHF will advocate the adoption of these policy proposals by government.
Kenya Healthcare Students Summit
Kenya Healthcare Students summit (KEHSS) held it’s annual conference themed “Towards a Multidisciplinary Approach for the achievement of Universal Health Coverage (UHC) in Kenya and Africa” on 8 – 9 February 2019 at United States International University, Nairobi. The Kenya Healthcare Students Summit is a conference that brings together healthcare students and interested professionals from all over Africa. The conference aims at building capacity of Kenyan and African healthcare students on matters pertaining to UHC as well as equip them with the necessary soft skills needed in their future profession as healthcare practitioners.
In his opening remarks Dr. Githinji Gitahi, CEO Amref Health Africa and UHC 2030 co-chair emphasized that UHC is a social justice concept, a philosophy founded on equity where everyone receives quality healthcare. The panel was focusing on “What it takes to be the correct health worker for UHC” and Kenya Healthcare Federation (KHF) was well represented therein. Dr. Robert Nyarango, CEO, Gertrudes Children’s Hospital responding to the question on why medical professional graduates find themselves unemployed, emphasized that healthcare organizations are looking for human resource that is highly skilled, visionary, emotionally intelligent and with a focus on problem solving.
Dr. Daniella Munene, CEO, Pharmaceutical Society of Kenya, addressing the pharmacy students encouraged them to establish a relationship with patients during their practice and ask the right questions to enhance compliance with medications. She further added that every encounter with a patient is an opportunity to educate them about their right to the highest attainable standards of healthcare, as an informed public will be the driver for UHC. Professor Gilbert Kokwaro, Strathmore University, encouraged the students to be open-minded big picture oriented. “Identify the areas that have leadership gaps and work on adding value to them”. He indicated that teaching institutions need to train job creators and leaders not job seekers,.” Professor Njeri Wamae, USIU Africa, encouraged lecturers to train youths that are fit for purpose, keeping in mind that the vision of UHC is ensuring that no one is left behind. “Think of what is needed in healthcare today and in the future” Professor Njeri Wamae, United States International University(USIU)Africa.
Sharing experience in healthcare leadership, Dr. Jacqueline Kitulu, President, Kenya Medical Association highlighted that the lag in prioritizing healthcare stems from being too inward facing in health practice. She encouraged the student to explore other value adding skills like management and leadership to enable them effectively articulate the needs of the health sector. “Through knowledge and skills acquired while pursuing my MBA, I learned how to articulate healthcare needs in a language that the economist can understand” she continued. Dr. Kitulu further encouraged the students to join professional associations for mentorship, which she explained is one sure way of leapfrogging young professionals to effective leadership.Dr. Amit N. Thakker, Chairman, KHF, encouraged the students to identify mentors in their area of passion and interest, who can walk with them towards pursuing their career. In addition, he encouraged the students to focus on being job creators and not job seekers. The healthcare students summit was a success and the students expressed their gratitude to the panelists for the impactful session.
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.
Setting the pace for affordability of quality medicines
Med source Group Limited Kenya, was launched on 11th October 2018 at Villa Rosa Kempinsky Hotel in Westlands. This is the first organization of its kind in Kenya – ‘a group purchasing organization’ dedicated to improve the availability and affordability of quality medicines and related supplies for the people of Kenya as well as assist members to build sustainable businesses and provide services they can use to grow and prosper. MedSource Group leverages the combined purchasing power of it’s members to negotiate favorable contract pricing from suppliers and offers members access to a broad catalogue of quality products from prequalified distributors and manufacturers.
This launch brought together different leaders from the pharmaceutical industry representing both public and private sector who saluted the entrance of Medsource group into the market, as a much needed solution to various problems ailing the health sector. Dr. Fred Siyoi, Chief Pharmacist and registrar -Pharmacy and poisons Board, welcomed Medsource group to the market. He reiterated that “The presence of Medsource group will contribute to the achievement of Universal Health Coverage through reducing the cost of medication. The government welcomes the important role played by all health stakeholders and Medsource Group’s role cannot be overemphasized.
According to the sustainable development goals 2030 set by the United Nations, goal 3 states that; ensure healthy lives and promote well being of all at all times. Many nations worldwide are making efforts to achieve this for example in Kenya this falls under the big four agenda set by his excellency president Uhuru Kenyatta for his second term. Affordability of quality medicine is one of the challenges faced towards enhancing access to affordable and quality care. “Even as the world is making great strides at improving health outcomes, even in low – resource countries, access to medicines continues to be a challenge. MedSource Group also presents an innovative way for Management Science for Health, to create private – sector opportunities to help deliver quality health services and products to more people. We are happy to add this novel approach to the range of other work that we have done over the years and we hope this venture in Kenya is just the beginning of similar work throughout Africa” Marian W. Wentworth, CEO Management Science for Health.
