Survey warns of new barriers to universal health

A new report has poked holes on President Uhuru Kenyatta’s flagship project - the multi-billion shilling Universal Healthcare Coverage (UHC) piloted in four counties last year.

According to a study by Kenya Medical Research Institute (KEMRI) between January and March on the UHC programme in the four pilot counties of Isiolo, Kisumu, Machakos, and Nyeri, a myriad salient concerns have been flagged.

Runaway graft, congestion in hospitals, human resource capacity, inadequate infrastructure and lack of public participation among others have been highlighted in the report commissioned by the Ministry of Health.

The UHC is one of the main pillars of Uhuru’s Big Four agenda, and key determinant in his legacy. “Corruption was seen as a major setback to UHC’s implementation by both community members and key informants in various sectors,” read the report.

The report proposes need for national dialogue to address equity issues through increasing a number of facilities to reach all.

A respondent in Nyeri said, “Some corrupt staff hide drugs and other supplies you are supposed to get for free.”

At governance level, the report faulted limited engagement of MCAs in the programme.

At community level, poor marketing and promotion of package, and insufficient coordination with community were cited as challenges. There are also delays in disbursement/trickling down of funds to lower level health facilities and unpredictable supply and delivery of essential medical commodities and drugs.

The survey found a disconnect on the flexibility between voluntary monthly contributions to NHIF premiums by populations to augment the UHC “free health services” costs for sustainable venture.

The report said, “Respondents argued that sustainability of the programme is to be questioned if there is no clear pathway on how different insurance schemes play a role in UHC more so the NHIF and community members who have been using it.”

UHC is high on the global agenda as a means to ensure population access to health services, quality services and financial risks protection. According to the report, UHC puts the focus on people and not disease. “All counties expressed an upsurge in number of patients seeking care following the launch of the UHC initiative,” added the report.

It went further to express concerns that there is potential for commodity shortages and this could in the long run create mistrust in health workers if patients do not receive required treatment due to shortages.