The Kenya Medical Practitioners and Dentist Council (KMPDC) has released a new report detailing findings and recommendations to achieve Universal health Coverage (UHC) by year 2022.
Released in October 2020, the Universal Health Coverage Systems Strengthening in the Counties report underpins the need for enactment of sound policies and legislation in health as a means to attaining UHC.
In the report, KMPDC details recommendations in human resources for health, universal health care structures, essential health services, primary health care networks, quality of health care monitoring and evaluations, health products and technologies (HPTs) and health care financing mechanism.
“There is need replace, procure or improve dilapidated health facilities and target conformance to the guidelines that uphold the health systems,” says Jean Mathenge, KMPDC consultant and Lead Coordinator & Chief Rapporteur Secretariat, Ministry of Health (MoH) Technical Assistance Team.
The KMPDC study highlighted limitations in basic infrastructure and equipment required to achieve basic health services.
“One of the most tenacious finding is the extreme deficit in the human resource for health category, widely considered a cornerstone in achieving UHC,” she said.
The report calls for strategic investments in the human resource capacity calling on MoH to address shortages in health workforce for optimal provision of quality health services.
KMPDC advises counties to allocate adequate budgets in capacity building for health care workers. Further, the report urges county governments to draft policies that seek to retain health workers, addressing interruptions in service delivery because of labour turnover.
To achieve UHC, there is need to build capacity in professional cadres that include pediatric dentistry, nuclear medicine, clinical pathologists, critical care physicians, forensic psychiatrists, child and adolescent psychiatrists, medical endocrinologists and pediatric neurologists.
Mathenge added that the technical committee findings recommended the establishment of a task force that will steer the formation of a Health Service Commission (HSC) to mechanize, normalize, and centrally coordinate the human resources for health at the national level.
Moreover, the report also calls for a national census of health workers to accurately establish the numbers of health workers per 10,000 population. Further recommendations include the training of healthcare staff on UHC and the national insurance claims process.
In ensuring that healthcare is affordable to all Kenyans, the report recommends continuous sensitization and enrolment of all households to national health insurance fund (NHIF).
Kenya has adopted social health insurance model provided through NHIF to achieve UHC. Under the model, citizens are enlisted to affordable health insurance cover aimed at reducing out of pocket expenditure in financing healthcare services.
In ensuring that facilities have uninterrupted supply of quality health care products and technologies (HPTs), KMPDC recommends that Kenya Medical Supplies Agency (KEMSA) –the government body mandated with ensuring HPTs supply- automate its bill card to ensure end-to-end procurement and consumption data.
The report says that health care facilities whose current fill rate averages 60%, should aim to achieve over 70-90 percent of forecasted medicines and health technologies supplied to each county to avoid stock out of essential commodities.
Furthermore, the report recommends that all facilities should have a stand-alone Information and Communication Technology (ICT) departments and invest in IT upgrades to support essential health care provision. KMPDC encourages all facilities to improve internet infrastructures and upgrade biometric registration systems to strengthen UHC registration and claims processing mechanisms.
County Governments have also been urged to allocate at least 30 percent of their budgets to healthcare and sustain the funding to support the implementation of UHC.
Counties are advised to ensure that primary health community networks (PCHN) are fully implemented and all county residents are registered to PCHN.
Further, the report recommends an enhanced referral system as well as re-categorization of all health facilities to validate the current classifications.
The report highly recommends strengthening and promotion of oral health as an essential health service at all levels and inclusion into community health system to make it accessible under UHC.
It advises collaboration and partnerships with the county governments to complete this exercise as it emphasizes inter-governmental collaborations.
