Tuesday, 31 July, 2018
Universal Health Coverage (UHC) is anchored in the principle that everyone should receive needed health services without facing financial hardship.
At its core, UHC aims to protect the general population from falling into poverty as a result of the high cost of healthcare. More fundamentally, UHC is about social justice and national development.
An estimated one million Kenyans are pushed below the poverty line every year due to out of pocket spending on healthcare. The average Kenyan household spends 1 in every 4 shillings on healthcare, this means that healthcare costs account for about a quarter of household budgets. This is further accelerated by the country’s high dependency rate, which, according the World Economic Forum, stands at 80.9 per cent and is attributable to a high youthful population which is yet to reach working age.
Kenya’s healthcare spending reflects the need for reform that can only be addressed through the implementation of UHC. In essence, 36 per cent of healthcare costs are covered by the government, 32 per cent is financed though household spending otherwise called out of pocket expenditure, 20 per cent from donors, 10 per cent from employers and two per cent from other sources. Presumptively, the 10 per cent employer contribution factors in sources such as salary advances, debt and insurance all of which eventually lead back to a dip in household incomes.
In contrast, UHC seeks to formulate a plan that would in essence strip away the direct dependence on personal and household incomes to pay for healthcare. In Kenya’s case, UHC would increase household disposable incomes as well as increase predictability and this would in turn result in spending on other needs such as proper nutrition, education and savings.
The country can draw lessons from Turkey, which has taken bold steps to improve her overall healthcare system. Over a 10-year period, starting 2002, the country managed to reduce the proportion of households with catastrophic health expenditure from 81 to 14 per 10,000 people.
The incidence of household impoverishment due to health expenditure (the situation in which a non-poor household becomes poor after spending for health services) decreased from 43 to seven per 10,000 in the same period.
In achieving these milestones, the country established a generous and equal benefits package cover the poor. All of the emergency and intensive care, primary care and hospital care needs were contained in this benefits package.
Turkey progressively used the economic gains to include more expensive care, such as organ transplants, heart surgery and cancer treatments.
UHC is based on the conviction that health is a human right, not a privilege. It argues that people must not choose between buying medicine and buying food or a mother should not lose her baby because the services needed to save it are too far away.
Dr Gitahi is the Group CEO of Amref Health Africa. Twitter: @daktari1