4.6.2 Broad coverage of the population ... recommended that other studies on universal health care in Kenya be done to avail more information on the health situation in Kenya. Discussion: People in LMICs often suffer from high out-of-pocket healthcare expenditures, which in turn, impedes access to quality health services. About 33% (1673) of all health facilities had piped water and 5.1% had landline telecommunication system. Kenya National eHealth Strategy 3 Foreword The development of the E-Health Strategy comes at an important time when the health sector is implementing far reaching reforms to achieve universal coverage. Globally there is limited data that has examined mortality related to such strikes in countries where emergency services were preserved. Of all Health Centers only 115 (22.2%) were offering the CEMONC services. Prior allegations of corruption and financial sustainability of the initiative were key concerns. This paper draws from two datasets collected under the African Health Markets for Equity (AHME) program. For, others. GoK. legitimate concern in protecting their own Health care costs currently absorb over financial interests. Gok. Where health systems are strong, we are better able to prevent, monitor, detect and respond to health emergencies, At the same time, univer- Draft Health Po. UNIVERSAL HEALTH COVERAGE (UHC) What does UHC mean? Providers reported low public‐sector wages were a primary driver of informal fee solicitation coupled with collusion among senior staff. The study interrogates the following three interrelated issues: Is the ‗big four‘ agenda anchored on a policy framework that will realize the dream of universal health coverage? Universal health coverage (UHC) - World Health Organization well-trained, motivated health workers (WHO, 2010. reform initiatives and how these relate to universal hea, relevant literature on key policy initiativ, such as the draft Kenya National Health Sector Strate, statergic plans, aperational plans, among others), the C, was also collected from relevant commissioned, now estimated at 62 years (Male- 60 years and female 65 years)(PRB, 2015). Payments may be motivated by a combination of factors such as low supervision, weak sanctions, and inadequate provider salaries. Despite the achievements, still there is a high demand for good physical statuses and functioning of primary health facilities with capacity to offer essential and safe surgical services in the country also as an important strategy towards achieving UHC. It was nested within the Nairobi Urban Health and Demographic Surveillance System. Of these 115 health facilities, only 20 (17.4%) were offering the CEMONC services with all 9 - signal functions and only 17.4% had facilities that are offering safe blood transfusion services. continuing education, scheduled accreditation, and the introduction of career development incentives, it has not considered management options tailored to the new setting, a human resources strategy that has the consensus of key players and sector policy, or a process for understanding the needs of health care staff and professionals. Clients and providers would benefit from education on what is included in the SHI package. GoK. It derives from a cross-sectional survey of social franchise clients at three social franchise networks supported by AHME. approach that can be replicated in Kenya. For context, in some counties, salary delays were as long as five months, Kenya National Health Sector Strategic Plan (KHSSP) I. Research Article Kenya National Hospital Insurance Fund Reforms: Implications and Lessons for Universal Health Coverage Edwine Barasa *,1,2, Khama Rogo3, Njeri Mwaura 3, and Jane Chuma3 1Health Economics Research Unit, KEMRI–Wellcome Trust Research Programme, Nairobi, Kenya 2Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, … Public health facilities are congested and over-utilized by the local population majority of whom cannot afford even low cost private care. Each of these parties has a today's health care delivery system. Kenya National Health Sector Strategic Plan (KHSSP) I. (2008). In the social, Health financing Strategy of 2010. For instance, following the dwindling, articulated. The highest incidence rate of out-of-pocket health payment indices occurred in the first quintile (poorest or Q1). UHC is also a matter of global security. The goal is that by 2022, all persons in Kenya will be able to use the essential services they need for their health and wellbeing through a single health. Outpatient Services 7,512,551,228 5,075,532,866 48% 3. We recently adopted a community of practice strategy in the region. Key Message Ÿ Universal health coverage (UHC) is the access to safe, effective, quality essential health care services, including affordable essential medicines and vaccines for all without going into poverty. It is hoped that Universal Health Coverage will go a long way in building the social pillar in Kenya’s Vision 2030 since, over the next 5 to 10 years, the majority of poor Kenyans will have access to quality and affordable health care as the government rolls out its … This study aims to review the challenges facing UHC in Ghana, Kenya, Nigeria, and Tanzania, and to suggest program or policy changes that might bolster UHC. According to the findings, 20.7% of households experienced catastrophic health expenditure. Universal Health Coverage (UHC), referring to access to healthcare without financial burden, has received renewed attention in global health spheres. Universal Health Coverage among Counties in Kenya. Is the legal and policy framework aligned to define an appropriate architecture of universal health coverage? This was lauded, s and in-depth interviews revealed increased utilization, icy dialogue. 