Saturday, February 18, 2017

Obstacles In The Path To Universal Health Coverage In Kenya (Part Two)


As a follow up to my earlier piece, this second installment looks at two other factors that could derail efforts to ensure attainment of UHC in Kenya.


Lack of a woke citizenry


As has been evident from the health workers strike for implementation of CBA, there has not been much anger and effort by the populace to support the worthy cause done to help them. Other than muted support from a few political types and Johnny-come-lates like Okiya Omtatah much of the anger both on the streets and online has been by doctors and few exceptional Kenyans like Wandia Njoya. It is shocking that a great majority of Kenyans have resigned themselves to the status quo of run down public healthcare facilities, high-cost of healthcare in private facilities and lack of regional distribution of medical care. For as long as the commoner (mwananchi) does not realize it’s possible to achieve change, they will forever be stuck in their own Plato’s cave unable to escape and forever looking at the shadows of the puppeteers.


Several people have asked me after the first part of the article. ”What can I do?” and “How can I help as a citizen?”. It all starts with and ends with health activism to make the cause of universal health coverage heard constantly and by all policy makers and shapers.


Next time a political aspirant speaks up at a healthcare fundraiser; ask him or her track record or agenda for change in healthcare to avoid the catastrophic health expenditures for all Kenyans. If they do not have a convincing answer, you should reconsider their worth as a candidate and look for other options. Next time you have to raise funds for medical appeal, ask yourself, what is the government role? Next time doctors and advocates for Universal Health Coverage call for street demos do not sit back, be part of the change by joining in the initiatives to make all Kenyans voices be heard. Next time glorification of privatization of healthcare is touted as a beacon of efficiency, ask yourself, what’s the cost of care?


In the meantime, in as much as Kenyans are not really into issues based politics ,it’s time we changed this by demanding an issues based campaign and to ask more people to 
Sign The petition asking political parties to state categorically their stand on Universal health coverage. I hope we can attract at least 10,000 online signatures before forwarding to the political parties for comment. Make this a reality by sharing widely and remember health policies are political in nature and the key to change is your ballot, Vote wisely for better Kenya. Vote for candidates who aspire for UHC.


Government debt burden


A major factor in ensuring a good health financing mechanism is having sustainability of any intervention. Tax-based financing of health is a very effective method. However due to the current scenario of increased government debt to finance construction of the Standard Gauge Railway and other infrastructure projects, that might be a challenge. The government also is faced with competing obligations to improve other sectors of the economy, national defence projects and the ironical allocation of corruption in the national budget as was highlighted by the government spokesman in a recent public forum


So, in as much as I believe am an optimist, I believe there might be a need to consult development economists on best approach to ensure a phased approach to implementing UHC soonest possible. If we cannot implement UHC immediately, we need to look at priority health concerns and increasing allocations to those areas for a rapid and cost-effective implementation. There has been an increase in lifestyle diseases and more government investment in non-communicable diseases prevention and control needs to be emphasized.


Other avenues for short-term health financing need also to be evaluated to help increase healthcare access, but in my opinion a tax-based health financing in the ideal model for Kenya.


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