County Health
To reduce the disease burden and eliminate geographic and financial barriers to accessing health services by Kenyans the National Government has consistently increased funding for the health sector to support innovative projects which are currently transforming lives across the 47 counties .
The true success of the Managed Service Equipment ( MES ), the Free Maternity Service , the elimination of user fee in primary health care facilities , the Beyond Zero innovations and public private partnership for health are the cornerstones of UHC in Kenya . A key feature of UHC is the NHIF the Health Insurance Subsidy Programme for the Poor ( HISP ) and the Health Insurance Subsidy for Older Persons & Persons with Severe Disabilities and the Chronic Illness Care Package , covering hypertension , CT scan , Renal Dialysis , MRI , cancer , diabetes and Rehabilitation . Currently 21.3 million Kenyans are now enjoying access to inpatient and outpatient covers and quality services up from 14 million .
Growing evidence shows that the government focus on strengthening health systems has made a positive effect on access and uptake of some services and Kenya is making efforts to achieve UHC . Kenyans now have access to increasingly innovative and specialized care , including improved diagnosis and treatment options that were not available in the past .
The evidence is the drop in death rate to 7 / 1000 population . More people are living longer free of disability and disease . According to the latest WHO data published in 2015 life expectancy in Kenya is : Male 61.1 , female 65.8 and total life expectancy is 63.4 which gives Kenya a World Life Expectancy ranking of 145 .
The country has made great strides in improving the nutritional status of children . Kenya is the only country that has met 4 out 5 WHO nutritional goals . Stunting reduced from 35 % to 26 %, while exclusive breast feeding improved from 32 % to 61 %. The
NHIF roadshow to educate the public .
under-five mortality has declined from 115 to 52 translating to 30,000 children ’ s lives saved . Neonatal mortality has also declined from 33 to 22 per 1000 live births over the same period . Vaccination coverage for fully immunized child has gone up to 76 % from 68 % in 2013 / 14 . Maternal mortality has also dropped from 488 to 362 / 100,000 . This represents 2000 mothers lives saved . Primary healthcare utilization has increased from 69 % in the financial year 2013 to 77 % in 2016 as a result of foregone user fees .
Similar improvements have been made in HIV / AIDS , currently stabilizing at below 6 per cent . Malaria prevalence has dropped from 14 percent in 2010 to 8 percent in 2015 , TB treatment rate is 90 % and 80 % in multi drug resistant TB .
The ability of these programs to make strides in achieving the country ’ s ultimate goal of UHC depends on the ability of the programs to be scaled up and its long
... a key feature of UHC is the NHIF ...
run sustainability . We contend that UHC in Kenya can be achieved by addressing both supply and demand-side constraints simultaneously .
The solution must also include building on existing public and private institutions and informal networks , leveraging existing capital , and empowering clients and local communities . The innovative models such as the Managed Equipment Service could be replicated in the planned cancer centres of excellence to eventually achieve the goal of access to health care and financial protection for all .
Simultaneously , coverage expansions could be linked to other health system reforms , including ones designed to give providers and patients the information they need to make appropriate health care decisions . Community support and strong acceptability , capacity building and close cooperation with providers are key factors to achieve this .
November-December 2016 53