5.Cost of illness. The potential of social protection to contribute to inclusive growth has been increasingly recognized throughout the last two decades. Although many sub‐Saharan African countries have made efforts to provide universal health coverage (UHC) for their citizens, several of these initiatives have achieved little success. The contingent valuation method is used to estimate the mean WTP for the health insurance scheme proposed by the social health enterprise in Viwandani slum (Nairobi, Kenya). Universal Health Care (UHC) is a programme set out to help communities in our society to be eligible to receive health services without undergoing any financial hardships. Of 5072 (518 are Health Centers and 4554 are Dispensaries) existing public primary health care facilities, the majority (46%) had a physical status of A (good state), 33% (1693) had physical status of B (minor renovation needed) and the remaining facilities had physical status of C up to F (needing major renovation). The results suggest that those differences are partly explained by differences in preferences among agents or the institutional legacies within each domain. Methods While evidence suggests that SHI is a promising strategy for achieving UHC, low-income countries often struggle to implement and sustain SHI systems. Key words: Universal health coverage, health insurance, informal sector, health financing 1.1: Introduction Many countries have been seeking for ways of how their health financing systems can provide sufficient financial risk protection to all of the population against the costs of healthcare Social protection reforms involve comprehensive processes of long-term institutional change. References Kenya has recently adopted universal health coverage (UHC) as one of the ‗big four‘ priority agenda. As the population ages lems, and what is a range of possible so-and lives longer, more dollars will nec-lutions. The end goal is to enhance the capacity of sex workers to actively participate in the UHC implementation process and benefit from it, accordingly. On the 10th anniversary of the constitution, we describe However, there are glaring inconsistencies and incoherence in the legal, policy, and institutional design to realize the dream of universal health coverage. The practice of soliciting informal fees from patients may result in restricted access to medical care and reduced care‐seeking behavior among vulnerable populations. Abstract The national hospital insurance fund’s (NHIF) mandate by the Ministry of In the Kenyan context, reduction of user fees at public facilities revealed increased health care utilization which in turn put pressure on the public health care system, ... Health system infrastructure ranges from the physical facilities, information systems to medical equipment and also involves construction of new infrastructure as a strategy to achieving UHC [4]. Social Health Insurance (SHI) is widely used by countries attempting to move toward Universal Health Coverage (UHC). NAIROBI, Kenya—Universal health coverage (UHC) has the potential to transform the lives of thousands of Kenyans—guaranteeing access to lifesaving health services while helping individuals and families avoid crippling health expenses that push so many into poverty. New & Innovative Initiatives. Overcoming this challenge is in the hands of the experts charged with designing public health strategies and policies. And problems in the health care system before yet, there are over 35 million uninsured there is a crisis that cannot be solved. Since 2002, Chile's health care system has been undergoing a transformation based on the principles of health as a human right, equity, solidarity, efficiency, and social participation. This study argues that the absence of a clearly defined legislative, policy, and institutional framework has contributed to the failure to realize the dream of universal health coverage in Kenya. Kenya has made progress towards universal health coverage as evidenced in the various policy initiatives and reforms that have been implemented in the country since independence. As Kenya, continues making strides towards promoting UHC, at least 3.2 million Kenyans in four counties will be the first beneficiaries of a new health package being developed by the Government. Government Printers. The study applies the doctrinal research methodology to identify and examine whether the laws, policies, and institutions critical to universal health coverage can support its realization in Kenya. Households were selected using simple random sampling and data obtained for all household members who reported having sought care for an illness in the 12 months preceding the study. DiscussionIn this article we evaluated the existing literature to examine the impact that SUS has had on an increasingly, Introduction (GNP). 2 Outline 1. Join ResearchGate to find the people and research you need to help your work. While shifts more costs to employers and indi-this was not the federal government's first viduals while attempting to hold provid-foray into health policy, the Commission's ers responsible for adding to the price es-vision was an important catalyst shaping calation. with the United Nations high-level declaration on universal health coverage (UHC), which includes a commitment to strengthen legislative and regulatory frameworks for UHC.4 In this respect, measuring change in Kenya’s health reforms would contribute knowledge to advance UHC. Results: Achieve 100% Universal Health Coverage by scaling up NHIF uptake. • The Universal Health Coverage index for Kenya was 52% in 2014. ;Q"�x�h�L^�K{�XH�[H��)�)�Y�BC�LĔ�����ge��w���i�@�,�fil���)�,�6i��&�\yC�c�)1&zI}0��u���� �X�t�xa�d���uy���{��)����؅[�g��Op�wH�T��x��/�d����L,�&Is�f���v�'�O�kC� � 0 ���ƣ\�JJ�6Hk��8��HQ��0D�!