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Universal Health Coverage: What you need to know

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The new initiative is expected to herald the transformation of country’s health sector that is marred by inequalities because of poverty and lack of medical insurance.
Besides Kisumu, Nyeri, Isiolo and Machakos counties will also pilot the first phase of the programme that targets 3.2 million Kenyans with full rollout in all the 47 counties expected by 2022.
But just what is universal healthcare? What does it entail and who is eligible? Most importantly, what are the benefits and range of services that one can access services under this programme?
Millions of Kenyans cannot afford to pay for health services in public or private clinics because of poverty. A 2014 World Bank report on healthcare in Kenya showed that only 20 per cent of Kenyans have access to medical insurance.
Eligibility
• All Kenyans are eligible for UHC services.
• You need to obtain a UHC card which will be issued by National Hospital Insurance Fund (NHIF) in various health facilities.
• To access UHC services, you are required to produce your UHC card.
Benefits
• Kenyans will have increased access to preventive, curative, rehabilitative and palliative health services at minimum financial burden, thereby eliminating inequalities in access to health care.
• Kenyans will have free consultation, diagnosis services for normal ailments and get drugs for free.
• UHC is expected to boost access to medical and minor surgical services, maternal and child healthcare services through the support of elaborate public health education.
• The programme will also enhance HIV, tuberculosis and malaria treatment in the country.
Funding
• To access all the initial benefits, Kenyans have to wait until 2022 when the programme will be rolled out nationally.
• The pilot programme of the universal health care is being funded by the government and other development partners.
• The World Bank has contributed Sh2 billion to the programme.
• Counties will pay community health workers for services within the counties.
Setbacks
• The success of UHC is predominantly dependent on the efficiency and effectiveness of NHIF.
• So far, only one in eight Kenyans is registered with the NHIF.
• In its current state, the national insurer does not have the capacity to reimburse all hospitals after treatment of patients.
• NHIF is also currently dogged by corruption scandals and loss of more than Sh50 billion.
Good news
• There is political will to undertake this project after Jubilee government listed healthcare as one of the key pillars of its Big Four agenda.
• Governors from all the 47 counties have pledged to support the programme.
Other issues
• Most public health facilities across the country lack the capacity to treat certain ailments and often have to refer patients to other facilities after diagnosis.
• Lack of equipment and amenities such as water and electricity are some of the shortcomings.
• Occasional strikes by doctors and nurses over pay threaten to derail the success of this programme.
Previous programmes
• In 2014, the government launched the collaborative Health Insurance Subsidy Programme (HISP) with the support of the World Bank Group, International Development Association, UK Aid and Gates Foundation.
• HISP sought to extend financial risk protection to Kenya’s poorest families by providing them with a health insurance subsidy.
• HISP was to cover both inpatient and outpatient care in public and private health facilities.
• Details on the extent of its success and whether it actually succeeded are hazy.

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