Handling the situation of the Coronavirus in Kenya is not only a test of health financing models and budgets, but state of preparedness of the health systems, whether the government focus and funds curative more than preventive services and emergency response within the context of a devolved system of government.
It’s not about the presence of the virus in Kenya anymore and whether we are prepared, but more on how our health policies are ready to deal with such emergencies including sharing information to the public on what is being done to protect the country, management of the infected and affected, disease surveillance and protection of the population. Are will investing in preventive services as promised in the various health policies and instruments to enable handle myriad health challenges or are we always reacting?
The coronavirus pandemic should not be viewed at in isolation and in addition to dealing with the increased demand for information by the public in relation to how the government is dealing with the virus, more attention and focus needs to the overall health policies in the country including budgeting, staffing, financing and preparedness for interventions during mass outbreaks and the overall health ecosystem in general.
There is no need to panic or call it a deadly virus, but to listen to advise from Government and experts, stop misinformation of the virus and more importantly, seek from Government information on the overall management of affairs in the health sector including the establishment of the health services commission and increased budget
Over the last six years, the health sector in Kenya has exhibited significant developments, including the introduction of the Linda Mama (free maternity) initiative, the Beyond Zero campaign, efforts to revamp the National Hospital Insurance Fund (NHIF), as well as a multi-million dollar Medical Equipment Leasing scheme aimed at bringing advanced medical equipment closer to citizens across the 47 counties and in key referral facilities. The inclusion of health in the president’s legacy priorities (Big Four Agenda) underlined this stated commitment to improving healthcare.
This obviously follows the Constitutional requirement, Kenya Health Act 2014 and Kenya Health Policy 2014-30. In addition, Kenya has ascribed to the Sustainable Development Goals (SDGs), including SDG No 3, that commits governments to provide quality healthcare for all.
The bedrock of a functioning and pro-poor approach to the provision of affordable and quality health requires a right-based and public good approach with the primary responsibility lying on governments and not a market forces approach, where the for-profit private players dominate.
Already, the financing, human resource, and governance together with the rising burden of Non-Communicable Diseases (NCDs) remain a big challenge to the constitutional promise of the right to health.
At the core of the intervention and discourse on the coronavirus outbreak and handling is whether we are funding our preventing services more than curative services as committed in the various government pronouncements including vision 2030, big four agenda and the Constitution. Looking at the strategies and messages employed globally against Corona Virus- Covid 19, you notice that what it would cost to prevent the virus is cheaper and relies on community investment and involvement more that governments are spending on treating it or managing the information around the virus.
Indeed, at the core of the prevention strategy is pushing people to abandon the long-held cultural traditions like handshaking, gathering at funerals, political rallies, games and other communal activities. Whether this will suffice is a different point – but remember, the clarion call is care for yourself, your loved ones and the community through observing cleanliness and keeping social distance.
In a recent study titled “Reframing the Gap Understandings and Narratives of Health System Reform and Governance in Kenya”, it was concluded that for Kenya to live to the Constitutional expectation to provide quality health care for her people, there is need to: increase budgetary allocations to health above their current levels, and several invoked the Abuja Declaration target number of 15%; strengthen primary healthcare as the basis for any strong, sustainable, affordable healthcare system; achieve a clear and functional balance and distribution of powers between the national and county governments; and strengthen legal and systemic mechanisms of accountability at both the community and national levels.
In the Social Pillar of the Vision 2030, the Government commits to improving the overall livelihoods of Kenyans, the country aims to provide an efficient and high-quality health care system with the best standards. This will be done through a two-pronged approach: (i) devolution of funds and management of health care to the communities and district medical officers; The Medium Term Plan for Kenya 2008-2012 health development targeted emphasizes the need for increased investment in preventive health care. The Government says it will continue to shift focus from curative to preventive care, help to expand immunization coverage, improve reproductive health needs and allocate additional resources to facilitate an effective multi-sectoral response to epidemics.
Flagship project to be singled out include; revitalise community health centres to promote preventive health care (as opposed to curative intervention), de-link the Ministry of Health from service delivery in order to improve management of the country’s health institutions primarily by devolution of health management to communities and healthcare experts at district, provincial and national hospitals.
Health just like other sectors including security, telecommunication, education, ports and others must be protected from the jaws of the market forces. In addition, to streamlining the management of public resources by both national and county governments, the government should increase the budget allocation to the sector to the Abuja Declaration stated of 15% of the national budget.
Bwire is the Head of Media Development and Strategy at the Media Council of Kenya