Why we need to align UHC services with community cultural practices
For UHC to be truly universal and inclusive, it must incorporate cultural beliefs that link human and animal health, especially in communities where livestock is central to life and well-being.
Under Article 43(1) of the Kenyan Constitution, every Kenyan is entitled to the highest attainable standard of health, including reproductive health services.
However, current universal health coverage (UHC) frameworks, as defined by both the World Health Organisation (WHO) and the Kenyan government, focus exclusively on human health.
Although these frameworks aim to ensure access to promotive, preventive, curative, and rehabilitative health services without financial hardship, they overlook the crucial role of animal well-being, especially in communities that have strong ties to livestock.
This oversight is particularly significant when examining culturally specific healthcare needs, such as those of the Maasai community.
A recent study in Kajiado County assessed county-based governance in UHC implementation and highlighted key gaps most notably, the failure to integrate the Maasai’s holistic health practices, which encompass livestock health as part of their well-being.
For the Maasai, health is a holistic concept, extending beyond humans to include animals. Livestock holds not only economic value but also deep cultural significance.
By exclusively prioritising human health, the current UHC model fails to capture this vital aspect, creating barriers to healthcare delivery and acceptance in the Maasai community. As a result, services under UHC are often viewed as incomplete or less relevant to their lives and beliefs.
The study’s findings suggest that similar gaps likely affect other indigenous and pastoralist communities worldwide, where cultural beliefs significantly influence healthcare practices. This research thus calls for a culturally adapted UHC framework that includes animal health.
Such a framework could bridge the divide between national healthcare policies and the specific needs of indigenous and pastoralist communities, making healthcare services more effective and culturally resonant. A key finding was a strong correlation between healthcare system challenges and Maasai cultural practices.
Regions with high healthcare challenges showed a weaker alignment with local beliefs, including the Maasai’s holistic view of health. The study revealed that when healthcare services failed to incorporate these beliefs particularly the link between human and livestock health perceptions of healthcare efficacy declined.
The qualitative data also pointed to the Maasai’s reliance on traditional medicine and the impact of language barriers, which further complicate the adoption of modern healthcare services. To address these issues, the study advocates for adopting the One Health approach, a model that integrates human, animal, and environmental health.
The One Health framework aligns well with the Maasai’s holistic view of health, recognising the interdependence of human and animal health. By incorporating livestock health into UHC policies, healthcare services would be more relevant and acceptable to communities like the Maasai.
In conclusion, for UHC to be truly universal and inclusive, it must incorporate cultural beliefs that link human and animal health, especially in communities where livestock is central to life and well-being.
The One Health approach offers a promising model for delivering culturally relevant healthcare by acknowledging the interconnectedness of human, animal, and environmental health.
By aligning UHC efforts with local cultural practices and addressing the unique needs of indigenous and pastoralist communities, policymakers can significantly improve healthcare access and outcomes in underserved areas like Kajiado County.
Expanding UHC to embrace One Health enables a healthcare system that respects and integrates diverse cultural needs, ensuring that healthcare services are not only accessible but also meaningful and effective for all.
The writer is the acting General Manager, GE HealthCare for Eastern Africa
