Health agenda: Unpacking Raila Odinga and William Ruto manifestos

A child reacts as a health ministry official administers Measles-Rubella vaccination on her at Daraja Mbili village in Kisii on June 26, 2021. [Denish Ochieng, Standard]

As a stakeholder in the health sector, I’ve looked at both William Ruto and Raila Odinga-led manifestos and picked out the healthcare elements. Both promise Universal Health Coverage (UHC), here is what I have picked from both presidential candidates.

Ruto’s team picked out Out of Pocket expenditure on health as the pain point to address. Making a case for it 27 per cent as actual out-of-pocket expenditure, 10 per cent prepaid as insurance premiums, be it NHIF or private insurance. That’s 37 per cent of the expenses, about Sh200billion.

To bridge that gap, with the now mandatory NHIF contributions, their proposal is to have the graduated contributions between Sh300 to Sh3,000 max per month per household and NOT individual. (Sh3,600 - Sh36,000). That raises the Sh200billion and a budget-neutral health plan.

Their argument is that a household with two contributors of say Sh1,700 or Sh20,400 a year (which is Sh40,800 from two people) gets the same benefits and treatment as an individual contributor in the same bracket. Change of contributions to a household is a major shift.

They’re also looking at the Pharmaceutical manufacturing sector. Last I checked, 40 per cent of hospital bills (private sector) is medicine. If this is addressed, cost of hospitalisation for example, is likely to be reduced by half. That’s good for the end user.

To boost this manufacturing sector, the cost of production (from small small things such as the cost of electricity), imports of raw materials and getting a market for final products should keep anyone looking at cracking this awake. And a plan to scale up away from essential medicines. IT is everything if a government is to make evidence-based decisions and proper investment in this is expected. This has to link across all private, faith-based and public facilities. This is needed, urgently but the procurement process will need to be transparent.

The healthcare workforce, its equitable distribution across the country is key if we are to curb the brain drain by allowing them proper career progression, inter-county transfers etc. Health is a service industry, labour intensive and its HR is the backbone. No promise was made.

If the initial financing reforms are accomplished, why a fund for chronic and catastrophic illnesses? Why should it not be covered under the NHIF and other insurance benefits? Or better still, contribute these funds to the entire pool of health expenses. This one is ???

As for Raila Odinga’s health agenda unfortunately isn’t as detailed. I start with this emergency fund which I see no point of, if the insurance (NHIF, private) is mandated to cover and reimburse. Also, why eradicate malaria only? There’s TB, HIV, NTDs and others. This is the general starting point of where we are for Azimio. General points, a bit disappointing.

And the promise, for which I have very many questions on the ‘How to…’. I will wait to get more details and break it down.