If implemented effectively, UHC laws could transform the healthcare sector
13 December 2023
Author: Derick Ngaira
(Third right) Rose Oronje PhD, AFIDEP’s Head of Kenya Office joined Kenya’s President H.E (Dr) William Ruto, Deputy President H.E Rigathi Gachagua, Cabinet Secretary for Health Susan Nakhumicha and other invited guests at the signing ceremony of the universal health coverage (UHC) bills into law at State House Nairobi in October 2023. AFIDEP, through the Advance Domestic Health Financing project, supported the government of Kenya in developing the laws that aim to enhance domestic financing of the healthcare sector in the country.

The commemoration of International Universal Health Care Day on 12 December 2023, takes place on thebackdrop of the recent enactment of new laws on Universal Health Care (UHC) and Ministry of Health’s invitation for public views in the development of regulations to guide the implementation of the laws. A move that underscores commitment to ensuring health for all and addressing the longstanding healthcare challenges faced by citizens.

The importance of universal health care cannot be overstated. For too long, access to quality healthcare has been a privilege rather than a right for many Kenyans. Economic disparities, geographical constraints, and systemic inefficiencies have perpetuated a situation where a significant portion of the population has struggled to obtain primary healthcare services. Therefore, reforms to address the disparities and bring forth a paradigm shift towards a more inclusive and equitable healthcare system are long overdue.

The focus on primary health care emphasizes the significance of preventive and community-based services. This approach aligns with global best practices and recognizes that a robust healthcare system starts at the grassroots level. By investing in preventive measures, health education, and community engagement, the country would be guaranteed of a healthier and more resilient population.

Financial barriers have posed significant challenges to healthcare accessibility. The Social Health Insurance Act has the potential solution to enhance healthcare resources, provided it is effectively implemented. According to analysis by African Institute for Development Policy, the proposed levy of 2.75% on gross salaries could generate Kshs.44.4 billion from the private sector and Kshs.20.5 billion from the public sector. This would result in a total increase of Kshs.65 billion in revenues for the Social Health Insurance Fund (SHIF), surpassing the current Kshs.60 billion from all funding sources. If other contributions remain constant, the suggested levy has the potential to double the available funds for SHIF, thereby significantly improving its financial capacity. Progressive onboarding of the informal sector and efficiency in management and use of SHIF resources has the potential to transform the health financing landscape as well has health outcomes.

Given that healthcare is a devolved function, the national Facility Improvement Fund Act provide counties with the opportunity to streamline the Facility improvement funds (FIF). As Counties embank on developing FIF regulations, there is expectation that the county specific regulations will fully address the bottlenecks that have consistently inhibited the full realization of the objects of the Facility Improvement Financing Act initially developed by counties. This legislation will play a significant role in ensuring that the resources generated at health facilities are safeguarded and not diverted to other sectors.

The provisions for financial risk protection, including mechanisms such as health insurance and subsidies, can go a long way in alleviating the burden on individuals and families. This not only ensures that healthcare services are affordable but also mitigates the catastrophic health expenditures that have for years plungedfamilies into poverty.

However, the successful implementation of the UHC laws requires sustained commitment, collaborative partnerships, and effective governance. Adequate funding, transparency in resource allocation, and the involvement of local communities and non-state actors will be crucial to the success of this ambitious healthcare reform. Moreover, continuous monitoring and evaluation mechanisms should be put in place to ensure that the intended benefits of universal health care are realised and sustained over time.

As the country joins the world in marking the International Universal Health Care Day, let it be a moment of reflection on the progress made and a renewed commitment to the journey ahead. The UHC laws are not just legal statutes; they represent a pledge to transform the healthcare landscape, fostering a nation where health is a universal right, not a privilege. By embracing the spirit of universal health care, the country is not only investing in the physical well-being of its citizens but also laying the groundwork for a more resilient and prosperous future for all.