�a�r�4�?�� � �A+���;����x���G(�H �;��3��^1��J� 0 Strategies for reducing this behavior include more adequate and timely remuneration within the public sector, educating patient populations of free or low‐cost services, and evidence‐based methods to increase provider motivation. To provide quality health services required for universal health coverage, health facilities should be structured to meet health care needs and equipped with utilities such as electricity, water and skilled health workforce and also to construct or renovate primary health facilities that are able to offer quality services, ... Near the time of data collection, Kenyan doctors and nurses were on strike to protest low wages, salary delays, and unequitable distribution of promotion and training opportunities ("Kenya's nurses strike takes its toll on health-care system" 2017; Makana 2016). 4.Health services accessibility. The objective of this study was to determine the equity in health care payments and determining factors among households in Hamedan, a province in Iran. Government Printers, Nairobi. Framing improves on approaches to understanding the health policy process by accounting for agency, emotion and social values. GoK. 5 Universal Health Coverage: Critical Drivers Critical drivers 100% universal coverage Populaon Coverage Financial protec’on Access to quality Services 100% populaon covered by an essen*al health benefit package 1 2 Vulnerable populaons 3 Hard to reach areas 5 Strengthen & broaden Primary Health Care System 8 Digi*ze health e.g. Plusieurs facteurs y jouent un rôle, mais la mauvaise gestion des connaissances existantes est sans aucun doute un enjeu majeur. Communities of practice: The missing link for knowledge management on implementation issues in low-income countries? The available infrast, personnel or providers or alternative health care serv, may seek services from private facilities which may be relatively expensive thereb, facilities (both County and National govern, exhibits a robust public/private mix in healthcare servic, facilities, over-utilization the public fac, The pursuit of UHC has been a critical focus for many health care providers including governments, multilateral, of primary health care (PHC) and continued training of, the health sector in Kenya has operated in the con, shift from purely government provided for care to, government introduced cost sharing in public health in ”, Sector Strategic Plan (NHSSP) of 1999-2004 wherei, development, as well as healthcare service delivery were, was. Kenya Health Policy Framework. The focus of the Jubilee government is framed around free primary healthcare for all Kenyans, starting with women, expectant and breastfeeding mothers and persons with disabilities, by increasing health financing from 6% to 15% . Our work touches lives around the world every day – often in invisible ways. Ÿ There have been deliberate efforts to increase access and demand for healthcare services. Although many sub‐Saharan African countries have made efforts to provide universal health coverage (UHC) for their citizens, several of these initiatives have achieved little success. Mwaabi P (2017) Universal health care coverage: healthcare financing and access to health care services in Kenya Clin Case Rep Rev, 2017 doi: 10.15761/CCRR.1000378 Volume 3(10): 2-3 incurring catastrophic expenditure, which may further push them In 1998, the NHIF act was amended to enhance coverage among the poor, accelerate coverage of the informal sector, and enhance the benefit package [13,14]. Health care utilization patterns by explanatory variables were described using proportions and multinomial logistic regression used to identify the predictors of private or public health care use. Th, workers. It is expected that this percentage will continue to grow at a faster rate than G health care ' costs hayje -b-QcoM-e anyvd*W-@s@@econDMY. However, facilities have also been, Whereas these initiatives are lauded for their po, facilities with reports indicating incidences of political, facilities lacking necessary resources (h, facilities. This was recently affirmed in Sessional Paper No. However, clients sometimes were charged for services that should have been covered by insurance. Government Printers. The paper relied heavly on secondary sources of information although primary data data was collected. Nepal faces the challenge of high levels of poverty, difficult access to health facilities and poor, though improving, health indicators. Conclusion: Since clients valued provider proximity and both Kenya and Ghana have a dearth of providers in rural areas, both countries should incentivize providers to work in these areas and prioritize accrediting rural facilities into SHI schemes to increase accessibility and reach. The worldwide This has seen, although there are still no reliable statistics, the scheme which seems to have had a negative impact on enrollment levels. 