Healthy priorities, budget worries
July is the overly ambitious target for the team of Kenya’s President Uhuru Kenyatta to roll out its universal healthcare coverage programme. There is a lot of conflicting messaging coming from the government about what the programme will be and worries about financing. In June 2018, Kenyatta claimed: “We are extending health insurance to every household,” but other officials have stressed that the healthcare element of Kenyatta’s ‘Big Four’ agenda will not yet offer universal insurance but will instead expand access and reduce costs.
What the programme entails is a strengthening of the healthcare system from the ground up. In 2018, the government started pilots in four of Kenya’s 47 counties. The government is pushing to widen enrolment massively in the National Hospital Insurance Fund (NHIF) and work on new financing initiatives for the health sector.
In 2018 about 7.7 million of the 49.7 million population had health insurance through the state-backed NHIF – more than through the private sector. Nairobi intends to reform the NHIF and raise state commitments to health spending, from 7% of the national budget in 2018 to 10% in 2022. But this comes amidst a squeeze on government spending as debt levels rise.