“The MedSource Group platform will be valuable to stakeholders such as pharmacies, hospitals/clinics, distributors, manufacturers and especially patients. Our main focus is and will always be to improve accessibility and availability of affordable, quality medicines and laboratory and health supplies for healthcare providers and people from all walks of life.” Dr. Douglas Keene, MedSource Group Chairman and Management Science for Health vice president for the pharmaceuticals and health.
Dr. Peter Kamunyo, Medsource Group CEO, expressed his optimism that the organization will fill the gaps in the availability and affordability of quality assured life- saving medicines, including those used to manage non – communicable diseases. “Many families are struggling to continuously provide medication, especially to handle non – communicable diseases such as cancer, hypertension and diabetes among others. Through Medsource Group, healthcare providers will be able to procure the medicines their clients need at more affordable prices.” Dr. Peter Kamunyo, Medsource Group CEO.
The organization’s membership is open to pharmacies of all sizes, hospitals & hospital groups, institutions, in-house clinics, dispensaries, clinical laboratories, and health networks. Based in Nairobi, it is a fully owned subsidiary of Management Sciences for Health (MSH), a global nonprofit organization based in the United States.
Key membership benefits, in addition to the MedSource electronic platform to access price agreements, order and pay for their quality-assured medical supplies directly to the distributors includes; training support for business skills, pharmacy practices, and inventory management, facilitating access to credit, IT solutions and data analytics for improved integration and tracking of business transactions including purchasing and inventory management.
6th Healthcare Management Conference
The 6th annual Healthcare Management conference, organized by Medic East Africa, took place at Kenyatta International Conference Centre ,Nairobi, Kenya from 25th to 27th September 2018.The conference had three different themes for each of the three days. The first day’s theme was “From vision to Action – Reinforcing Healthcare Systems in East Africa, the second day was “The Role of Clinical Officers in the Implementation of Universal Health Coverage” and the third day’s theme was “Quality and Access under Universal Health Coverage”. The objective of the forum was to drive the region towards a health leadership infrastructure that is focused on perfomance and is held accountable for delivering on specific health system goals.
The conference brought together over 150 exhibitors from 18 countries. The first day conference was moderated by Dr. Amit N. Thakker, Chairman, Kenya Healthcare Federation. In his presentation, he emphasized that the key barrier to reinforcing healthcare systems in east Africa are; geographical and financial. Dr. Thakker informed the attendees that over 85% of Kenya population do not have any form of a cover and rely on out of pocket. 50% of the population do not have an access to primary healthcare and this set back results from poverty. He called upon all healthcare workers in attendance to come out strongly in health advocacy because unfavorable health outcomes such as maternal mortality are increasingly becoming a daily occurrence. Dr. Thakker further urged the attendees to capitalize technology, which is in itself revolutionizing daily.
“We need to adopt auxiliary health workers and also strongly recognize community health workers for the big role they play in health. The ministry of health should have considered hiring the specialists that we don’t have instead of employing what we already have because this doesn’t help in filling the identified gaps in the workforce. The BIG 4 Agenda is supposed to ensure creation of job opportunities and 5% of the jobs are expected to come from the health sector. Therefore I call upon the public and private health sector to operate in harmony to see great job creation and ensure good service delivery.” Dr. Amit Thakker, Chairman ,Kenya Healthcare Federation.
Dr. Andrew Mulwa CEC-Health, Makueni County informed the attendees that some of the challenges in the county level towards achieving Universal Health Coverage are: lack of healthcare workers i.e. the recruitment and retention of human resources for health is very low. This is because most of the specialists that are required in the counties, are mostly concentrated in the urban areas. Finance is an important factor affecting access to quality healthcare and is challenge because most of the population does not have a formal employment therefore cannot purchase or contribute to medical cover plans. This leads to over reliance on out of pocket expenditure. He however added that recruitment and retention of the health workers should match the county’s economical abilities.
Dr. Janet Muriuki, Deputy Chief of Party/ Technical Director – Intrahealth International was in attendance and said “We need to motivate the health workers, to help in reducing immigration. Assessing the reason for immigration, creating a favorable environment for them to work and giving them a good remuneration will also help in retaining the health workers. However, there is low distribution of health workers where majority are concentrated in the urban areas. Question is, are we taking training where it is needed? Are the specialist deployed where they are needed? This should be the initial stage in gap analysis. Technology should be a vital tool in this .This is because it can display the gaps in the human resources and distribution of health workers and track the training of health workers i.e. who needs long term training and who needs short term training. Therefore it’s important to deploy specialist where there is deficiency and not where there is a surplus.” She emphasized that the health sector needs to employ workers who are fit for purpose and the health workers should ensure they are safe in their working environment. This would serve as one of the solutions for curbing immigration of health workers. According to world health organization(WHO),the ratio of health workers to the population per county should be 23:10,000 in Kenya whereas the current ratio is still low as we stand at 13:10,000. Dr. Muriuki noted that the counties with highest health workers deficiency are Isiolo and Wajir.