1 Every Kenyan can access quality health services that address the most important causes of disease and death. Are institutions like NHIF and County governments properly positioned to steer Kenya towards UHC? Additional data, timates for the under-five-year mortality rate over the, reveals that, there exist overall staff shortages with an, re capacity exists forcing individuals to, a concern as this seem not to be addressed, e-for-profit providers. Methods: Copyright for this article is retained by the author(s), This is an open-access article distributed under the te. Since its independence in 1963, the government of Kenya has initiated policy, reforms and strategies towards UHC for all, including those in vulnerable situations such as low-income mothers and children. • The Universal Health Coverage index for Kenya was 52% in 2014. More in general, we consider these platforms as the way forward for knowledge management of implementation issues. universal health coverage by the National Hospital Insurance Fund in Kenya Rahab Mbau1*, Evelyn Kabia1, Ayako Honda2, Kara Hanson3 and Edwine Barasa1,4 Abstract Background: Kenya has prioritized the attainment of universal hea lth coverage (UHC) through the expansion of health insurance coverage by the National Hospital Insurance Fun d (NHIF). UHC is a potential goal in the post-2015 development agenda. %%EOF 1.World health - trends. Funds for the free delivery policy ('Aama') are found to be adequate to cover the main costs of services, with some surplus which can be invested in staff and in improving services. GoK. The sixty-year old Kenyan man fell victim to a violent attack in which he sustained a … Kenya Demographic Health Survey. This data was analyzed using an inductive, thematic approach. universal health coverage by the National Hospital Insurance Fund in Kenya Rahab Mbau1*, Evelyn Kabia1, Ayako Honda2, Kara Hanson3 and Edwine Barasa1,4 Abstract Background: Kenya has prioritized the attainment of universal hea lth coverage (UHC) through the expansion of health insurance coverage by the National Hospital Insurance Fun d (NHIF). Kenya Demographic Health Survey. Kenya Health Bill 2015. For instance, reforms relating to the way, well as community involvement in service provisio, in 1996, the Ministry of Health with the suppor, lic health sector aimed at enhancing access to quality, es of fraud at facilities experienced (NHIF, to all Kenyans by introducing social solidarity mechanisms founded on, apse of health care delivery at the county level. Government Printers, Nairobi. To build our case, we capitalize on our experience in our domain of practice, health care financing in sub-Saharan Africa. UHC is a potential goal in the post-2015 development agenda. There is considerable inequity in health care financing as well as households' health payments. In 1952, President Truman's Commis-The health care financing system is al-Na-ready undergoing significant change as sion of the Health Care Needs of the governments, employers, providers and tion proclaimed that "access to the means individuals attempt to hold down costs or for the attainment and preservation of maximize profits in an era when no one health is a basic human right." Many clients appreciated that insurance coverage made healthcare more affordable, reported seeking care more frequently when covered with SHI. We find that the feasibility of setting up a social health enterprise could be promising with 97 percent of respondents willing to pay about US$ 2 per person per month for a scheme that would provide quality healthcare services. The physicians' strike saw a significant decline in mortality (ß) coefficient - 19.0 (95%CI -29.2, - 8.87) p < 0.0001. This study adopted the descriptive research design targeting 291 respondents made up of 7 specialist This study aims to review the challenges facing UHC in Ghana, Kenya, Nigeria, and Tanzania, and to suggest program or policy changes that might bolster UHC. This study aimed to understand the public sector's efforts to improve the infrastructure of primary health facilities between 2005 and 2019. 0 �aK This study indicates that between 2015 and 2019 there has been improvement in physical status of primary health facilities as a result constructions, upgrading and equipping the facilities to offer safe surgery and related diagnostic services. The findings will inform stakeholders to formulate better strategies to ensure access to UHC in general, and for a highly vulnerable segment of the population in particular, including low-income mothers and their children. Conclusion: The study presents the first empirical estimates of the mean willingness-to-pay (WTP) for setting up a social health enterprise that will simultaneously run a health center and provide health insurance scheme in an urban resource-poor setting and explores whether the benefits outweigh the costs. We conducted in‐depth semistructured interviews in 2015–2016 among a sample of 20 public and private‐sector Kenyan health care workers. Knowledge of health care utilization is particularly crucial in low-and middle-income countries where inequalities in burden of disease and access to primary health care exist. Checking out and experiencing the thrill of the Renault Virtual Reality Technology at the @Total motorshow @KICC_kenya … Health worker strikes in Kenya where the public health system is the only financially accessible option for 80% of the population pose a significant threat to universal access to care. Findings include that utilization of services (at the facilities visited) continues to rise, with caesareans proportionate to the general growth in deliveries. However, the more 11 percent of the Gross National Product global question remains of how to ensure *Coopers & Lybrand, Washington, D.C. 20036. being discharged from hospitals in Hamedan, were selected for study by using a stratified random sampling method. Monthly mortality data was abstracted from four public hospitals, Kenyatta National Referral Hospital, AIC Kijabe Hospital, Mbagathi Hospital and Siaya Hospital between December 2016 and March 2018. In this cross-sectional study, 772 families of patients, who were. Universal Health Coverage (UHC), referring to access to healthcare without financial burden, has received renewed