Letters

LETTERS: Scale up access to basic health services

clinic

Patients at a health centre. FILE PHOTO | NMG

Through the National Hospital Insurance Fund (NHIF), the government has promised to spread universal health coverage to all Kenyans as part of President Uhuru Kenyatta’s Big Four agenda.

This means that all Kenyans will have access to the health services they need without the risk of financial hardship when paying for them.

Essential health services (including for HIV, tuberculosis, malaria, non-communicable diseases and mental health, sexual and reproductive health and child health) should be available to all who need them.

Since a country’s universal health coverage is a combination of whether people obtain the health services they need and financial risk protection, measurement needs to include both components.

Coverage of health services can be measured by the percentage of people receiving the services they need. For example, women in fertile age groups accessing modern methods of family planning or children being immunised.

On the other hand, financial risk protection can be evaluated by a reduction in the number of families pushed into poverty or placed under severe economic strain due to health costs.

The impact of these steps on population health and financial wellbeing of households can also be measured as can many of the factors that make it easier to increase coverage.

This requires an efficient health system that provides the entire population with access to good quality services, health workers, medicines and technologies. It also requires a financing system to protect people from financial hardship and impoverishment from health care costs.

Access to health services ensures healthier people; while financial risk protection prevents people from being pushed into poverty.

Therefore, universal health coverage is a critical component of sustainable development and poverty reduction, and a key element to reducing social inequities.

Universal health coverage is not something that can be achieved overnight, but all 47 counties can take action to move more rapidly towards it, or to maintain the gains they have already made.

Universal health coverage is fundamental to ensuring social protection for health. The poorest populations often face the highest health risks and need more health services.

A key element of financing for universal health coverage is sharing resources to spread the financial risks of ill health across the population.

Expansion of NHIF system should collect large pools of prepaid funds that can be used to cover the health care costs of those in need, regardless of their ability to pay.

To achieve this progress on providing universal health coverage, the government should implement a mandatory contributions for people who can afford to pay through taxation, or compulsory earmarked contributions for health insurance.

Reducing the reliance on direct, out-of-pocket payments lowers the financial barriers to access and reduces the impoverishing impact of health payments.

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In terms of financial protection, the most vulnerable people should have access to the health services they need without restrictions.

The government should have to use general budget revenues to meet the health costs or insurance premiums of poor and vulnerable people.

Ensuring access to health facilities, workers and medicines in remote, rural areas is also important, as is providing special interventions for stigmatised populations. Universal health coverage has a direct impact on a population’s health and welfare.

Access and use of health services enables people to be more productive and active contributors to their families and communities.

It also ensures that children can go to school and learn. At the same time, financial risk protection prevents people from being pushed into poverty when they have to pay for health services out of their own pockets.

Universal health coverage is thus a critical component of sustainable development and poverty reduction, and a key element of any effort to reduce social inequities.

Universal coverage is the hallmark of a government’s commitment to improve the wellbeing of all its citizens in the Big Four agenda.