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What Kenya needs to do to attain universal health coverage goals

Doctors during a strike last year. file PHOTO | NMG
Doctors during a strike last year. file PHOTO | NMG 

During his inauguration late last year, President Uhuru Kenyatta scheduled a self-imposed target of 100 per cent universal healthcare coverage (UHC) by 2022.

While this is a very ambitious target, it’s heartening to appreciate health listed among the ‘Big Four’ priorities for the government. The expectation is that citizens realise increased access to healthcare, especially to the vulnerable groups arising from concerted government efforts.

The universal healthcare coverage’s goal is to ensure that everyone can access medical services they need without being hindered by finances or suffering economic ruin in the process.

The Daily Nation on October 13, 2015, reported how a road traffic accident victim spent over 18 hours in an ambulance looking for emergency care, eventually succumbing to the injuries.

This illustrates how weak our health system is, and thus the need for reforms to improve its performance and protect the right to access health services.

These reforms must address both the demand side including healthcare financing (hence UHC) and public awareness, as well as the supply side including provision of accessible, quality health services at affordable costs.

The UHC is not just a concern for the vulnerable in society but for businesses as well. The structure and ways of financing the health system of a country affect businesses in many ways including the taxation policies adopted, direct costs of funding employee medical schemes, as well as impacts on firm productivity from absenteeism and ill health.

A well-functioning health system is expected to lead to better health outcomes, which has a positive impact on the productivity of employees. Indeed, studies have demonstrated a positive correlation between a country’s health status and gross domestic product, albeit with ongoing debates on reverse causality.

It’s, therefore, incumbent on the government to develop and implement policies that will optimise the health system not only to meet its human rights obligations but also as a factor of productivity and economic growth.

That the President pronounced himself on his intentions, the next question is which way the government will take in pursuit of the UHC objectives. This will, of course, become clear once the relevant policies are spelt out in detail.

For now, those of us in the health insurance sector can only speculate based on the choice of words that the President used so far in relation to this subject.

In his speech, he said: “This vision will be driven by a complete reconfiguration of the National Hospital Insurance Fund (NHIF) and reform of the laws governing private insurance companies, … that plan requires strong collaboration between the NHIF and our private sector insurance providers. We will review the rules governing private insurers, to bring the cost of cover within the reach of every Kenyan.”

One obvious conclusion from this is that the NHIF is the vehicle that the government has picked to drive this agenda. Indeed, the fund has made great strides in expanding coverage in recent years and now represents the largest pooled insurance fund in the country.

The NHIF has embarked on an aggressive recruitment drive that has so far netted more than seven million as at last December. This has served to raise the level of awareness on health insurance in the general population.

Additionally, the recent reviews in coverage to include outpatient services and other procedures such as dialysis and surgeries have had a profound impact on healthcare for many who would not have been able to afford otherwise.

There is obviously a lot that needs to be done to achieve 100 per cent coverage from less than 25 per cent currently. A lot has been done to come up with models and policy papers and what now needs to be done is to bring together all stakeholders to lay down a roadmap clearly defining the key actors and their roles.

The government will lead the way through leadership and governance while the private sector can bring on board innovation and industry as has happened in other sectors.

Isaac Nzyoka, group managing director- Health Insurance, UAP Old Mutual.

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