Availability of affordable health products crucial in achieving UHC
A section of the Kenya Medical Supplies Authority Embakasi Depot, Nairobi County on May 18, 2023.
What you need to know:
- The Kenya Demographic and Health Survey 2022 shows that out-of-pocket (cash) payments are the most common means of payment for both inpatient and outpatient expenditures, with only one in four
- Kenyans (26 per cent) having some form of health insurance.
- Kenya imports most of its medicines and may not have much control of their prices, especially now when the shilling has weakened against the dollar.
When Homa Bay Governor Gladys Wanga opened the modern Rachuonyo East sub-County Hospital last month, she received many congratulatory messages and questions.
The inquisitors wanted to know if drugs would be available, for the bane of Kenya’s public health sector has been the lack of medication and generally health commodities, forcing patients to go to private service providers whose rates are high.
Medicine prices are a major determinant of access to healthcare. However, owing to low availability of medicines in Kenya’s public health facilities, most low-income residents pay out-of-pocket for health services in private health facilities.
According to a 2019 study titled Medicine Prices, Availability and Affordability in Private Health Facilities in Low Income Settlements in Nairobi, medicines account for up to 60 per cent of healthcare costs in developing countries, including Kenya, and even when the drugs are available, patients have to pay for them.
Yet in Kenya, says the study, only seven per cent of income for low-income earners is available for healthcare costs, including medicines.
The Kenya Demographic and Health Survey 2022 shows that out-of-pocket (cash) payments are the most common means of payment for both inpatient and outpatient expenditures, with only one in four Kenyans (26 per cent) having some form of health insurance.
Kenya imports most of its medicines and may not have much control of their prices, especially now when the shilling has weakened against the dollar.
The United Nations COMTRADE database on international trade shows that Kenya’s imports of pharmaceutical products stood at $776.76 million (Sh110 billion) in 2021.
“Most of the medical supplies are imported and due to currency devaluation and supply chain challenges, several vendors have revised prices upwards by between 12 and 15 per cent,” says Rashid Khalani, the CEO of Aga Khan University Hospital.
Last week, President William Ruto said Kenya imports pharmaceutical products worth Sh140 billion every year, and called for investments in local manufacturing.
Health commodity security is one of the four pillars of Universal Health Coverage (UHC) that Kenya hopes to achieve by 2030.
The UHC policy states that the availability, accessibility, quality and pricing of medicines, vaccines and health products and technologies is a crucial component and challenge to the success of UHC.
Health Cabinet Secretary Susan Nakhumicha says the biggest challenge in the availability of medicines lies in the supply chain systems of the Kenya Medical and Supplies Authority (Kemsa) – the State-owned sole supplier of Health Products and Technologies (HPT) to public health facilities.
Dr Andrew Mulwa, the Kemsa chief executive, says the authority has undertaken timely procurement and prompt payment to suppliers to ensure health products are affordable and accessible to all Kenyans as a step towards achieving UHC.
“The authority is planning to revise and update over 35 policies which will ensure that staff operate within the procedures and regulations,” Dr Mulwa says.
Since health is a devolved function, county governments are the key purchasers of health commodities and, thus, the most prominent clients of Kemsa.
Kirinyaga Governor and Council of Governors (CoG) Chair Anne Waiguru says counties are focusing on local manufacturing to make health commodities more accessible and affordable to all Kenyans.
“The sector has already set clear policy objectives on increasing the value of purchases from local firms to 50 per cent,” says Waiguru.
To ensure the medicines reach their intended destinations, Kemsa and county governments say they are investing in technology that will enhance end-to-end visibility in the supply chain and track the movement of healthcare products from the point of origin to that of consumption.
Waiguru says an elaborate e-LMIS (Logistics Management Information System) will help address the timeliness and completeness of reporting health commodities data, given the limitations in staff capacity.
The World Health Organization recommends developing and implementing a “medicines pricing policy to achieve a greater level of transparency, uniformity and predictability in the pricing of medicines, including the consideration of reference pricing for medicines in the private sector.”
Ombogo is a consulting Science editor. [email protected]
