Inside Makueni's universal Health Care Programme

In spite of a huge national health budget, most Kenyans are yet to enjoy quality healthcare services but Makueni County is showing this is possible in a trail-blazing scheme.

Until October 2016, retired diabetic teacher Josephine Matilu could barely afford insulin and other drugs to manage her condition.

Thanks to the county government’s Universal Health Care Programme, Matilu can now access free medical attention at any of the county’s hospitals. The programme was initiated during the last quarter of 2016.

The program has so far attracted over 45,000 households across the county. A household is required to register its members with only Sh500 per year. Each of the family members is then issued with a Makueni Care card which makes every member eligible for inpatient and outpatient health services all year round at any of the county hospitals.

Those aged 65 years and above are exempt from this fee and treated free of charge. People who have lived in the county for at least six months also qualify for the programme. In addition, the county government caters for mortuary fees up to 10 days in case one dies at the county facilities.

We found Ms Matilu at Mbooni Sub-County Hospital where she had been admitted for four weeks. Some of her toes had been amputated but she looked every bit jovial.

"Luckily for me, I am a senior citizen and the county government is taking care of my medical bills. For the period I have been here, I have not paid anything but I'm getting the best treatment and all the drugs I need," says Matilu from her hospital bed.

"This programme has alleviated the suffering of Makueni people most of whom would be detained in hospitals because of inability to settle hospital bills," she says.

Just outside the hospital, we bump into Janet Mwanza who had brought her 15-year-old daughter for outpatient treatment. Ms Mwanza registered with Makueni Care in December 2016.

"My daughter has been treated and given drugs. I have been using this card for a whole year without paying any extra coin; it is a huge relief," said the mother of three.

At Makueni County Referral Hospital, we came across John Mutunga, 53, who suffers from stomach cancer. His wife Georgina Mbula sits beside him at the hospital bed.

Mr Mutunga had been admitted to the hospital for six weeks, during which period he did not pay a single coin from his pocket.

"The card has catered for my bills here; medication, food and everything. If it were not for it, the bill would have been insurmountable for a poor family like ours," he said.

In a hospital where a daily bed fee ranges from Sh500 to Sh600, Mutunga would be staring at an over Sh25, 000 medical bill for that brief period.

Sometimes last year, he was admitted to the same facility for a week but unfortunately, he had not registered for the programme. He forked out Sh9300.

"We could not raise that kind of money and we had to sell a cow to settle the bill. It was quite a challenge for us because we have two children in university," explained Mbula, his wife.

Mr Robert Musau, the health administrative officer at Mbooni Sub-county county hospital, says the facility that has registered the highest number of members with universal health care with slightly over half of Mbooni households enrolled.

“Inpatient services have increased by 70 percent while outpatient services have shot up by 40 percent. That means health services are becoming accessible to all,” Musau says.

The county chief officer in charge of health services Dr Patrick Musyoki says the county government is committed to offer quality free health care services.

"This programme was informed by high poverty levels in the county… we thought it would be a timely move to cushion people from unwarranted suffering and inability to access quality healthcare. The surging registration is a clear indication that a lot of people were suffering at home," says Dr Musyoki.

The officer noted that the county government had made deliberate steps to expand and operationalise health facilities in terms of infrastructure, staffing and stocking of drugs and other consumables.

He says the county hospitals are fully stocked with drugs and have enough, well-motivated health personnel.

"With the onset of the free healthcare programme, we expected an influx of patients and therefore made deliberate investments so as not to shock the system. Our endeavour is to offer quality, timely and convenient health services," says Dr Musyoki.

Towards this end, the county government allocated Sh200 million in 2016/2017 financial year, Sh250 million for 2017/2018 and Sh300 million for 2018/2019 financial years.

Among critical services offered free upon registering with Makueni Care include laboratory tests, X rays and surgical operations. Dr Musyoki says in two years’ time, others such as ICU, dialysis and operations that need implants will also be offered free under the scheme.

The county government has also put up a modern trauma centre at Makindu Level IV Hospital and a modern mother and child wing at Makueni County Referral Hospital.

In addition, the county government recently acquired eight high voltage generators worth Sh31 million which have been installed at 11 newly-established theatres in sub-county county hospitals.

"In the long run, we want to ensure not only highest standard of healthcare for our people but also become a county of medical tourism where others come to learn the best healthcare provision practices from us," Dr Musyoki says.

The county residents are however advised to register with other health providers such as NHIF in case of referrals.