Achieving Universal Health Coverage in the Counties
Kenya Healthcare Federation held county Stakeholder engagement forums in Uasin Gishu County, Kisumu and Isiolo County. Dr. Bola Tafawa, a retired KHF Director, conducted the forum at Uasin Gishu County. Where she introduced Kenya Healthcare Federation to the attendees ,in her opening remarks, she said “The BIG FOUR Agenda has helped Kenyans think on how to get the country back to business” She informed the attendees that, inorder to achieve Universal Health Coverage, quality healthcare should be accessible and affordable without financial strains.
It was noted that Uasin Gishu County has 80% of the population living in the informal sector, the poverty index is at 48% and 5% of the population is over 70 years of age. However, the percentage increase in private hospitals is higher than public hospitals which shows that the private hospitals are gaining more from NHIF. “Can we devolve Universal Health Coverage? Is it possible to start at the county level rather than at NHIF level and how can we be more innovative?” Dr. Bola Tafawa. The discussion was divided into three parts as follows: Bucket A – Focus on the 12% who can pay but are not paying ( find out whether they are willing to pay and not able to pay or they are able to pay but don’t want to pay.),Bucket B – pool the poor, Bucket C – pooling from the rich to the poor.
“People need to understand that Universal Health Coverage is not free and we need to look internally and think about whether we have the resources to pay. The schemes must look at prevention because we cannot afford to treat all the people. It is known that the best athletes come from this area, why do we not give more priority to encourage this? let us not think about NHIF only but also think about what model will work. People run away from the public sector because they feel like they are not getting the services they need and we need to address that.” Dr. Sitinei, JHPEGO.
“In the context of Universal Health Coverage, there is more of healthcare financing and it is well noted that NHIF focuses on curative and this may be a burden to NHIF, therefore, as a county we need to push for preventive care as we think of a model in Uasin Gishu and consider what is legal.” Maurice Oduor – Moi University.
“We need to be clear what we mean by Universal Health Coverage. I am representing healthcare financing in the County members. We know that UHC agenda is rolling out and in Uasin Gishu we have done assessments of facilities so that we are able to provide the minimum care. We have identified the gaps and now we just want to fill in. The steering committee is designing a package and we are thinking about what the minimum package should be.” Ms. Everlyne Rotich Health CEC – Uasin Gishu County. Ms. Rotich further encouraged the attendees to consider the innovation to put in place inorder to provide preventive care in Uasin Gishu County which should also be equitable and accessible.
The Deputy Governor, reassured the attendees that they are going to solve a lot of problems and save lives so as to achieve UHC. He further noted that the cost of treatment is part of the reason why people slide into poverty.
KHF further held a county stakeholder engagement forum, in Isiolo County, Hon. Isaack Abduba Fayo, leader of majority and member of health committee ,informed the attendees that Ksh.220Million has been given to the countie’s health sector. The Deputy Gorvenor, Dr. Abdi Issa informed the attendees on the important of strengthening primary healthcare and decongest the hospitals so as to increase accessibilit
Isiolo County has 38,000 households of which only 22% have a cover the only coverage is 22% of the population. The biggest challenge is the poor. There are 200,000 patients waived every month at the referral hospital. If Makueni care is to be adopted, 500Ksh cannot quarantee quality healthcare. However, National Hospital Insurance Fund(NHIF) is a challenge because 80% of People in Isiolo county do not have a formal employment therefore, subsidization is important.
Dr. Amit Thakker, Chairman, Kenya Healthcare Federation challenged the county health stakeholders, come up with strategies that will allow better healthcare he emphasized that they should capitalize on county stakeholder forum and Public – Private Partnership(PPP).
“Remember that if you improve healthcare then there will be economic development and you will be able to improve quality” Eddine “If frontier counties development council (FCDC) are facing the same issues on supply chain then maybe they can do group purchasing for the nine counties. Private sector would support this since the interventions would have an immediate impact” Dr. Daniella Munene, Director, Kenya Healthcare Federation.
A fruitful county stakeholder engagement was observed in Kisumu County. From a survey that has been carried out by the county in partnership with PharmAccess and world Bank, there are 160,000 households in Kisumu. 30% of the populations is unable to pay and the county government is planning to cater for the 30%. From a gap analysis and economic survey carried out in 2017, 10% of the population are from the formal settlements and are able to pay. 20% are from the informal settlement and may be struggling to pay.
Dr. Thakker, advised the county health stakeholders to come up with a better financing model that will also put the poor into consideration. Some of his concerns were; if a person is on low income and is able to pay for year one, what happens to the same person for the second year if they are not able to pay? Therefore, inorder to roll out Universal Health Coverage, The finance model should be affordable and sustainable throughout. He further advised them to have different levels for example, 1000 – 3,000Ksh. or start with what they can afford. Dr. Amit assured the attendees of full support from the private sector such as giving technical advise, actural support, banking model and others who will come in.
The Deputy Governor thanked Kenya Healthcare Federation team, under the leadership of the chairman Dr. Amit Thakker, for organizing the meeting.in his remarks he said “ This meeting has come at the right time, we have learnt a lot and from this meeting and our programs are on course and have been enriched as a result of the engagement. Dr. Mathew Ochieng Owili.