By HENRY OWINO (Senior Correspondent)

A one-year pilot programme for Universal Health Coverage (UHC) in four counties launched by President on 13 December, 2018 has attained milestone. The implementation of the programme has been through Ministry of Health in Machakos, Kisumu, Isiolo and Nyeri which realized increased utilization of health services.

According to Sicily Kariuki, outgoing Cabinet Secretary for Health, the increase in services ranges from 20% to 50% across the four counties. It clearly demonstrates that a significant number of Kenyans were not able to access health services due to financial constraints.

The approach to the implementation of UHC Pilot exercise was centered on the strengthening of health systems with focus on Community Health services and Primary Healthcare systems at large. The other was ensuring availability of essential commodities and basic equipment in health facilities and removal of user fees in level 4 and 5 public health facilities.

A total of Ksh3.9 billion (about USS40 million) was inverted in the four pilot counties and implemented through an Intergovernmental Participation Agreement framework. The plan to scale up UHC was informed by lessons learned from Makueni County Government implementation of its UHC programs and initiatives.

Those who were registered under the programme were mostly the unemployed, who are not automatically covered by the National Health Insurance Fund (NHIF).

World Health Organization (WHO) defines Universal Health Care as access to quality preventive, promotive, curative, rehabilitation and palliative health services regardless of their ability to pay.

Since mid-January, 2020 County Governors have been signing the UHC programme as Intergovernmental Participation Agreements (IPA) with Ministry of Health. Those who had signed by the time we went on press are:Samuel Tunai (Narok), dep Martin Moshisho(Kajiado), dep James Nyoro (Kiambu), Alex Tolgos (Elgeyo Marakwet), Martin Wambora (Embu), Ndiritu Muriithi (Laikipia), Muthomi Njuki (Tharaka Nithi), Anne Waiguru (Kirinyaga) Kiraitu Murungi (Meru), Mutahi Kahiga (Nyeri), Francis Kimemia (Nyandarua) and Governor Wilberforce Otichilo of Vihiga County.

During the signing of the agreement the Cabinet Secretary for Health announced that in order to progressively implement UHC, the National Government will this financial year 2019/20 invest Ksh 41.9 billion in key strategic areas informed by lessons learnt from the pilot and existing health system gaps in Human Resource for health, Commodities, Primary Health Care services, Community Health services and service delivery to supplement County investments.

“This investment is expected to significantly increase even in the subsequent financial years,” Kariuki noted after signing the IPA with the second team of Governors from the Counties of Narok, Kaijido, Kiambu and Elgeyo Marakwet.

She said under the IPA, the Counties are also required to allocate a minimum of 30% of the respective county budget to health and progressively increase it. For counties that have met and exceeded the minimum threshold, they are required to maintain it.

TheCS Kariuki said event marked the next phase of the project, which involved bringing on board more other counties.

She said the partnerships would involve the hiring of 4,000 interns, complimenting health technologies in counties, provision of basic equipment to health facilities and partners in monitoring and evaluation.

“The two levels of Government have committed to recruit additional skilled human resources which include engagement of the interns through the Youth Empowerment Program,” she revealed.

The Cabinet Secretary emphasized that the negotiated county specific IPA spells out roles of both levels of Governments and details of the prioritized investment areas, in line with the Constitution of Kenya and the Intergovernmental Relations Act 2012.

“Under the IPA key areas prioritized for investment in the scale up of UHC nationally, are based on the lessons learnt in the UHC pilot exercise in the first four counties,” CS Kariuki clarified. “These include progressive move towards increasing the human resource for health to enhance access to health services.”

Given the lessons learnt in the UHC pilot exercise and multiple consultations between the National and County Governments, a number of key areas have been prioritized for investment in the scale up of UHC nationally.

The National Government is therefore committed to supplement county allocations for the supply of essential medicines and medical supplies including laboratory commodities to be made available to public health facilities in Kenya through the Kenya Medical Supplies Authority (KEMSA).

The UHC package will be catered for outpatient care such as consultation, mental illness and emergency health care. The cover also included the inpatient care that covers medical and surgical services. It will also include treatment and medical care of tuberculosis, malaria and HIV.

She also added that there will be joint investments in community health services to ensure full implementation of the Community Health Strategy and ensure augmentation of Primary Health Care to bring health services closer to the community.

Also present was Eugene Wamalwa, Devolution Cabinet Secretary who said the signings demonstrated a major step in strengthening the relationship between the two levels of government.

“This is a major step towards realization of Government’s Big Four Agenda,” he reiterated, while assuring that his ministry will work closely with counties towards realization of UHC.

 Wamalwa, Devolution Cabinet Secretary said the President, upon assumption of office in his second term, made a commitment to deliver affordable health care for all citizens by the year 2022.