If countries considered Universal Health Coverage (UHC) a central policy, Covid-19 has demonstrated the need for its urgent and widespread rollout. The pandemic has upended world systems in a manner that no scientists or sophisticated global intelligence could have foreseen.
Having been tapped to join the WHO Executive Board to represent Africa in the middle of this global crisis, I am persuaded that despite its toll, this pandemic has ‘blessings’ on its flipside.
Covid-19 has exposed the global crisis of weak healthcare systems that lay under the carpet and forced nations’ global attention on strengthening systems to achieve UHC.
Kenya, for example, has never suffered any major epidemic, having escaped the Sars, Swine Flu and even the deadly Ebola that ravaged neighbouring countries. This is therefore a first and has indeed tested its preparedness for epidemics.
Thankfully for Kenya, the Covid-19 epidemic appeared in the midst of the roll-out of the President’s Big 4 Agenda, which prioritised UHC as a key pillar. The UHC pilot in four counties in Kenya has demonstrated better impact on the health outcome and greater accessibility while building Resilient and Sustainable Health system that can respond to unforeseen shocks.
However, the success of UHC in Kenya will require more than executive or national-level goodwill. With health as a devolved function, each of the 47 counties must put in systems and resources to ensure its success.
The county bosses ought to give priority to delivery of a better healthcare system. Its success requires a cohesion between the national and county governments. Both the national and county budgets have to be aligned and apportioned appropriately towards this goal.
Primarily, sufficient resources have to be channeled towards better healthcare infrastructure such as more hospitals and better equipment. However, investment in infrastructure must be done simultaneously with that in human capital.
The country needs to improve the current ratio of healthcare workers to population to reach every citizen with quality healthcare. Continuous medical education and training of healthcare workers is required to use latest technologies and deal with emerging diseases.
WHO recently adopted home-based isolation and care as one of the case management strategies for Covid-19.
For a continent whose population largely resides in rural areas, this change in strategy has highlighted the importance of competent, capable and motivated community health volunteers (CHVs).
Whereas most of these volunteers may not have college training in health-related fields, their experience and informal training have gone a long way to help alleviate Covid-19 challenges.
Kenya has, for example, trained and oriented 60,000 CHVs to handle patients who may present with Covid-19 symptoms.
Results from the CHVs during this pandemic demonstrate that CHVs are a key component of the UHC success. Covid-19 has been a perfect crucible for testing the effectiveness and efficacy of technology in healthcare management.