Josephine Kibaru-Mbae and Evelyn Samba
Universal health coverage is one of the hottest topics of discussion in Kenya and the rest of the world, and for good reason.
Universal health coverage is about ensuring that people have access to the health care they need without suffering financial hardship.
This definition of universal health coverage as provided by the World Health Organisation (WHO) comes very close to what the Constitution of Kenya (2010) says about the right to health in Kenya. That every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care.
It is not uncommon to come across stories of families being plunged into poverty because a member of the family became unwell. Medical appeals and fundraisers have become the norm rather than the exception.
The National Health Insurance Fund (NHIF), is one of the paths that Kenya has taken towards achieving universal health coverage, one of President Uhuru Kenyatta’s Big Four agenda.
A common source of distress for many Kenyans is reproductive health, including lack of access to family planning services.
A good pointer of this distress can be highlighted using two indicators – maternal deaths and unmet need for family planning.
Despite the progress we have made in reducing maternal deaths, Kenya still records an unacceptable high number of maternal deaths. An estimated 6,300 women die each year during pregnancy and childbirth.
A major contributing factor to maternal deaths is unplanned pregnancy.
Many Kenyan women are at risk of unplanned pregnancy. One in every five women (18 per cent) in a marriage or union in Kenya, and want to postpone their next birth for two years or more, or not have any more children, are not using any method of contraception.
Access to family planning services, including access to contraceptives, can go a long way in reducing these maternal injuries and deaths.
Unfortunately, NHIF does not entirely cover members seeking family planning services, with access to contraceptives not included as part of the cover.
As it stands, couples seeking access to family planning services have enough social and cultural barriers to dodge. Financial considerations should not be an additional barrier.
Indeed, the government of Kenya, in its commitment to the family planning 2020 process, identifies including provision of contraceptives to the NHIF cover by 2020.
Inclusion of all aspects of family planning in the NHIF cover will have high returns on investment.
Studies have established that family planning investments have a tremendous return on investment in health and other development outcomes.
These studies have shown that when women and their partners have unfettered access to family planning services, the socio-economic benefits accrue to their families, communities and the entire nation.
Access to family planning services improves women’s opportunities for education, paid work, and full participation in society.
Family planning investments have also been shown to lead to savings in the cost of health care services by reducing pregnancy related injuries and deaths, while reducing the burden on public amenities such as health, water and sanitation, as well as education.
It is, therefore, important that we include the entire family planning services spectrum, including contraceptives, in the NHIF cover. Doing so will boost Kenya’s efforts towards universal health coverage.
— Kibaru-Mbae is the Director General, National Council for Population and Development
— Samba is the Kenya country director at Deutsche Stiftung Weltbevoelkerung (DSW), an international development agency