Accountability key to achieving UHC

A robust healthcare system does not solely rely on well-designed structures, but also on sustainable financial systems that ensure adequate resources that are then equitably utilised. Universal health care (UHC) hinges on the principle that all individuals should access quality health services without suffering financial hardship.

However, achieving this ideal remains elusive, with the World Health Organization estimating that nearly one billion people globally lack access to essential health services.

In Kenya, where access to healthcare is a constitutional right, millions still face significant barriers to affordable treatment in both public and private facilities. This includes individuals under the Social Health Authority. These barriers perpetuate social inequalities, hinder economic growth and undermine societal progress.

Despite the government securing significant loans from institutions like the World Bank and the International Monetary Fund, benefits to citizens remain unclear. How has this influx of funds improved the healthcare system?

Expanding healthcare access

A glaring disconnect exists between financial investment and meaningful outcomes. Citizens are increasingly rely on fundraising to cover treatment costs. While urban populations may use social media to mobilise support, rural communities remain largely excluded due to lack of access to technology, knowledge, or government connections.

This highlights a systemic failure to address healthcare access equity across the country. It raises critical questions about the effectiveness of governance, resource allocation and implementation. Why can’t these funds be utilised to build a resilient health system that prioritises equitable access to affordable, quality care?

Every year, nearly one million Kenyans fall below the poverty line due to healthcare-related expenses. Expanding healthcare access can alleviate this economic burden. However, this cannot happen without meaningful citizen engagement and social accountability.

Citizen participation is critical in holding governments accountable and bridging the gap between public demand and government action. Yet, many Kenyans remain disempowered, unable to trigger recognition or action from their leaders. The lack of effective mechanisms for citizen engagement undermines the potential for transformative change in healthcare.

Social accountability

Empowering citizens to demand action and fostering accountability at all levels of government are crucial. Social accountability involves more than transparency — it requires the government to actively respond to public needs. While transparency provides the data and tools to assess government performance, it is accountability that ensures action and results.

Moving from transparency to accountability necessitates a coordinated approach. Transparency alone — whether in government expenditure, public health statistics, or policy announcements — does not ensure outcomes. Accountability requires the government to act on the commitments it makes.

To achieve this, Kenya must use data to monitor national commitments and hold leaders accountable for meeting them. Other actions include tailoring health interventions to address the unique cultural values and social norms, and governance challenges of each county, and promoting inclusive engagement, especially for marginalised communities.

Ultimately, achieving universal health care in Kenya will require shifting from rhetoric to actionable accountability. Empowered citizens, transparent governance and responsive leadership must work in tandem to close the gap between aspiration and reality. Only then can Kenya build a healthcare system that serves all its people equitably and sustainably.

Mr Shuaib is the executive director, Epic Youth Organization.