NGAIRA: Ruto's government should walk the talk on healthcare financing

It was a momentous occasion for many Kenyans when President William Ruto, during his inaugural speech on  September 13, 2022, listed health as one of the priority areas at the heart of his transformational agenda.

Ruto who was addressing the nation for the first time as President assured Kenyans of affordable healthcare anchored on strengthening primary Health care.

He defined his intentions of allocating adequate resources to the sector and instituting reforms at the National Health Insurance Fund.

Kenyans beamed with delight as the President outlined his plan for universal health coverage, which had ostensibly hit a snag in the previous regime.

But eight months into office, Ruto's government seems to be veering off the path he pledged to follow religiously.

This was evident last week when National Treasury CS Njuguna Ndung’u read his maiden budget at the Parliament buildings.

The budget was Ruto's first after clinching power in the 2022 Presidential election.

Ndung'u, in a blow-by-blow account, laid bare the government's plan for various vote heads in the country for the financial year 2023/24.

As the CS waded through the 120 pages budget statement, I paid a special focus on the resources allocated in the healthcare sector.  

The budget capped at Sh3.6 billion saw Sh141.2 billion allocated to the health sector.

Of the allocation, Sh116 billion would go to the Medical Services department and Sh24.6 billion to Public Health Standards.  

This allocation is way below the commitments and would work against the promises that the government has undertaken. 

Worse, the amount is a drop from the Sh146.8 billion former President Uhuru Kenyatta allocated to health care, in his last budget as Head of State, for the financial year 2022/2023.

Important to note, the Sh146.8 billion allocation to health was the biggest ever in the history of the country Kenya.

When Kenya joined other African Union member states in Abuja in April 2001, the country committed to allocating 15% of the budget to health in a given financial year.

The Abuja Declaration became a rallying call to mobilize more resources from government coffers for the health sector.

The declaration aimed at delivering increased, sustained and more impactful financing for health.

The same was emphasised during the African leaders meeting of 2019 in Addis Ababa where leaders committed to increase investment in health.  

The commitment was touted as a breath of fresh air to the sector that for long had been on its deathbed.

Two decades down the line, however, Kenya is still on the long list of African nations that are yet to meet the target of allocating 15% of their budget to the healthcare sector.  

As a result of underfunding, citizens still struggle to get access to quality, timely and affordable healthcare due to their inability to keep up with the out-of-pocket payments.

Families have been forced to languish in poverty as a result of incurring exorbitant medical costs.

Others have forgone the need to seek healthcare services, putting lives at risk.  

Vulnerable populations, like those living in informal settlements, women and girls have been the hardest hit.   

As the country gears towards the National High-Level Dialogue on Domestic Health Financing next week, leaders need to understand that the convening should not be the usual events where public resources have been spent with no commensurate value for money for the taxpayers.  

The event should bring forth impactful action points on domestic health financing that will be followed through to the spirit and letter.

Actions that will improve domestic health financing should be prioritized.  

After six decades of independence, Kenyans deserve access to healthcare services without worrying about the cost. 

It is time to shelve rhetoric on the subject matter and honour commitments made in the past. 

Derick Ngaira is a Communications Officer, African Institute for Development Policy. [email protected]