KMTC Holds Symposium Targeting Health Workers
KMTC held a symposium under the broad topic “Health Care Financing Towards Universal Health Coverage” at the Nairobi Campus School of Nursing Assembly hall April 30, 2019.
While officially opening the event, Deputy Director (Finance and Administration) Mr. John Anyira representing the CEO, termed the symposium “an opportunity to stay abreast of new and emerging trends in Universal Health Coverage (UHC), one of the Government’s Big Four Agenda.” He noted that “KMTC has a key role to play in supporting the Government to achieve UHC goals and we must therefore be proactive.” Mr. Anyira informed participants that the College had started a number of courses such as Family Health Nursing, Family Medicine and Community Health Extension Workers towards this end.
The Government of Kenya on its part, has taken a pilot phased UHC approach in four (4) Counties aimed at providing essential health services coverage while strengthening the health systems to guide scaling the exercise across the remaining 43 counties. The four counties selected are Isiolo, Kisumu, Machakos and Nyeri.
Head of UHC in the Ministry of Health Dr. David Kariuki noted that UHC is a journey that has taken various countries many years to achieve. “Countries constantly re-examine their assumptions and revise their financing models in order to further improve coverage, access and financial protection”. He noted that when all people have access to promotive, preventative, curative, rehabilitative and palliative health services they need without suffering financial hardship, then Universal Health Coverage will have been achieved.
Kenyatta University, Division of Family Medicine’s Dr. Joseph Thigiti observed that the onus is on governments globally to make concerted efforts to ensure health care reaches everyone. Reiterating the merits of community based health care in achieving UHC, Dr. Thigiti said that governments should focus on ensuring there are enough community health centers because “the cheapest model of looking after people’s well-being is health prevention.” He also noted that health care should be people centered and training of health professionals must conform to people centered care.
Drawing examples from countries such as Japan, Thailand and Rwanda that have successfully implemented Universal Health Coverage, Dr. Kariuki, representing Ministry of Health Acting Director General Dr. John Masasabi, emphasized the need to provide access to essential healthcare for all Kenyans while lowering the financial barriers and improving the overall quality of health services. To achieve this, the following will need to be done: Equipping health facilities across the country with basic equipment, strengthening Primary Healthcare including Community Health Services, expanding access to essential medicines and supplies list and increasing the number of health workers from 9: 10,000 to 14: 10,000.
National Hospital Insurance Fund’s (NHIF) Mr. Daniel Mulinge highlighted the measures the national insurer is putting in place to ensure attainment of Universal Health Coverage in Kenya. Among these measures are strengthening the governance and regulatory framework for a sustainable health financing system, promoting efficiency in the use of resources, increasing resources available for health and increasing the population covered in prepayment and risk pooling schemes.
Ministry of Health’s Senior Economist Mr. David Njuguna, noted that health care financing remains a critical element of the social and economic development of any country. Other presenters were Retirement Benefit Authority’s Mr. John Muli Mutisya, First Assurance’s Mr. Hillary Mwangi and Purity Kiguta from Jubilee Insurance.
From the symposium’s plenary session, it was established that financing issues facing developing countries included declining donor funding while governments have not increased funding to bridge the gap and the available fiscal space limits the expansion of funding to the health sector. Other emerging issues identified that may affect UHC include disease burden, skewed health workforce, health leadership and governance, inefficient use of available resources, inadequate and skewed distribution of available health infrastructure. Further environmental changes caused by climate change have led to increased incidences of diseases and re-emergence of neglected tropical diseases e.g. Kalaazar.
It was agreed that in Kenya, all stakeholders have roles to play to make the achievement of UHC a reality. The National Government is charged with the responsibility of policy formulation, quality assurance, additional resource mobilization among others. On the other hand, the County Governments are expected to maintain adequate budgetary allocation, strengthen primary health care, leadership and governance and invest in equipment, infrastructure and human resources. The Kenya Medical Training College is charged with the responsibility of training human resources for health; undertake research and consultancy services to bridge the gaps in the health sector. Other sectors/ministries are also expected to increase financing, institute legal reforms enhance road infrastructure among others.
As a way forward, it was resolved that there is need for sustainable health financing through re-prioritization of public spending towards health to recommended international standards and development of various pooling mechanism to reduce out of pocket spending by household. Further, earmarked funds are to be directed towards the health sector while addressing the inefficiencies, by ensuring proper utilization of allocated funds and aligning spending to address health outcomes/disease burden. Emphasis was placed on the importance of mobilizing more domestic resource allocation to ensure sustainability of provision of health services in view of reduced donor funding in addition to exploring alternative innovative financing mechanisms.