Kenya: Uhuru Kenyatta’s “Golden Baby” CHU still struggles to crawl
In December of last year, while on his deathbed, Dr. Stephen Mogusu managed to contact the Nation.
In a long post, he left behind a grim but detailed picture of what President Uhuru Kenyatta’s “golden baby” – the Universal Health Coverage (UHC) program – had become.
All the brave frontline warrior wanted was for things to get better for many Kenyans as well as for doctors looking for affordable health services, but eight months after his death things seem to be going badly. worse.
“I contracted the virus… sasa niko (I’m in) self-isolation… I’ve never seen death so close in my life…” were some of the last sentences he could piece together before the virus won out over him. body.
The young doctor died before he could earn his first salary.
Dr Mogusu was one of 200 doctors deployed to counties in July 2020 under the UHC program to serve in the Covid-19 County Isolation Wards.
Like his colleagues at the time, he had not received his salary during the five months he had spent at his duty station in Machakos.
The father of one of them also had no medical insurance, despite working in a high-risk center, which predisposed him to infection with the very virus he was fighting. And when he tested positive for Covid-19, there was no bed for him there.
Big four agenda
In 2018, the country adopted UHC, one of the four major programs to empower the nation.
Four pilot counties, namely Isiolo, Kisumu, Machakos and Nyeri, were selected because, according to the government, they are characterized by a high incidence of communicable and non-communicable diseases, maternal mortality and road accidents.
In 2019, then-health cabinet CS Sicily Kariuki said the program expanded health services to 3.2 million Kenyans over a 12-month period.
Mr Kenyatta said his aspiration is to ensure that Kenyans can use the essential services they need for their health and well-being through a single unified benefit package, minus the risk of financial disaster. , by 2022.
This was to be done in accordance with the human right to health as guided by the 58th World Health Assembly of the World Health Organization (WHO) held in 2005, which urged member countries to aim to provide health care universally accessible to all members of the population based on the principles of equity and solidarity.
The human right to health as enshrined in Kenya’s 2010 Constitution is part of the development agenda outlined in Vision 2030.
The adopted model is a two-phase medium-term approach, which in the first phase should abolish all user fees at the primary level (local health centers) and at the secondary level (county referral centers).
The second phase is the deployment of a social health insurance scheme.
Funding comes mainly from the central government budget, which from the outset set aside 4.4 billion to 4.9 billion shillings for CSU.
The government has considered various sources of funding, such as taxes and the reallocation of funds from other budgetary areas.
Kenya also obtains funding for parts of the health system, such as monitoring and evaluation, from partner organizations such as the World Bank.
Sadly, CSU is nothing to write home about, according to doctors, nurses, counselors and administrators.
“CSU is a flop, it’s not even debatable. If you look at those of us deployed to county hospitals as part of this program, they’re lacking basic things, basic lab tests. Ordinary people are forced to go and buy drugs, and sometimes syringes, so that we can treat them. Healthcare is just too expensive and it only shows you that UHC is as dead as a dodo ” , explained a doctor in charge of a Covid-19 isolation center at one of the county hospitals.
The doctor further added that the procurement issues between the national government, counties and other partners regarding the recruitment of doctors and nurses are hampered by trust issues.
“They took people with renewable contracts for six months, when the contract expires, they take over three months to renew it, which means you are left out of work. Some of my friends working in the counties tell me. that they left for three months without pay, “he said.
Dr Davji Bhimji Atellah, national secretary general and CEO of the Kenya Medical Practitioners, Pharmacists and Dentists’ Union (KMPDU), attributes the failure of UHC to what he describes as “general confusion”.
“There is a lot of confusion in the roles played by the counties as well as in the roles played by the Department of Health. As a solution, we suggest that they come up with a centralized unit, so that, for example, if the county de Machakos needs 200 doctors, this is the body that runs, supports and manages the program so that we have effective management and accountability.
“Governors know there is a lot of money in health care to pay doctors and health care workers, but they hang on to it as much as they can deliver and that’s where bribes and cartels intervene, ”he added.
The union official thinks President Kenyatta had good vision, but his team has failed him terribly.
“The technical team responsible for carrying out the implementation failed it. If you compare to what Nairobi Metropolitan Services (NMS) has achieved in just one year, they cannot match.
“Dr Ouma Oluga and his team have created more than 24 new centers fully operational in Nairobi and employing more than 200 doctors”, underlines the doctor.
Dr Collins Kizito Matemba, the CEC for health in Kakamega County, believes the national government has trust issues.
“The national government is delaying budget allocations and as a result things are getting complicated. The government does not trust the counties to run the program, while they take on an advisory role as health is a decentralized function, which is why we have two factions of health workers under the UHC, those who are paid by the national government and those who are paid by the counties, and there is a lot of confusion there, ”he explained to the Nation in a telephone interview on Monday.
But according to Dr Andrew Mulwa, director of medical services, preventive and promotional health at the Department of Health, if people understand the “fictitious” pilots, then they can assess the dashboard.
“After 100% testing in all four counties, we took lessons and stepped up funding for inputs. The 47 counties have 11,000 health workers who are already on board as part of the strengthening of health, community volunteers where we have trained 90% of them. We probably lost a lot of visibility when we went to the third phase, which is the financing of production.
“In the third phase that means you get the services and I pay for the services that were offered and we did that through the National Hospital Insurance Fund (NHIF) registering a million low income households between October of last year and now, ”Dr Mulwa, who is the creator of the UHC program, told the Nation.
“Right now we’re working on automating incident recording, which we call biometric recording. under the CSU program, “he added.