- UHC enables universal, integrated access to health services as close as possible to people's everyday environments.
- The evolution of training of health care professionals in response to emerging needs requires the adoption of the lens of preventive approaches and health promotion.
Kenya’s healthcare is at a defining moment. Despite championing of Universal Health Coverage (UHC) amidst a myriad of challenges including financing it, availability of trained healthcare professionals and navigating the murky waters of politics, UHC is a global well-meaning initiative that countries cannot run away from.
For those who may not know, attaining UHC is part of the United Nation’s Sustainable Development Goals (SDGs).
However, according to a 2023 report by the World Health Organisation, the world is off track to make significant progress towards universal health coverage by 2030.
Improvements to health services coverage have stagnated since 2015, and the proportion of the population that face catastrophic levels of out-of-pocket health spending has increased continuously since 2000.
But why UHC? one may ask.
UHC enables universal, integrated access to health services as close as possible to people's everyday environments.
It also helps deliver the full range of quality services and products that people need for health and well-being, thereby improving coverage and financial protection.
As countries including Kenya work towards achieving UHC, health workforce challenges remain one of the main bottlenecks.
A strong health workforce is crucial and we must therefore ensure that we are training enough qualified human resources for health who fully appreciate the role of UHC and the critical role of primary health care and health promotion.
In line with the desires of attaining UHC, the government of Kenya is actively working on aligning training to ensure that the country boasts a well-trained and adequately equipped workforce, not only catering to local needs but also capable of competing on the global stage.
This forward-looking approach is aimed at not only enhancing the quality of education but also better preparing healthcare professionals to meet the evolving healthcare demands of the 21st century.
Consequently, the role of the private sector in education and training cannot be underscored. The Aga Khan University School of Nursing and Midwifery in East Africa has been at the forefront of providing a competency-based curriculum whose key tenets are primary healthcare and health promotion, with a focus on critical thinking, problem solving and all of which intend to promote UHC.
More than 3,000 graduates have since joined the ranks of innovative, qualified, nurses and midwives in Kenya, Uganda and Tanzania to accelerate the UHC agenda.
Having acquired education of international repute our graduates have been deployed to primary health care settings and other levels of health care.
How then can training institutions ensure that the right parameters are instilled in the education programmes to better promote universal health coverage?
Kickstart healthcare at the home level.
The evolution of training of health care professionals in response to emerging needs requires the adoption of the lens of preventive approaches and health promotion.
Health care starts at home, at the primary level not when an individual comes to a health care facility for care. Healthcare is personalized and prevention is the best medicine. There is no better way to ensure this than operationalizing primary healh care and health promotion in education and training.
Retain the best talents in primary healthcare.
The conversation of moving the best and the most trained professionals from primary healthcare to the hospital needs to end. These best-trained and most qualified professionals like nurses and midwives, if retained at the primary healthcare level, are able to maintain and promote health.
This not only ultimately reduces the number of people who go into the hospital but also means that if people need health care at that primary level, they have a well-trained nurse and midwife who can provide that care or link to the relevant health care that is needed.
Through the Aga Khan University Advanced Practice Nursing and Advanced Practice Midwifery, the University is training nursing and midwifery graduates and equipping them to understand the importance of remaining at the primary level of healthcare because nursing is the one profession that you can find even in the far-flung areas in the most remote rural areas.
However, we need for a scheme of service that reflects this critical value of retaining the best and most qualified where they are needed the most.
Encourage collaboration.
Countries are transitioning from external assistance while pursuing ambitious plans to achieve UHC. This coupled with the need to shift training from being merely clinical, curricular, and delinked from the needs of the health system, there is an increase in the need to facilitate knowledge sharing and learning among healthcare practitioners.
This is something we value at Aga Khan University through our integrated health system that exposes nurses and midwives across the world to best practices and encourages peer-to-peer learning.
We start this at the classroom through our interprofessional education approach in which our undergraduate nursing and medicine students learn collaboratively together.
This approach not only breeds healthcare practitioners who are problem solvers and critical thinkers but also those who know how to work collaboratively. Ultimately, peer-to-peer learning facilitates knowledge sharing, learning and accelerates action at the institutional and health system levels.
Nurses in particular are great collaborators with multidisciplinary teams because they are the ones who bring the multidisciplinary team together. They are the ones who spend the most hours with any patient within the facility.
These efforts are instrumental and significant in the transformation of the educational landscape of the medical field in Kenya. The determinants of the achievement of UHC vary and the education system is key in nurturing outstanding medical professionals.
The role of nurses is a critical component that cannot be ignored in the implementation of Universal Health Care coverage.
By Prof. Eunice Ndirangu-Mugo, Dean School of Nursing and Midwifery, East Africa, Aga Khan University.