In 2018, the government of Kenya declared universal health coverage a national priority and part of the Big 4 agenda. The primary goal of UHC is to make health free and accessible at the point of need. The global agenda for UHC is to ensure people have access to healthcare without suffering financially. There are multiple laws, policies and guidelines that seek to support the improvement of healthcare for all.
The 2010 Constitution indicates that every person has a right to access affordable and accessible health services, including guaranteeing the right to non-discrimination (Articles 26 (4) and 27(4)). This emphasis was not a coincidence but done consciously and intentionally in an attempt to address health burdens.
Therefore, the move towards UHC as a tool towards the progressive realisation of the right to health has been met with hopefulness, though cautiously. To address UHC and ensure its effective implementation, it is important to prioritise community health promoters, making healthcare financially accessible since they play a critical role in responding to health burdens.
Kenya has a worrying doctor-to-patient ratio with the probability of some citizens never seeing a medic in one’s lifetime. For every 10,000 people, there are only 1.9 doctors and 8.6 nurses and midwives in Kenya. This has led to the introduction of community health promoters who carry critical health knowledge, skills and tools into communities and even homes.
As Kenya strives to achieve the sustainable development goals, including access to health services, the gap is still big due to the number of healthcare workers not being a reflection of the population. This makes Kenyans desperate in accessing health services. In some situations, a healthcare worker is desperately needed, such as during a difficult labour, infection or other complications, and there may not be one.
The Kenya 2020-2030 Community Health Policy seeks to empower individuals, families and communities at large to attain the highest possible health standards and this is not possible without strengthening the capacity of the community health promoters.
Community health volunteers with youth advocates carry critical information into communities and homes. They are vital to saving lives, preventing health burdens and helping communities to reach their full potential and flourish by supporting the work of doctors and nurses.
They conduct level one services, that is routine visits, and deliver health promotion messages that are key in health service; they also establish referral pathways for maternal and newborn babies which is essential.
The devolved governments have not been effective in motivating community health promoters because most of them don’t have NHIF cover while Kenya Community Health Policy mandates county government to pay stipends and even compensate for their time.
It is prudent to invest more in preventive rather than curative health measures so as to not overburden the health system. Community health promoters should, therefore, be a key priority quality, affordable and accessible health services should start with them.
Executive director, Epic Youth Organisation
