figures have uals without health insurance coverage is a very real effect on our everyday lives-also of great concern. Kenya has recently adopted universal health coverage (UHC) as one of the ‗big four‘ priority agenda. Plusieurs facteurs y jouent un rôle, mais la mauvaise gestion des connaissances existantes est sans aucun doute un enjeu majeur. We found that these regional differences are partially due to logistical challenges, especially in loosely populated areas but are also a consequence of disparities in resource allocations within SUS and under-capacitated health care facilities affecting transplantation services. For instance, whereas the ‗big four‘ agenda designates the National Hospital Insurance Fund (NHIF) as the institution to deliver universal health coverage by 2022, this new mandate is not enshrined in the National Hospital Insurance Fund Act (1998). Nepal faces the challenge of high levels of poverty, difficult access to health facilities and poor, though improving, health indicators. In addition, behavioral responses to uncertainty matter: Stronger information asymmetries within the cash transfer and fee waiver reform domains opened space for discretionary decision-making. Government Printers, Nairobi. 2 Outline 1. Under capitation, accredited providers receive a lump sum payment from the NHIF on a regular basis that is based on the number of clients registered to their facility, regardless of whether or not each client seeks service. Likewise, in an attempt to design sustainable health supply chains, Kenya has unified the distribution of donor-funded medicines (Serem 2014). 146 0 obj <> endobj Below are allocations for health sector; 1. Are institutions like NHIF and County governments properly positioned to steer Kenya towards UHC? While evidence suggests that SHI is a promising strategy for achieving UHC, low-income countries often struggle to implement and sustain SHI systems. It is expected that this percentage will continue to grow at a faster rate than G health care ' costs hayje -b-QcoM-e anyvd*W-@s@@econDMY. Situation Analysis 3. Universal Health Coverage is where communities have access to all needed health services without financial hardship. Kenya has made progress towards universal health coverage as evidenced in the various policy initiatives and reforms that have been implemented in the country since independence. Copyright for this article is retained by the author(s), This is an open-access article distributed under the te. Several factors play a role in this, but improper management of existing knowledge is no doubt a major issue. Evidence from LMICs has found user fees to be a barrier to health care utilization (Lagarde & Palmer, 2008). Kenya Health Policy Framework. This study adopted the descriptive research design targeting 291 … However, the more 11 percent of the Gross National Product global question remains of how to ensure *Coopers & Lybrand, Washington, D.C. 20036. being discharged from hospitals in Hamedan, were selected for study by using a stratified random sampling method. Nairobi – For 60-year-old Gabriel Wahome, it is simple: “universal health coverage was a very good idea,” he says.“We were happy about it.” Two years ago, the Kenyan government piloted a universal health coverage programme in four of its 47 counties, easing access to health services for millions of people. There was a significant decline in the numbers of patients seen, comparing the non-strike and strike periods; beta (ß) coefficient - 649 (95% CI -950, - 347) p < 0.0001. well-trained, motivated health workers (WHO, 2010. reform initiatives and how these relate to universal hea, relevant literature on key policy initiativ, such as the draft Kenya National Health Sector Strate, statergic plans, aperational plans, among others), the C, was also collected from relevant commissioned, now estimated at 62 years (Male- 60 years and female 65 years)(PRB, 2015). Although many sub‐Saharan African countries have made efforts to provide universal health coverage (UHC) for their citizens, several of these initiatives have achieved little success. In this cross-sectional study, 772 families of patients, who were. . we begin to focus on these problems, it is The demographics of the country are important to understand why the prob-changing, making it more important to lems exist, what are the forces in the begin solving the problems inherent in our economy that will exacerbate these prob-health care system. %%EOF Between 2015 and August 2019, a total of 419 (8.3%) health facilities (Consisting of 350 health centers and 69 District Council Hospitals) were either renovated or constructed and equipped to offer safe surgery services. The empirical methodology employs a process tracing approach including primary and secondary data covering the time period between 2001 and 2017. 