attention in global health spheres. One dataset, collected in 2013 and 2017 as part of the AHME qualitative evaluation, consists of 106 semi-structured clinic exit interviews conducted with patients in Ghana and Kenya. In total, 240 households from 24 villages in Kakamega will be followed to capture their health, health knowledge, health-seeking behavior, health expenditures and enrolment in health insurance over time. Differences in mortality were assessed using t-tests and multiple linear regression adjusting for facility, numbers of patients utilizing the hospital and department. Kenya is among countries that have pledged funds for improving maternal and newborn health and social ... Kenya joins Sh2.3trn universal health coverage fundraising drive … Evidence from LMICs has found user fees to be a barrier to health care utilization (Lagarde & Palmer, 2008). Kenya Health Bill 2015. Inpatient Services 14,695,395,233 12,048,865,574 22% 2. The Kenya Health Sector Strategic and Investment Plan III 2018–2023 (Draft) in line with the Kenyan Constitution and the Kenya Health Policy 2014-2030, also outlines ‘The attainment of Universal Health Coverage’ as the main sectoral priority and includes expansion and coverage of services for the last mile. Summary of Key Highlights . Among these include promotion of solidarty in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, engagement of various stakeholders at both county and national government in fast tracking the enactment of Health Act; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources, enhanced awareness amongst members, enhanced benefit package among other recommendations. L’implémentation des politiques reste un énorme défi dans les pays à faibles revenus. Kenya is a country in East Africa with a population of about 48 million people and a life expectancy of 64 years for men and 69 years for women. Ministry of Health. Leading Causes of Deaths and Disabilities in Kenya, critically review the various initiatives that the gov, Health and development partners, primary data was collected throu, health care system; minimal opportunities for contin, capitation, fraud at facility levels, low pay ou, Universal health coverage ensures that all peo, Universal coverage brings the hope of better health and. In this article, we argue that new platforms should be created that gather all stakeholders who hold pieces of relevant knowledge for successful policies. Data was collected from existing policy reports, the Services Availability and Readiness Assessment (SARA) tool (physical status), the Health Facility Registry (HFR), implementation reports on infrastructure development from the 26 regions and 185 district councils across the country (covering assessment of physical infrastructure, waste management systems and inventories for ambulances) and Comprehensive Emergence Obstetric Care (CEMONC) signal functions assessment tool. Required data regarding households' health and non-health expenditures were collected through World Health Organization standard questionnaire by interviews and observation method. Due to a lack of understanding of SHI benefits, clients rarely knew they had been charged inappropriately. The Constitution. Since the study was conducted in Kenya, it is recommended that similar studies be The survey was conducted between June and July 2018 on 300 households. supply chain, telemedicine In@W8, affeat concern of the federal and state over $2,000 per capita was spent on health governments, employers, providers and care, a 100 percent increase in per capita individuals. (2010). ISBN 978 92 4 156402 1 (NLM classification: W 84.6) ISBN 978 92 4 068480 5 (electronic version) (2015). The case of Kenya is one example for multiple institutional trajectories within a country: Whereas cash transfer reforms follow a pattern of cumulative incremental change, social health protection reforms reflect patterns of non-cumulative change including blocked reforms and reform reversals. It is therefore important to understand how SHI enrollees use health insurance and how it affects their health-seeking behavior. The framework is applied to the Kenyan case. This is also inline with the National Surgical, Obstetrics and Anesthesia plan (NSOAP). By having a broader understand-essarily be spent on health care as elderly ing of the challenges we are facing, even individuals generally require more care incremental change can be effective. The purpose of this analysis was to critically review the various initiatives that the government of Kenya has over the years initiated towards the realization of Universal Health Care (UHC) and how this has impacted on health equity. (Submitted: 31 May 2019 – Revised version received: 1 June 2020 – Accepted: 21 July 2020 – Published online: 3 September 2020) Legal and institutional foundations for universal health coverage, Kenya We sought to assess the mortality impact of an 100 day physician strike which was followed by 151 day nurses' strike and 20 day clinical officer strike in Kenya. • 4 out 10 Kenyans were at risk of getting into financial hardship or poverty because of out of pocket healthcare payments in 2014. -This booklet is an easy tool that is designed to sensitize and create awareness about Universal Health Coverage (UHC) in Kenya. I.World Health Organization. The of the underinsured and uninsured pop-United States spends more on health care ulation should cause us to address the than any other industrialized country. h�l��+�Q��s�)Y��%�b��! Clients also noted that the coverage gave them access to a wider variety of providers, but rarely sought out SHI-accredited providers specifically. 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