By Zak Syengo
Nurses in most counties downed their tools to demand implementation of resolutions agreed with the regional governments. I consider this one of the major challenges affecting universal health coverage(UHC), but not the only one.
I find the discussions around UHC phenomenal and interesting especially for Kenyans living in rural areas where access to health facilities remains a challenge. Allow me to revisit a personal encounter etched clearly in my memories.
In August 1990, together with my brothers, we cut short our hunting expedition to respond to a wailing mother suffering from a stomach condition that had persisted for a while.
That year, the nearest health care center was 24 km away, devoid of any equipment to carry out tests for any meaningful examinations. The nearest hospital with substantial analytic devices was 95km away, a distance one will have to cover in three hours due to deplorable conditions of the roads. Only one public service vehicle plied that route, one return trips a day. Boda-bodas had not been introduced, so were mobile phones. It took 20 hours for my mother to reach an established facility and compete with thousands of other needy cases from all over the expansive county.
Twenty-eight years later, a lot has changed, both in developing hospital facilities and also significant progress in streamlining infrastructure.
The fact that NHIF has registered 2.8 million beneficiaries is a sign of momentous steps towards universal healthcare coverage. In 2017, Kshs 2.5 billion was disbursed to health facilities who treated deserving Kenyans. Today, NHIF has composite membership of those in formal and informal sectors, anticipating to cover 8 million Kenyans by the year 2030.
In his first term, Pres. Kenyatta launched the ambitious program to equip key hospitals in the 47 counties. A total of Kshs 28 billion was used to buy equipment key in ensuring examination of various diseases removing the burden of referral to hospitals like Kenyatta National hospital. The challenge is now for each county to build capacity within their institutions and supplement the national government efforts.
The hiring of Cuban doctors, however controversial it might seem, breathed life into Kenya’s efforts towards access to quality health services. Cuba has a doctor to patient ratio of 1:100 as opposed to Kenya’s ratio of 1:17,000. Cuba is among the leading countries who have succeeded in facilitating affordable and accessible healthcare programs. The Cuban specialists in Kenya are supposed not only to assist in providing excellent services but also build capacity in our institutions during their tenure.
A number of county governments have developed health care programs to enhance grassroots outreach. Kitui County launched K-CHIC in July 2018, so far registering 28,000 beneficiaries at a cost of Kshs 1,000 per household. Benefits include access to diagnostic and treatment services at various county hospitals. Earlier, Makueni County started a similar platform which so far has benefited 30,000 households. This is likely to be replicated in other counties in the near future.
However, some challenges still abound. Access to drugs in most county managed hospitals remains a key issue. The fact that some counties have not paid the national government’s drugs distribution agency, KEMSA, hampers the drive to buy more medicines and ensure seamless delivery. Some counties still lack key personnel in tackling all the patient needs, including nurses and particular health specialists. This is part of the reason why nurses are on strike in a number of counties.
As we focus on solving those challenges, universal healthcare will no longer be a dream but a reality.