By Florence Gichoya
The biggest lesson for countries in the past year is the need to invest more in health care.
COVID-19 pandemic has globally left millions infected, loss of lives, and decelerated economic growth.
After his reelection in 2017, President Uhuru Kenyatta made affordable health care one of his Big Four blueprint for socio-economic development in the country.
He underscored that “without improved standards of health, our quest for prosperity and a better life for our people would remain hollow.”
A year later, he launched the Universal Health Coverage program in Isiolo, Kisumu, Nyeri, and Machakos counties with the goal to scale up the coverage to the rest of the country by 2022. These areas have a target population of about 3.2 million people,
According to the Ministry of Health, within the first year of the pilot project, more than 1.6 million people visited health facilities than previously recorded. This is after fees at the county and county referral hospitals were scrapped.
The objective of the Universal Health Coverage (UHC) is to have all people receiving quality health care services, whenever they need them, without suffering financial toil in the process.
UHC is anchored in Sustainable Development Goal 3 which calls for ensuring healthy lives and promoting well-being for all ages.
One of its targets is to achieve universal health coverage, including financial risk protection, access to healthcare services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.
Even though the government has committed to increasing funding in the healthcare sector, Kenya’s annual average budget allocation for health is 5.7 percent of the overall budget.
Health is a devolved function and in the same manner, county governments’ budget allocation for health is below 10 percent and largely comprise of recurrent expenditure.
In terms of Gross Domestic Product (GDP), Kenya’s budgetary allocation is 1.73 percent of the GDP. In East Africa, Uganda is 0.98 percent, Tanzania 2.16 percent, and South Africa 8.5 percent.
Financial burden
Due to funding shortfall, the cost of treating diseases has been a great burden to the population with the majority having to fundraise to cover high medical bills.
According to the Kenya Household Health Expenditure and Utilization Survey that was last conducted in 2013, by the Ministry of Health and Kenya National Bureau of Statistics, only one in every five Kenyans had some form of health insurance coverage.
Insurance coverage is higher (26.6%) among urban dwellers compared to rural populations (12.1%). The National Hospital Insurance Fund (NHIF) is the largest health insurance provider in the country covering 88.4 percent of the insured population, while private insurance covered 9.4 percent.
However, the uptake of NHIF in the informal sector stands at 18.9 percent. The survey explored Kenyan’s health-seeking behavior, use of health care services, out-of-pocket spending, and health insurance coverage in Kenyan households.
It’s imperative for the Kenyan government to increase financing the health sector so that to ease the financial burden of Kenyans who have to pay out-of-pocket in order to access healthcare services.
Data from Kenya Institute for Public Policy Research and Analysis (KIPPRA) reveals Kenya’s out-of-pocket spending is 26.1 percent against the recommended 12-15 percent.
World Health Organization (WHO) estimates 11 million Africans fall into poverty every year due to high out-of-pocket health payments. In 2017, WHO and World Bank released the ‘Tracking Universal Health Coverage” 2017 Global Monitoring Report ‘that showed Sub-Saharan Africa has the lowest Universal Health Coverage in the world at 42 percent.
Southern Asia has 53 percent, while East Asia, Europe, and Northern America stands at 77 percent.
The report also revealed 97 million people became poor globally due to out-of-pocket spending in 2010. Africa and Asia accounted for 97 percent of the world’s population facing poverty due to out of pocket spending on health.
Increased funding in the health sector will aid in the recruitment of adequate health care workers, purchase of medical equipment, and medicines.
Accessibility to UHC by all people will not only save lives but also build thriving economies.
We need to ensure increased funding to Health care in the urban, rural, and marginalized areas, making healthcare affordable to everyone, thus leaving no one behind.
Florence Gichoya is a communication specialist.
