Joe Kimondo @PeopleDailyKe
Slightly over a year after President Uhuru Kenyatta assumed office for his second and final term, focus has now shifted to actualisation of what he plans to be his legacy – the Big Four agenda.
If the foundation of the Big Four is laid well, analysts say it will put the country on course to its most tangible development track since Independence, by the time the president leaves office in 2022.
Of the Big Four – manufacturing, universal healthcare, affordable housing and food security – it is Universal Health Care (UHC), also known as Universal Health Coverage, that Kenyans need most. UHC is both anchored in the Constitution and World Health Organisation (WHO) as a human right.
According to WHO, UHC means all people should have access to promotive, preventive, curative, rehabilitative and palliative health services while also ensuring that use of these services does not expose users to financial hardship.
A key indicator that the government is determined to lay a firm foundation for the development pillars was the 2018/19 budget, in which the Big Four were allocated more than Sh400 billion.
Universal Healthcare was allocated Sh44.6 billion, with the biggest chunk of the money, Sh13.7 billion, directed to free maternal health care and leasing of medical equipment.
The government recognises the huge task ahead in delivering on this pillar, given that health coverage stands at 38 per cent, with majority of the poor in rural areas without access – or cannot afford – decent health services.
Treasury CS Henry Rotich said in his Budget speech in June the government will ensure all households access quality healthcare by 2022.
The designers of the Big Four, and specifically UHC, were cognisant of the fact that health care for all can only be achieved if the government partners with the private sector .
In the budget, Rotich said the main reason for public-private partnership in rolling out UHC “is to guarantee affordable health care and involves reconfiguring the National Health Insurance Fund (NHIF) and reforming governance of private insurance companies.”
The government manages big referral hospitals and county facilities. But it does not have clinics in most places outside the county headquarters, which is what UHC should offer if it is to be labeled ‘Universal’.
The capacity of NHIF on its own to provide all Kenyans with medical insurance is limited unless it partners with private health care providers, some which have presence off the beaten tracks in most counties.
An independent survey of health care providers across Kenya shows that many private hospitals are in areas where the government has never set up a health facility. For instance, Bliss Medical Centre, has clinics in 43 out of 47 counties.
Also widely available in many counties is AAR Health Care, Mediheal Group among others that provide both insurance and health services.
They also partner with NHIF to offer health care services under the public insurance cover. The hospitals and clinics focus more on providing affordable services as opposed to the big facilities based in major towns.
Most private hospitals are situated in areas where the government may never reach even with the Big Four outlay.
In the Big Four budgetary allocation for universal health care, the Treasury also set aside Sh2 billion to free primary health care and Sh800 million to the health insurance subsidy programme.
The bulk of this money will go to leasing equipment for public hospitals which have been operating below capacity for lack of diagnostic equipment.
“In view of increased cancer-related deaths, early screening and management is imperative. We have allocated Sh7 billion for leasing of computed tomographic scanners which will help diagnose the disease at the early stages,” said Rotich.
Partnering with the private sector will take the headache off the government, leaving the Ministry to concentrate on other issues.