Governors say cautious yes to UHC, put stringent terms
From left: Kilifi Governor Amason Kingi, Health CS Mutahi Kagwe and Italian Ambassador to Kenya Alberto Pieri when they visited Malindi Sub-County Hospital on November 2, 2020 . Photo | POOL
What you need to know:
- Dr Mutua however expressed reservations about using the NHIF to spearhead the UHC over corruption and other challenges.
- President Kenyatta said his administration will ring-fence health sector funds to support the attainment of the UHC.
County governments have finally agreed to the Universal Health Coverage (UHC) following an intervention by President Uhuru Kenyatta.
On Friday, governors had expressed reservations on the programme, pointing out that its piloting in Machakos, Isiolo, Nyeri and Kisumu counties had faced huge financial challenges.
But on Saturday, Council of Governors chairman Wycliffe Oparanya agreed to the UHC, albeit on certain conditions.
Governors want a UHC fund established, recruitment of UHC health workers, reforms at the National Hospital Insurance Fund (NHIF) and a review of its Act to allow county representation in the NHIF board.
In a joint communiqué signed by Health Cabinet Secretary Mutahi Kagwe, his Devolution and Asals counterpart Eugene Wamalwa and the CoG, the parties agreed to involve counties in the establishment of a social health insurance whose plans are ongoing, the finalisation of a UHC policy in consultation with stakeholders including counties and an insurance model that guarantees financing for primary healthcare as well as preventive and promotive health.
On the hiring of health workers, the MoH said it will transfer the payroll to counties once the respective County Public Service Boards have completed their recruitment processes and made returns by January 1.
Future recruitments
Counties will undertake all future recruitments. The MoH will provide resources where possible for the training of community health volunteers by the counties. The ministry further agreed to give conditional grants to the counties to purchase medical equipment for levels two and three health facilities.
On the strengthening of primary healthcare, the intergovernmental forum on UHC agreed to put in place a mechanism that guarantees for its financing.
The forum further agreed to set up county and sub-county level surveillance structures and financing for timely epidemic preparedness and response.
The UHC will enable Kenyans to gain access to outpatient and inpatient services, communicable and non-communicable disease management, maternity, dialysis, radiology, mental health, minor and major surgery, substance abuse rehabilitation, emergency services and cancer treatment, among others at Sh6,000 per household per year.
President Kenyatta said his administration will ring-fence health sector funds to support the attainment of the UHC.
“This scheme must be a success. I know we can do this. I know we have the ability to do this if we just work together. I am really calling each one of you to be active partners in this endeavour so that we can achieve this objective on behalf of our people,” Mr Kenyatta told the governors in Mombasa during the launch of Biometric Registration for UHC Scheme Beneficiaries.
Scaling up its implementation will depend on reforms at the NHIF, which Mr Kenyatta insisted shall be comprehensive and fully implemented, to ensure the country has a national social health insurer able to responsively meet the needs of Kenyans.
Earlier, Mr Oparanya had said that governors cannot implement the programme unless there is proper financing. CoG health committee deputy chairman Anyang Nyong’o said there are lessons to learn from the piloting.
Affordable healthcare
“In Kisumu County, we had a very difficult time getting money on time. It taught us that financing affordable healthcare through taxation handled by the national government then paid to the counties cannot work,” Prof Nyong’o said.
He stressed on the need for adequate human resources and functioning facilities: “We must set up a health insurance fund managed by both levels of government, make sure we get requisite human resources through proper training and set up health facilities in counties that have better services than private hospitals,” added Prof Nyong'o.
Governors Charity Ngilu (Kitui), Francis Kimemia (Nyandarua), and Alfred Mutua (Machakos) lauded the programme saying all Kenyans stood to benefit.
Dr Mutua however expressed reservations about using the NHIF to spearhead the UHC over corruption and other challenges.
He instead proposed an increase of the UHC allocation to counties to Sh50 billion. He pointed out that Machakos County gets between Sh700 million and Sh800 million yearly for UHC which goes into buying drugs and medical equipment.