Ms. Faith Muigai, Regional Director, SafeCare, Pharm Access Foundation reiterated that there is need to need to shift attitude and create a good environment for patient care. We also have to change the narrative if we want to see good service delivery. However, she noted that there is poor or lack of infrastructure to enhance this. There is no independent body that checks the health workers performance thus there is no competition that would drive quality of service delivery. Ms. Faith said that more health facilities should be accredited and the accreditation system need not be a pass or fail model but one of incremental growth. In conclusion, Ms. Faith mentioned that data is required to drive transparency and accountability, that there is need to leverage on public private partnership so as to drive the quality agenda, and finally that there is need to invest in proactive and responsive versus reactive solutions.
Some of the major concerns that were raised from the audience were: there should be an assessment carried out on why there is poor distribution of health workers and even lots of immigration observed among the health workers and come up with a solution. There should also be a safe working environment for the health workers because some of the equipment and medication used exposes them to the dangers of contracting infections or even developing other health conditions. There was a recommendation that the health workers should be trained on disaster management even as we assess the training needs in the healthcare industry. Participants expressed unanimous consensus that there should be capacity building among the leaders to enhance accountability on financial management and on performance of healthcare workers. The policies created should also speak to each other.
The 6th annual Healthcare Management conference was a success bringing together a wide representation of stakeholders. The presenters provided key insights into the challenges and opportunities in the healthcare industry while the audience contributed engaging and thoughtful questions and remarks. If these ideas were implemented, we would expect to see the healthcare industry change for the good of all Kenyans! We look forward to the next conference
Effective supply chain will establish a strong road map to achieving Universal Health Coverage
Quality and affordable medicines is key in achieving Universal Health Coverage. However in Kenya the prices of medication is very high thus putting patients with Non Communicable Diseases especially Diabetes and Hypertension in financial hardship and others are not able to keep up with the medication leading to more complications.
It has also been noted that there is importation of illicit drugs and the government should be very keen in curbing this. How can the private sector contribute in improving the quality of medication and ensuring the medication is affordable?
Kenya Healthcare Federation (KHF) supply chain committee held it’s quarterly meeting on 28th August 2018 at KHF offices. The meeting was chaired by the committee chair Dr. William Mwatu. Supply chain falls in two of the president’s BIG 4 Agenda that is manufacturing and affordable healthcare. The supply chain committee has been pushing for the support of local manufacturers this makes the medicines affordable.
“What are the reasons that support parallel importation and what are the impact? One of the major reason is to make profit but this has a negative impact on patients safety” Dr. Peter Kamunyo, Director Kenya Healthcare Federation. “When it comes to the supply of medication, the private sector should use Public Private Partnership (PPP) as a channel to advocate for the pharmaceutical regulatories to operate within the law.” Dr. Anastacia Nyalita, Director.
There was a consensus on developing a unique identifier and best coding mechanism, for example each drug pack should contain original details so that when a patient uses the code to search on the details of the pack , they should be able to get them. “Therefore the supply chain should use PPP as a channel to advocate for this.” Dr. William Mwatu Supply Chain Committee Chair.
Recently, the Pharmacy and Poison Board (PPB) of Kenya made a bold decision to address what maybe the local pharmaceutical industry’s most controversial issue, ‘Parallel Importation of pharmaceutical products. There has been few attempts made to tackle this but not be successful, however PPB hopes that the current attempt will be successful through considering all important aspects in order to build a consensus among all interested parties in coming up with a policy position that is not only widely acceptable but also addresses most of the contentious issues once and for all.
The key issues to consider is create more incentives towards local manufacturing, change perspective and strategize on how to marketing for local products. A consideration should be put on what percentage off is to be given to the local manufacturer to give value addition. The main aim of reducing the cost is to increase on accessibility and not maximize profit. The committee will be pushing for implementation of the guideline draft act by pharmacy and poisons Board (PPB) Dr. William Mwatu was re-elected as the committee chair and Mr. Chris Masila was elected as the committee vice Chair.
