Experts bet on pr*mary c*re to slash health expenditure

At least 40 per cent of Kenyans cannot afford healthcare services, with another 40 per cent only able to pay partially.

Only 20 per cent of Kenya’s population can afford to access treatment mainly through their employers’ insurance.

Experts who attended an Economic Forum organised by Commercial Bank of Africa (CBA) yesterday advised that health sector stakeholders shift focus to primary healthcare (PHC) to guarantee wellness across all income classes.

PHC addresses the majority of a person’s health needs throughout his or her lifetime. It is people-centred rather than disease-centred and focuses mainly on preventive as opposed to curative measures.

“Primary health care has been proven to be a highly effective and efficient way to address the main causes and risks of poor health and wellbeing today, as well as handling the emerging challenges that threaten health and wellbeing tomorrow,” said Kenya Healthcare Federation chairman and Avenue Healthcare co-founder Dr Amit Thakkar.

Mixed model approach

Thakkar said the only way to tackle high medical costs is to adopt a mixed model approach and lay focus on primary healthcare where those who can pay are allowed to make healthcare contribution while those who cannot are covered through taxes.

Thakkar said among the 40 per cent who work in the informal sector, those who can contribute to the National Health Insurance Fund (NHIF) and need to be encouraged so the government only sort those who are unemployed.

If the country focused on the primary healthcare treatments at the community level, Thakkar said, the money being used to treat preventable illnesses would be channelled to curative treatment.

“Primary healthcare has been proven to be a highly effective and efficient way to address the main causes and risks of poor health and wellbeing today, as well as handling the emerging challenges that threaten health and wellbeing tomorrow,” he said.

He added that Kenya uses nearly Sh360 billion every year as out-of-pocket expenditure on health, arguing that the amount spent was enough to fund the Universal Health Coverage (UHC) if only unemployed individuals were placed under NHIF.

According to Thakkar, investment in the healthcare system was critical because it yields 10:1 dividend compared to other investment such as infrastructure.

“It has also been shown to be a good value investment, as there is evidence that quality primary health care reduces total healthcare costs and improves efficiency by reducing hospital admissions,” he said.

Private investment

The amount spent on healthcare could be channeled to run UHC, which has already been rolled out in four counties, that is, Isiolo, Kisumu, Nyeri and Machakos on a pilot basis.

Health Administrative Secretary, Rashid Aman, who read Cabinet secretary Sicily Kariuki’s speech, said a number of opportunities for investment are available in the healthcare system that the private sector needs to take.

According to Aman, rolling out UHC was not something that could be achieved at once but would take time to be realised. He said the government was committed to rolling out accessible healthcare.

Kenyatta National Hospital, acting chief executive Dr Evanson Kamuri said Kenya needs a change of ‘mindset’.

“Changing the mindset for Kenyans is critical. Whether it is about the food they eat, lifestyle they lead or their views about generic drugs,” he said.

Kamuri said if Kenyans want good treatment they must be ready to pay for it. He said for the country to roll out UHC, it needs adequate funds which must come through taxes.

He challenged Parliament to legislate what is eaten and drank as is seen in the case of alcohol and tobacco. 

“Why has the government passed a law on alcohol and not fast food, sugar and beverages that people drink?” he posed.

CBA CEO Jeremy Ngunze urged the government to strengthen PHC in a bid to achieve UHC.

He called on a more collaborative approach to delivering affordable and accessible healthcare to the majority of Kenyans.

Charles Kariuki, managing director, AAR Healthcare Kenya said there is a need to address the broader determinants of health and focus on the comprehensive and interrelated aspects of physical, mental and social health and wellbeing.