By Paul Okal
Even though several steps have been made in the right direction, Kenya still faces multiple hurdles in the pursuit of health targets and the attainment of recommended health outcomes against an ever-increasing population of underprivileged citizens leaning only on the Constitutional promise of the highest attainable standards of health (Article 43, Constitution of Kenya, 2010).
With the rate of high poverty in the country, population estimates of about 39.8% of Kenyans (KNBS 2022) live below the international poverty line, and an additional 20% live in extreme food, water, and economic poverty. The burden of a well-serving health system should be one of the government’s top priorities to ease the weight on about one million other citizens who fall into poverty every year due to the exorbitant out-of-pocket expenditures on health. The instability of the national health scheme brings these about.
Records estimate that, out of about 26 million Kenyans registered for the scheme, only about 4.5 million actively contribute to the health insurance. Much can be derived from this alone, pointing to a higher economic burden due to unemployment, poverty, and mistrust in government systems. Experts have also hinted that the instability of the scheme has made expenses soar higher than what is collected, and that fraudsters and corrupt officials have also taken advantage of the loopholes.
Additionally, most health seekers around the country share in the pain of multiple challenges as they pursue health, with some going through compounded challenges. Some will cite the lack of or insufficient medical health personnel, including medical officers, nurses, midwives, surgeons, and machine operators, or commodity or drug stockout in public health pharmacies or government chemists. Others will mention the lack of necessary equipment for ultrasound, oxygen, radiology, chemotherapy, or dialysis needs. Around the country, several others flung into rural and hard-to-reach areas also share challenges in accessibility to level 3, 4, and 5 health facilities since the disease burden is not confined to urban centers alone.
As one of the most crucial social determinants, health plays a critical role in the development of a nation. Without a reliable health system, citizens are left grappling with the option to survive through a system marred by counterfeit drugs, widespread quacks, illicit cash requests, and a dwindling research-based health improvement system. Those who can temporarily afford the costs out of their pockets are immediately pushed into poverty due to expensive medication and services. Some of these setbacks also cause potential medical personnel to leave the country in pursuit of environments that appreciate and pay them better for the important work that they do.
To meet the national health targets and expectations, the Government of Kenya, through the Ministry of Health, in collaboration with the Departments of Planning and Finance, needs to honor financial and policy commitments set out for health. These include the regional Abuja Declaration of 2001, the commitment to the Sustainable Development Goals, and the manifestos shared by the current political regime. Research into indigenous health can also promote health around the country. Above all, good governance free from corruption at all levels of the healthcare system would sort more than half of the health needs required to improve the national health system.
Okal Paul is a guest writer at NAYA Kenya.