Second Universal Health Coverage Conference in Nyeri
Kenya Vision 2030 delivery secretariat in partnership with Ministry of Health (MoH), Kenya Healthcare Federation (KHF), Amref Health Africa, Kenya Cardiac Society, Council of Governors, NCD Alliance Kenya, Kenyatta University and Nyeri county health department organized the second Universal Health Coverage Conference held at Green Hills Hotel, Nyeri County from 11th – 12th September 2018. The conference sought to address the non – communicable disease (NCD) challenge to the country and was appropriately themed “Universal Health Coverage for Sustainable Development – Transformative Solutions to Halt and Reverse the Non-Communicable Disease Epidemic”
The conference was graced by several dignitaries: Her Excellency Dr. Carol Karugu, Deputy Governor, Nyeri County; His Excellency Prof. Peter Anyang’ Nyong’o, Governor, Kisumu County; His Excellency Prof. Kivutha Kibwana, Governor, Makueni County; Dr. Julius Muia EBS, Principal Secretary, State Department for Planning; Dr. Racheal Kamau, CEC Health, Nyeri County.
Rev. Samuel Njenga of the Presbyterian Church of East Africa opened the conference with prayer and thereafter giving a brief address. He said that the church has a vital role to play in advocating for and sensitizing the people about good health.
Dr. Kamau welcomed participants and thanked the organizers for choosing Nyeri County to host the conference, adding that she looked forward to fruitful deliberations. “Nyeri County is facing a high burden of NCDs. We need to change our ways of practice and take up the challenge” she remarked. Thereafter Dr. Kibachio Mwangi, the Head of NCD unit at MoH highlighted the key objectives of the conference which were: Understand the NCDs challenge; outline the role of private sector in addressing NCDs; outline the role of consumer organizations in protecting the public from sale of harmful products; and outline the role of government, civil society and the youth in addressing NCDs. Dr. Mwangi emphamphised that NCDs are not purely a health agenda, but require a multi-sectoral approach incorporating sectors such as transport, education and agriculture particularly in prevention measures.
“We should put health first; unfortunately what are addressing is a result of our choices such as what we eat. Good health plays an important role in boosting the economy, reducing poverty, increasing education and boosting investment” Dr. Julius Muia said in his address to the conference.Preventive measures against NCDs took center stage in the deliberations. It was appreciated that more focus needs to move to prevention as we continue in disease management interventions.
The consensus on the way forward included creating awareness, education of the public and preventive measures against NCDs, adoption of a multi-sectoral approach, utilizing Public- Private Partnerships and supporting local pharmaceutical manufacturers to make medicines affordable and strengthening the supply chain. “Managing NCDs is very expensive. If we truly want to make UHC achievable, we need to address the issue of cost. If we reduce costs we’ll be able to expand the care. The biggest PPP opportunity in cost reduction is in supply chain”, said Dr. Peter Kamunyo, Director, Kenya Healthcare Federation.
Further, there was consensus that community health volunteers (CHVs) should be officially entrenched in the health system. It was recognized that CHVs play a very critical role in NCD public sensitization. It was agreed that NHIF be strengthened, that it should cover preventive health checks and that it should ensure that the poor and vulnerable are covered. The country should strategize on addressing the poor availability, lack of affordability and inadequate resources as barriers to UHC. Young people should be informed and sensitized on NCDs so they can act as role models to their peers in NCDs prevention. NCD education should be incorporated in the school curriculum.
A patient representative at the conference made an appeal to the health sector to address survivorship of NCDs, a phase of management that insurance doesn’t cover. She highlighted that cancer patients are usually deserted by friends and family after diagnosis due to the burden of their disease on their loved ones. “We are left alone. It’s time for medics to inform us how we can survive after diagnosis of an NCD like cancer. This way trauma can reduce and a patient can accept the situation, love on themselves and even achieve their goals. The price of medications is usually very high and almost unaffordable. Patients get financially drained while trying to get medication”, said Elizabeth, a cancer survivor of nine years.
Professor Nyong’o called on stakeholders to identify areas of inequity in health care, and strategize on how to fill the gaps. “Counties don’t have a strong primary healthcare system, the aim of UHC is to strengthen primary healthcare” said Dr. Karugu, while Prof. Kibwana called upon all pilot counties to learn from each other as a way achieving UHC uniformly, further adding that CHVs will play a big role in rolling out UHC, particularly in educating communities.
The conference was well attended attracting 400 delegates drawn from both public and private health sectors. There was representation from national government, county governments, World Bank, the United Nations office in Kenya, Non-governmental organizations and youth organizations. KHF was represented by the chairman, Dr. Amit Thakker, directors Dr. Peter Kamunyo and Dr. Daniella Munene, Dr. Joy Mugambi, deputy Secretary General, Kenya Medical Association (all panelists), as well as several KHF members who attended as delegates. A number of KHF member organizations sponsored the event.