Raila, Ruto remedies for health sector

Kenyans are eager to know what parties have in store for them regarding health as the two top contenders in the presidential race expound on their manifestos with less than two weeks to the polls.

Azimio-One Kenya presidential candidate Raila Odinga and Deputy President William Ruto of UDA have promised ambitious health programmes if they win the election.

Both of their blueprints speak about the wider objective of the Universal Health Coverage (UHC) — a health system that ensures everyone has access to quality healthcare, their social standing notwithstanding.

In their policy blueprints, Raila and Ruto have made numerous proposals, which they argue will transform the approach to health and realise UHC’s aspirations.

The Azimio presidential candidate is promising to introduce a healthcare programme that will guarantee all Kenyans  health care under his BabaCare slogan. “I will ensure access to quality and affordable healthcare services by all,” Raila said during the launch of his manifesto on June 6.

BabaCare, he explained, will focus on social protection and transformation and improving UHC. “Every Kenyan shall receive adequate primary healthcare services as per need, which will be free,” he says.

It also says the approach to primary healthcare will involve incorporating community healthcare workers as key drivers of service delivery.

Infrastructure

Under ‘Babacare’, retired civil servants would continue to enjoy medical insurance at the government’s cost.

And to address cases of emergency health requirements, Raila has promised to establish an emergency medical services fund. He is also proposing a review of funding to the sector in order to strengthen efforts to handle major health concerns such as the plan to eradicate malaria by 2030.

His administration, Raila says, will promote local production of drugs, medical equipment and other healthcare-related inputs while improving and expanding the country’s healthcare infrastructure.

Related to this is the pledge to instill transparency in the pharmaceutical manufacturing sector through the establishment of a framework to monitor the safety and standards of all products.

“We will establish a framework to monitor the safety and standards of product and also promote local production of drugs, equipment and other related healthcare inputs,” he said.

Raila has promised to review the remuneration of healthcare workers. This is one of the issues that have caused conflicts between health workers and counties since health services were devolved.

If he wins and makes good his promise, this means he will have to address the frequent staff strikes that have affected health service delivery in many counties.

And in the Kenya Kwanza manifesto, Ruto proposes delivery of a primary health care-based approach that will give priority to preventive and promotive services, which he calls Afya Bora Mashinani.

“We will establish multi-disciplinary teams to take primary health care services to the grassroots as envisioned in our bottom-up health care model,” he said when he unveiled his manifesto on June 30.

He highlighted a number of key issues to ensure equitable access to health services with a focus on health financing and commodity supply, health information technology and human resources for health.

Procurement scheme

Ruto proposes a fully-financed primary healthcare that accords patients a choice between public and private facilities as well as more financial input on conditions such as HIV, TB, malaria, family planning, immunisation and nutrition programmes.

He has also promised to reduce monthly contribution to the National Hospital Insurance Fund (NHIF) from Sh500 to Sh300.

“Our total health expenditure stands at Sh550 billion per year, financed by the government at 63 per cent, by households out of pocket at 27 per cent, and the balance of 10 per cent also by households through insurance schemes. The out of pocket share translates to Sh150 billion per year, which is a big burden to households,” Ruto said.

And in order for the sector to operate seamlessly, Ruto says his administration would invest in a health information management system to address rampant corruption in the sector.

He also seeks to establish a national procurement scheme in an effort to achieve transparency and accountability in procurement of medical supplies.

Ruto further pledges to review the current health sector tax regime as well as the cost of doing business in the pharmaceutical sector, besides scaling up local manufacturing of essential supplies which will, in turn, make Kenya a regional pharmaceutical manufacturing hub.

The DP has also indicated that he will push for the establishment of a health service commission whose mandate will be to ensure equal distribution of human resources for health.

Kenya Medical Pharmacists and Dentist Union  Secretary General Dr. David Bhimji agrees that the two manifestos focus mainly on UHC with Kenya Kwanza planning to drive it on NHIF, while Azimio is focusing on health service provision and activation of emergency fund.

He called for more seriousness in strengthening human capacity in the healthcare sector.  He says a health service commission would ensure equitable distribution of healthcare workers, uniform remuneration and promotions, hence high retention.

“Health facilities and hospitals from the primary healthcare level to referrals should be geared toward service provision. Thus, investment in human resources at same rate with infrastructure is key,” he says.