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High cost of medical care derailing UHC agenda

George Kebaso @Morarak

Stakeholders are now warning that the high cost of drugs and medical care could derail the Universal Health Coverage (UHC) plan, one of President Uhuru Kenyatta ‘Big Four’ agenda pillars.

They called on the Kenya Medical Practitioners and Dentists Board (KMPDB) to review the “abnormal cost” of medicines and medical care, saying they remain out of reach for the ordinary Kenyans.

And to compound the situation, the stakeholders said the inability of the National Hospital Insurance Fund (NHIF) to manage social protection programmes such as Linda Mama initiative, which is part of the UHC, is alarming.

Costing guidelines

They were speaking during a forum convened by a Parliamentary committee at a Nairobi hotel on the UHC, which is set to be rolled out mid next month by President Uhuru Kenyatta.

Yesterday, the National Assembly Committee on Health gave the board one month to come up with a final cost that should be charged on patients because the current one is unaffordable for majority of Kenyans. The Health ministry concurred with the sentiments saying the current  costing guidelines that have provided a fertile ground for health facilities and practitioners  to exploit Kenyans. 

A recent survey by the committee found out that the cost of circumcision for adults, for instance, that cost between Sh5,000 and Sh10,000 as a maximum according to the 2006 costing guidelines had been inflated to between Sh18,000 to Sh70, 000. 

The committee said it was the same for children, who were initially a similar charged  Sh5,000 to Sh10,000 for only an incision and drainage in the 2016 guidelines, but it was now  between Sh25,000 to Sh50,000.

Committee chair Sabina Chege said it is unacceptable that Kenya was almost the only country in the world where price of medication including for drugs varied from one location to another.

UHC affordability

She said there is need for an urgent review of this cost.

“We have mandated the Board to go and review the 2016 guidelines and revert urgently to the cost that was there because when we sat down as a committee. We asked ourselves whether this cost is reasonable, and agreed that the one in the 2006 guidelines is affordable, therefore given a directive, and expect the Board to come up quickly, not to defend the cost, but to come up with something acceptable,” she said.

The fresh move to seek affordable cost for medication for Kenyans stems from the fact that patients are paying as much as 5,000 per cent more for medicines and medical procedures in public health facilities, according to a recent survey by the Ethics and Anti-Corruption Commission (EACC) has revealed.

“As a committee, we sat down to look at the cost of healthcare in Kenya, cost of drugs and medication in Kenya compared with the rest of the world, and found out that it is on the higher side. As we look towards achievement of UHC we must look at affordability,” said Chege, the Murang’a Woman Representative.

In a survey carried out by the Ethics and Anti Corruption Commission (EACC), between April and September 2017, it sought to identify the systemic weaknesses in the procurement of medicines and non-pharmaceutical supplies as well as loopholes for corruption, including price hikes and high user fees.

On the soon-to-be launched UHC, Kariuki said most of the Sh3.9 billion set for the pilot programme will go to the selected four counties namely Kisumu, Nyeri, Isiolo and Machakos, while the rest will support its overall roll-out. 

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