By Dr. Wanjiru Njugi; PharmD, Msc.
Universal health coverage (UHC) has a direct impact on a population’s health and welfare.
Access to health services enables people be more productive and active contributors to their families, society and nations. It also ensures that children can go to school and learn.
Universal health coverage, requiring coverage with needed health services and with financial risk protection, is thus a critical part of sustainable development and poverty reduction, raised literacy, level increased and a key element of any effort to cut social inequities.
For a Country to meet UHC, she must have a strong, efficient, well-run health system that meets priority health needs through people-centered integrated care.
Its services should be affordability – a system for financing health services so people do not suffer financial hardship. It must have availability of essential medicines, correct prescription and technologies to diagnose and treat its own citizens.
A sufficient capacity of well-trained, motivated health workers to provide the services to meet patients’ needs based on the best available evidence, including actions to address social determinants of health.
Universal Healthcare cannot pick up without financing, strategy and long-term goals since UHC isn’t a destination but a journey. Each country or region has its own health related issues hence they must start somewhere keeping in mind that nothing such as a perfect Healthcare system.
Availability, affordability and access to health services are increasingly becoming election issues globally, engaging attention of politicians as well as voters.
I have argued several points Kenya can adopt to fund UHC in line with the President memo, vision and aim towards achieving UHC.
First is cutting off wastage.
Over last one year we have seen high publicized seminars in big hotels to deliberate on UHC. This could have happened in our public universities to cut the cost and the money redirected to paying hospital bills to someone at Isiolo referral hospital.
Second is effective use of our tax funded health budget. The Abuja declaration requires governments to set aside 15 percent of the budget to health.
Countries that spend 8-9 percent of their GDP on health have advance healthcare systems. Do we need qualified health managers to run our public healthcare against our norm of Doctors running them? Do we need to get rid of our healthcare grading in level 1-6 and put a more efficient method that make that rural facility palpable?
Public must accept that there is nothing like free healthcare. Healthcare is an expensive service and UHC isn’t about making it free but affordable. Kenyans must understand that paying for their healthcare is their duty.
Role of Private-Public Partnership (PPP) in healthcare. In 2015, the Kenyan Government selected GE Healthcare as one of its main partners to deliver a seven-year Managed Equipment Services Partnership (MES) to give Kenya’s 46 million strong population with access to tele-radiology services across public hospitals in Kenya.
MES are a form of PPP that enables customers to adopt a ‘pay for service’ expenditure plan and affords a number of financial benefits including funding to cover equipment, maintenance and other project costs such as training. The model allows the Kenyan government to budget healthcare expenditure over several years by deferring upfront capital outlay. Such programs should be used well to achieve more.
Affordable Pharmaceuticals. India with more than 1 billion people has managed to offer good healthcare especially on medicines. This has been achieved by creating local manufacturing companies which produce generic and innovator brands at local level. This reduces the cost of production; improve quality and storage of medicines.
We should encourage more local pharma-industries to cut down cost of pharmaceuticals. Controlling cost of pharmaceuticals will reduce costs and increasing savings for other investments.
High skilled adequate and available health labor force is key to achieving UHC. In Kenya we have quite good school of health sciences that generate well conversant, trained work force. Investing in a well-trained labor force is a key tool to take us to our dream of UHC. The reason why we keep losing lot of billion dollars to international countries through medical tourism especially to countries like India, UK, and South Africa is due to affordable healthcare, skilled labor and modern technology used in those countries. By us imitating those countries health models, we shall create a local Health hub in Africa which makes Kenya a Medical destination, giving fund and more efficient system. However in Kenya we need an independent body away from politics to regulate health workers name Health Services Commission (HSC).
Exporting Health labor force. As we speak we have a hundred or more Cuban Doctors in Kenya making money for their country. This program can be adopted by Kenyan Government especially in this era where we have a large pool of unemployed Health workers in the country. Countries like Congo, which is facing Health crisis, can benefit with our unemployed Health workers through UN or Government-to-Government program that will make them earn and share of their fund to go Government to fund UHC. This is not a new phenomenon; we have seen in the past Kenyan Health workers being taken to West Africa to help solving Ebola menace. It’s only this time we make more efficient and lucrative both to the Government and practitioner.
Embracing Traditional Medicine. In Kenya despite being rich in traditional medicines, it hasn’t been utilized to its optimal level. Herbal Medicine is affordable and can cut cost of medication. What we miss in Kenya is a good research on potential herbal medicine, pharmaceutical modification to make it consumer use only product in form of tablets, syrups etc. in India, they have utilized its traditional medicine in form of homeopathy, Ayurveda and siddha which serve the society with it share.