0 Kenya Health Bill 2015. This was lauded, s and in-depth interviews revealed increased utilization, icy dialogue. Population and NHIF Coverage. Study methods included structured forms to retrieve financial and activity data from national, district and facility records (comparing 10 months before implementation with 10 months after). The question now turns to what Universal Health Coverage looks like for Kenya. December 15, 2018 December 16, 2018 HowKE Team 1 Comment UHC Kenya, universal health care, Universal Health Care Kenya What is universal health care UHC. As Kenya, continues making strides towards promoting UHC, at least 3.2 million Kenyans in four counties will be the first beneficiaries of a new health package being developed by the Government. There was no mortality increase in the post-strike period beta (ß) coefficient 7.42 (95%CI -16.7, 1.85) p = 0.12. Research Article Kenya National Hospital Insurance Fund Reforms: Implications and Lessons for Universal Health Coverage Edwine Barasa *,1,2, Khama Rogo3, Njeri Mwaura 3, and Jane Chuma3 1Health Economics Research Unit, KEMRI–Wellcome Trust Research Programme, Nairobi, Kenya 2Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, … Background: The purpose of this analysis was to critically review the various initiatives that the government of Kenya has over the years initiated towards the realization of Universal Health Care (UHC) and how this has impacted on health equity. The Kenya Health Sector Strategic and Investment Plan III 2018–2023 (Draft) in line with the Kenyan Constitution and the Kenya Health Policy 2014-2030, also outlines ‘The attainment of Universal Health Coverage’ as the main sectoral priority and includes expansion and coverage of services for the last mile. Government Printers, Nairobi. L’implémentation des politiques reste un énorme défi dans les pays à faibles revenus. The study attempts to delineate an integrated model of health supply chain enablers and their role in improving overall well-being. Kenya is a country in East Africa with a population of about 48 million people and a life expectancy of 64 years for men and 69 years for women. Other findings include governance concerns at NHIF coupled with, high operational costs, low capitation, fraud at facility levels, low pay out ratio, accreditation of facilities, and narrowness of the benefit package, among others. Further, while the Constitution devolves the health function with county governments mandated to deliver the bulk of health services, the ‗big four‘ agenda does not clearly articulate the place of universal health coverage in this devolved setting. Results: Health care utilization patterns by explanatory variables were described using proportions and multinomial logistic regression used to identify the predictors of private or public health care use. It is therefore important to understand how SHI enrollees use health insurance and how it affects their health-seeking behavior. Methods: The National Health Policy Strategy Plan 2014-2030 identifies universal health coverage … approach that can be replicated in Kenya. Abstract The national hospital insurance fund’s (NHIF) mandate by the Ministry of The Kenyan Constitution states that every Kenyan has a right to quality and affordable health care, and recognizes the role of the government in removing barriers to access. However, facilities have also been, Whereas these initiatives are lauded for their po, facilities with reports indicating incidences of political, facilities lacking necessary resources (h, facilities. ersal coverage exhibit matters of concern like oth, 2009; Harmonization for Health in Africa, 2010; and, support from its strategic partners has been on the, Health Systems Financing: The Path to Universal Coverag. Of 5072 (518 are Health Centers and 4554 are Dispensaries) existing public primary health care facilities, the majority (46%) had a physical status of A (good state), 33% (1693) had physical status of B (minor renovation needed) and the remaining facilities had physical status of C up to F (needing major renovation). The physicians' strike saw a significant decline in mortality (ß) coefficient - 19.0 (95%CI -29.2, - 8.87) p < 0.0001. Background: Key Message Ÿ Universal health coverage (UHC) is the access to safe, effective, quality essential health care services, including affordable essential medicines and vaccines for all without going into poverty. Providers reported low public‐sector wages were a primary driver of informal fee solicitation coupled with collusion among senior staff. mission further declared that "the Amer-Providers have become more savvy about ican people desire and deserve compre-maximizing their reimbursements from hensive health service of the highest the various payers, employers have be-quality and in our dynamic expanding come more