Kenya’s health budget cut stumbles road to UHC

In this year’s budget, the Ministry of Health was allocated Kes141.2 billion, a drop from last year, pivoting away from the East Africa regional agreement to keep raising health resources by 10 percent each year and dampening push towards Universal Health Coverage (UHC).

Although the current health allocation is 11 percent of the total amount of Kenya’s budget it is down from Kes146.8 billion allocated in the previous financial year 2022/23.

Kenya has departed for the first time from the 2018 commitment by East African Community (EAC) heads of state on health priorities, committing to gradually increasing health sector funding by 10% per year, following extensive national and regional consultations.

This situation not only calls into question the integrity of the EAC treaty, but also poses a serious threat to the lives of Kenya’s already vulnerable population. The meagre allocation of just 1 percent of gross domestic product puts Kenya’s ability to meet the African Union’s 2030 domestic health financing targets at risk.

Kenya’s commitment towards ensuring access to health for all is enshrined in the constitution under article 43 that provides that every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care. To actualize the constitutional commitment, several policies, institutional and legislative frameworks have been established, as well significant budgetary allocations over the years.

Health sector in Kenya is among the devolved services since 2013, with the goal of creating opportunities to make health services more responsive to the needs of grassroot citizens. Without improved standards of health, our quest for prosperity and better life for our people would remain hollow.

Health coverage related expenditures

When health systems fail to provide adequate services, the financial burden falls on people, especially on those who live below the poverty line and do not have resources to meet basic needs such as health. Every year nearly one million Kenyans fall below the poverty line because of health coverage related expenditures.

Several initiatives have been put into place to guarantee Kenyans’ access to quality healthcare at an affordable price and to lower their out-of-pocket expenses. To further reduce out-of-pocket expenditures in Kenya, it is critical to address the role of the private sector, such as through the inclusion of more health facilities under the National Hospital Insurance Fund arrangement and coverage of pharmaceuticals. The National Health Insurance Fund (NHIF) is the primary implementing institution for UHC in Kenya.

Even though the goal to achieve UHC across the 47 counties by 2022 has not been achieved, considerable progress has been made in the health sector. This is seen in Kenya’s ranking on the Global Health Security Index 2021 where the country ranked first in the East African Community region and 84th globally out of 195 countries. Across the six categories used in the index, Kenya ranked 27th globally at early detection and reporting epidemics of potential international concern. Under the category that measures a country’s commitments to improving national capacity, financing plans to address gaps and adherence to global norms, Kenya ranked 35th globally. These scores indicate that albeit at a slow pace, positive change is seen in the country’s efforts to provide access to health for all.

Health and survival index

The investment in social health protection has seen Kenya close gender gaps. It is no surprise that Kenya was honoured at the African Union summit 2023 held in Addis Ababa for the country’s approach to improving reproductive, maternal, new born child and adolescent health (RMNCAH).

The global gender gap index uses two indicators to score a country’s health and survival index. That is, sex ratio at birth and healthy life expectancy. Despite using only two indicators, Kenya’s performance of 97.5% highlights the milestone achieved in closing the gaps within the indicators. Kenya had closed 98% of the gender gap in health and survival in three consecutive years, 2020, 2019, and 2018. The sustained performance slightly drops to 97.5% in 2021.

With the current focus and investment in health, this might propel Kenya’s score to 100% in subsequent years. Quality maternal healthcare can also provide an important entry point for information and services that empower mothers as informed decision-makers concerning their health and the health of their children.

There is need to take care of the health work force and streamline the governance aspect of health care to ensure the progress is sustained and universal health coverage is achieved. The imperatives to achieve universal health coverage include the need to mobilise adequate resources, increase investments in Primary Health Care, and reform key institutions such as the National Hospital Insurance Fund (NHIF) to align them to the UHC agenda.

The authors Darmi Jattani is an Economist (@DJattani) while Oscar Ochieng is a Communications Practitioner (@JOchieng85)

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