Intensify focus on health target

A report in the media last week indicated that progress in realising the Big Four Agenda was woefully slow. In fact, the report indicated that only one percent of the targets had been met. While these statistics may be contested, they point to a problem of over-ambition in the plans.

During President Uhuru Kenyatta’s first term, the Jubilee administration had many promises to fulfil. Some of these were extremely ambitious and seem to have been quietly abandoned, like the laptop project. It was therefore refreshing when at the commencement of his second term, the priority interventions were reduced to four key areas. These were manufacturing, housing, food security and universal health coverage.

One cannot argue with the importance of these priorities for the country and the importance of focusing on them. However, half-way through his term the verdict seems to suggest the need for a rethink. Housing has had the most bumpy ride as a Big Four Agenda. Launched with a lot of pomp, the promise of delivering low-cost housing for Kenyans was extremely appealing.

However, the original premise of having employees make mandatory contributions to a housing fund was ill-advised and strongly opposed. The government eventually abandoned it as a funding model for delivering on this agenda.

While some initiatives are ongoing on housing, to continue having it as a big agenda within the remaining time period is akin to sprinkling water in the desert. The second is manufacturing. The private sector is the engine of any country.

Identifying manufacturing as a priority area was an acknowledgement of this reality and a signal of the need to ensure that the operating improvement improves.

Except for initial efforts to reduce the cost of power, not many tangible deliverables are discernable in this area. It, therefore, does not pay to be a Big Agenda in the short term. Work on improving our competitiveness should go on, but these efforts must be tempered with a dose of realism. This requires a recognition that delivering big impact in two to three years is impossible.

This would leave food security and universal health coverage. Both speak to the priority needs of the country now. We are at the midway point. If the agenda was the priority for an organisation based on a strategic plan, now would be the opportune moment to undertake a mid-term review.

This is an opportunity to reflect on the achievements thus far, assess the changes in the operating context and adjust where necessary. We recommend the same for the Big 4 Agenda. The review should lead to zeroing in on food security and universal health care. Under normal economic conditions, achieving both would be feasible and desirable. However, the context of operations in the country is such that even those two may be too much weight to carry.

The greatest intervention one can speak to thus far on food security is the construction of dams across the country. The results of these efforts have been tears and frustrations as opposed to progress. The one area where, despite challenges and initial skepticism in some quarters commendable traction has been had is the area of universal health care.

Many Kenyans are now able to access health care due to the initiative to expand health insurance through the National Hospital Insurance Fund Scheme.

Discussions about preventive action in the health sector are also a step in the right direction. Health costs are a big burden on many families. The recent upsurge in cancer deaths in the country is not only a national scare, it is a demonstration of the magnitude of the crisis.

Progress in health care delivery would very easily define Mr Kenyatta’s legacy. To drop the other three agenda items and dedicate the remaining period of his term would ensure that the programme is expanded across the country, resources are harnessed in delivering on a bigger scale. Kenyans would be able to recognise the achievements and laud its impacts on their lives.