Bold political choices best guarantee for good health care

Health CS Cisily Kariuki presenting a report on the Universal Healthcare before the National Assembly Health Committee at Parliament. [Boniface Okendo/Standard]

For Societies and Nations to prosper, good health and wellbeing are fundamental.

Primary Health Care (PHC) plays a critical role in achieving health for all. It is an essential feature of health systems that secures accessible, affordable, cost-effective, quality, equitable, comprehensive, integrated and people centered services.

Existing evidence indicate health systems that are developed around strong PHC deliver better health outcomes because 90 per cent of all health needs can be met at the Primary Health Care level.

Alma-Ata declaration

It is in this regard that 40 years ago, 134 countries adopted the declaration of Alma-Ata, which set a target for the attainment of health for all. Progress in the uptake of PHC across the world has since contributed to raising global standards of health care, delivered important population health gains, including improved life expectancy and increased child survival.

Kenya has made tremendous strides in health care provision. Life expectancy has improved from an average of 48 years in 1978 to 65 years.  Similarly, under-five mortality has reduced from 175 to 54 deaths per 1,000 live births and maternal mortality ratio from more than 800 deaths per 100,000 deliveries in 1978 to 362 deaths per 100,000 deliveries.

The use of modern contraceptives has increased from as low as 7 per cent in 1978 to 52 per cent in 2018 while fertility rate has reduced from 8.1 per cent to the current 3.8 per cent. Likewise, we have managed to increase the proportion of deliveries by skilled personnel to 62 per cent and the fully immunized children below one year to 80 per cent.

Malaria fatality cases and TB infections have been reduced while the prevalence of HIV has declined from 14 per cent to 5.6 per cent. Diseases like smallpox have been eradicated while guinea worm infections and maternal tetanus have reduced significantly.

While we cherish these tremendous achievements, the world is now grappling with emerging challenges. For example, close to six million children are lost around the world every year before their fifth birthday, mostly from preventable causes. Over 150 million children are stunted and many adults are still dying from non-communicable diseases.

The emerging challenges of non-communicable diseases including cancers and cardiovascular diseases, mental health, trauma and violence and the unattained goal of health for all has reignited a call for comprehensive PHC interventions.

At a recent global conference in Astana, Kazakhstan to revitalize PHC, Kenya renewed its commitment to develop people-centred PHC interventions, build on the principles of the Alma-Ata Declaration towards UHC and Sustainable Development Goals.

The adopted Astana Declaration pledges to make bold political choices for health across all sectors, build sustainable PHC interventions, empower individuals and communities and align stakeholder support to national policies, strategies and plans.

We share the common global goals. Consequently, we shall carry out the following: Firstly, prioritise, promote and protect people’s health and well-being at both population and individual levels, through strong health systems.

What we'll do

Secondly, promote primary health care and health services that are high quality, safe, comprehensive, integrated, accessible, available and affordable for everyone and everywhere, provided with compassion, respect and dignity by health professionals who are well-trained, skilled, motivated and committed.

And thirdly, create enabling and health-conducive environments in which individuals and communities are empowered and engaged in maintaining and enhancing their health and well-being and finally push for alignment of partners and stakeholders activities toward providing effective support to national health policies, strategies and plans.

The success of our health system depends on PHC-oriented interventions geared towards proactive care, prevention measures, and health promotion at the local population level.

We are investing in PHC through community-based care, first-level health facilities, and population-based interventions with a hinge on individual and social behaviour for healthy choices throughout the life cycle.

Mrs Kariuki is the Cabinet Secretary, Ministry of Health