On October 19 at State House, Nairobi, three key legislations that will transform healthcare provision and management were signed. The Primary Health Care Act, 2023, the Digital Health Act, 2023 and the Social Health Insurance Act, 2023 will enable Kenyans to access quality healthcare in an efficient, affordable and non-discriminatory manner.
These pieces of legislation are part of President William Ruto’s revolutionary and progressive approach to ensure Universal Health Coverage for Kenyans. The UHC journey started two decades ago under President Mwai Kibaki. Retired President Uhuru Kenyatta also tried but was unsuccessful during his tenure.
The laws seek to provide the necessary legal and institutional framework for the successful rollout of UHC. Speaking after the signing ceremony the President was categorical that his agenda to transform healthcare in Kenya, save lives, empower communities and make us a stronger and healthier nation is key in the plan. His key priority is primary healthcare in his quest to prevent diseases at the lowest level across the country.
The three acts seek to complement the Community Health Policy and Primary Health Care and Health Financing Strategies, putting an end to challenges in healthcare service delivery and ensuring efficiency of services as Kenyans access health services.
What was of keen interest is the repealing of the current National Hospital Insurance Fund (NHIF) by the Social Health Insurance Act thereby establishing three new funds. These funds include the Primary Healthcare Fund, the Social Health Insurance Fund and the Emergency, Chronic and Critical Illness Fund. These funds will see health facilities get financing to provide healthcare to Kenyans, purchase services from health facilities at levels 1 to 3 levels and 4 to 6.
What is significant among Kenyans is the Emergency, Chronic and Critical Illness Fund will handle emergency and chronic illness costs once social health insurance is depleted. This is a masterstroke because of the high cost of healthcare in Kenya. Kenyans will now ease the burden of healthcare and not worry about the cost of chronic illness.
I remember when my late mother died with a whopping hospital bill of Sh6 million; I raised Sh4.5 million but they could not release the body. The agony that we went through as a family speaks to what many Kenyans seeking healthcare go through with huge bills at various institutions providing healthcare.
I had to opt for other securities for my mother’s body to be released. This happened even after the facility wrote off millions of bills to highly connected and rich people. Tales like mine are what Kenyans go through on a daily basis at various facilities across the country.
Families whose kindred are detained at various facilities across Kenya now have a reason to smile. Imagine losing a loved one and the additional pain of the body detained as a result of failure to raise the hospitalisation bills.
Talk of chronic ailments where you first deposit some amount before admission. Imagine a situation where the patient is restricted on access to medicate just because his health insurance is depleted. Families have been left with no choice but to fundraise to bear the high cost of healthcare.
Article 43, a, of the Constitution of Kenya recognizes that every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care. The same article states that no Kenyans shall be denied emergency medical treatment. It calls on the State to provide appropriate social security to persons who are unable to support themselves and their dependents.
The Facility Improvement Financing Act addresses underfunding in public health facilities, while the Digital Health Act streamlines technology adoption to enhance data sharing and resource utilization.
In 1999 the government of President Daniel Moi developed the first National Health Sector Strategic Plan as a follow-up to the Ministry of Health’s efforts to translate the policy objectives into an implementable programme.
At the end of the five-year period of the plan an independent consultant audited the plan and observed that “having well focused national health policies and reform agenda whose overriding strategies were focused on improving health care delivery services and systems through efficient and effective health management systems and reform, the overall implementation of plan did not manage to make a breakthrough in terms of transforming the critical health sector interventions and operations towards meeting the most significant targets and indicators of health and socio-economic development as expected by the plan”.
This was attributed to a set of factors, most of which are interrelated, such as absence of a legislative framework to support decentralisation, lack of well-articulated, prioritised and costed strategic plan, among others.
The 1999 failure is what President Ruto has fixed by ensuring that there is enabling legislation to support his plan.
In the Kenya Kwanza Manifesto on Healthcare, President Ruto committed to realise the constitutional right to health in the shortest time possible by delivering a Universal Health Coverage system built on three pillars as follows: fully publicly financed primary healthcare, (preventive, promotive, outpatient and basic diagnostic services), that gives patients choice between public, faith-based and private providers, based on a regulated tariff.
He also promised a universal seamless health insurance system comprising mandatory national insurance and private insurance as complementary covers, with NHIF as the primary and private as secondary cover, a national fund for chronic and catastrophic illness and injury costs not covered (or with very restrictive cover) by insurance (cancer, diabetes, strokes and accident rehabilitation, pandemics) to be funded by combination of insurance levy and government.
This was demonstrated in the assenting of the tripartite acts to ensure provision, access and management of healthcare is realized.
In conclusion, we look forward to regulations that will now operationalise the laws. The President is succeeding where his predecessors failed. Kenyans need to support the President in his quest to have healthcare affordable and accessible to all Kenyans, especially poor households. Kudos my friend, Mr President.
Former Football Kenya Federation president