sophisticated consumers while economy the means can be found to pro-requiring employees to share more of the vide it"; the Commission stated that "the cost burden, and federal and state gov-same high quality of health services should emments have enacted legislation that be available to all people equally." Informal fees are payments made by patients to their health care provider that are over and above the official cost of services. Government Printers, Nairobi. GoK. There is considerable inequity in health care financing as well as households' health payments. This data was analyzed using an inductive, thematic approach. %PDF-1.5 %���� UHC is also a matter of global security. Creative Commons Attribution 3.0 Unported, The Impact of i-PUSH on Maternal and Child Health Outcomes, Health Care Utilization and Financial Protection: A Cluster Randomised Controlled Trial Based on Financial and Health Diaries Data, Economic valuation of setting up a social health enterprise in urban poor-resource setting in Kenya, Enabling health supply chains for improved well-being, The impact of the nurses’, doctors’ and clinical officer strikes on mortality in four health facilities in Kenya, Seeking care in the context of social health insurance in Kenya and Ghana, Patterns and predictors of private and public health care utilization in an informal settlement in Nairobi, Kenya: A cross-sectional study, Development and upgrading of public primary healthcare facilities with essential surgical services infrastructure: a strategy towards achieving universal health coverage in Tanzania, “If the Big Fish are Doing It Then Why Not Me Down Here?”: Informal Fee Payments and Reproductive Health Care Provider Motivation in Kenya, Different pathways of social protection reforms: An analysis of long-term institutional change in Kenya, An Examination of the Legal, Policy and Institutional Framework for Universal Health Coverage in Kenya. Kenya has recently adopted universal health coverage (UHC) as one of the ‗big four‘ priority agenda. Government Printers, Nairobi. Money spent on health care individuals are uninsured or underin-cannot be spent on other needed services sured is unacceptable. There is precedent for moving Kenya towards Universal Health Coverage. The paper relied heavly on secondary sources of information although primary data data was collected. For instance, following the dwindling, articulated. Ksh 47.8 billion to activities and programmes geared towards universal health coverage 2. continuing education, scheduled accreditation, and the introduction of career development incentives, it has not considered management options tailored to the new setting, a human resources strategy that has the consensus of key players and sector policy, or a process for understanding the needs of health care staff and professionals. In this regard, equity in terms of quality care ne, under-utilization, narrow benefit package, lack of incen, revenue especially that paid via EFT and R, of fraud at the health care facilities, lim, public providers face problems following the policy chan, cases where they are asked to purchase drugs and, (chemist/pharmacies/drug stores) not withstan, user fees on lower level facilities and maternal, have the required knowledge for policy making) an, Act currently under deliberation in parliament; in, that embrass social solidarity; effieciency in allocation and utilization, acreditation policy and strategy to foster credibility and obj, The authors declare that there is no conf, Harmonization for Health in Africa. Results Together with other United Nations member states, Kenya is working toward worldwide universal health coverage by the year 2030. This article examines the latest policy, which was introduced in January 2009: free delivery care across the country. Nous avons récemment adopté une stratégie de communauté de pratique dans la région. The goal is that by 2022, all persons in Kenya will be able to use the essential services they need for their health and wellbeing through a single universal health coverage by the National Hospital Insurance Fund in Kenya Rahab Mbau1*, Evelyn Kabia1, Ayako Honda2, Kara Hanson3 and Edwine Barasa1,4 Abstract Background: Kenya has prioritized the attainment of universal hea lth coverage (UHC) through the expansion of health insurance coverage by the National Hospital Insurance Fun d (NHIF). Discussion: People in LMICs often suffer from high out-of-pocket healthcare expenditures, which in turn, impedes access to quality health services. Patients utilizing the hospital and department the large in-such as repairing roads and bridges or creases in health care currently. Using an iterative thematic approach are over and above the official cost of services easy tool that is designed sensitize. 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