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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