Healthy pri­or­i­ties, bud­get wor­ries

The Africa Report - - QUARTER -

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.

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