Patients at a health centre. FILE PHOTO | NMG
Through the National Hospital Insurance Fund (NHIF), the
government has promised to spread universal health coverage to all
Kenyans as part of President Uhuru Kenyatta’s Big Four agenda.
This
means that all Kenyans will have access to the health services they
need without the risk of financial hardship when paying for them.
Essential
health services (including for HIV, tuberculosis, malaria,
non-communicable diseases and mental health, sexual and reproductive
health and child health) should be available to all who need them.
Since
a country’s universal health coverage is a combination of whether
people obtain the health services they need and financial risk
protection, measurement needs to include both components.
Coverage of health services can be measured by the percentage of
people receiving the services they need. For example, women in fertile
age groups accessing modern methods of family planning or children being
immunised.
On the other hand, financial risk
protection can be evaluated by a reduction in the number of families
pushed into poverty or placed under severe economic strain due to health
costs.
The impact of these steps on population health
and financial wellbeing of households can also be measured as can many
of the factors that make it easier to increase coverage.
This
requires an efficient health system that provides the entire population
with access to good quality services, health workers, medicines and
technologies. It also requires a financing system to protect people from
financial hardship and impoverishment from health care costs.
Access
to health services ensures healthier people; while financial risk
protection prevents people from being pushed into poverty.
Therefore,
universal health coverage is a critical component of sustainable
development and poverty reduction, and a key element to reducing social
inequities.
Universal health coverage is not something
that can be achieved overnight, but all 47 counties can take action to
move more rapidly towards it, or to maintain the gains they have already
made.
Universal health coverage is fundamental to
ensuring social protection for health. The poorest populations often
face the highest health risks and need more health services.
A
key element of financing for universal health coverage is sharing
resources to spread the financial risks of ill health across the
population.
Expansion of NHIF system should collect
large pools of prepaid funds that can be used to cover the health care
costs of those in need, regardless of their ability to pay.
To
achieve this progress on providing universal health coverage, the
government should implement a mandatory contributions for people who can
afford to pay through taxation, or compulsory earmarked contributions
for health insurance.
Reducing the reliance on direct,
out-of-pocket payments lowers the financial barriers to access and
reduces the impoverishing impact of health payments.
In
terms of financial protection, the most vulnerable people should have
access to the health services they need without restrictions.
The
government should have to use general budget revenues to meet the
health costs or insurance premiums of poor and vulnerable people.
Ensuring
access to health facilities, workers and medicines in remote, rural
areas is also important, as is providing special interventions for
stigmatised populations. Universal health coverage has a direct impact
on a population’s health and welfare.
Access and use
of health services enables people to be more productive and active
contributors to their families and communities.
It also
ensures that children can go to school and learn. At the same time,
financial risk protection prevents people from being pushed into poverty
when they have to pay for health services out of their own pockets.
Universal
health coverage is thus a critical component of sustainable development
and poverty reduction, and a key element of any effort to reduce social
inequities.
Universal coverage is the hallmark of a
government’s commitment to improve the wellbeing of all its citizens in
the Big Four agenda.
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