The study protocol was reviewed and approved by the AMREF Ethical and Scientific Review Board (AMREF-ESRC). For context, in some counties, salary delays were as long as five months, Kenya National Health Sector Strategic Plan (KHSSP) I. SummaryWe suggest that Brazil needs to improve its health outcome measurement system for organ transplantations and epidemiological surveillance, to gain more comprehensive and comparable data. Government Printers. Data was collected from existing policy reports, the Services Availability and Readiness Assessment (SARA) tool (physical status), the Health Facility Registry (HFR), implementation reports on infrastructure development from the 26 regions and 185 district councils across the country (covering assessment of physical infrastructure, waste management systems and inventories for ambulances) and Comprehensive Emergence Obstetric Care (CEMONC) signal functions assessment tool. Of all Health Centers only 115 (22.2%) were offering the CEMONC services. Kenya National eHealth Strategy 3 Foreword The development of the E-Health Strategy comes at an important time when the health sector is implementing far reaching reforms to achieve universal coverage. The results suggest that those differences are partly explained by differences in preferences among agents or the institutional legacies within each domain. Financial protection of household against the consequences of the health care expenditures is one of the most important functions of health care systems. In 1998, the NHIF act was amended to enhance coverage among the poor, accelerate coverage of the informal sector, and enhance the benefit package [13,14]. Universal Health Coverage is where communities have access to all needed health services without financial hardship. 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. This is also inline with the National Surgical, Obstetrics and Anesthesia plan (NSOAP). Determining Equity in Household's Health Care Payments in Hamedan Province, Iran. Framing improves on approaches to understanding the health policy process by accounting for agency, emotion and social values. Health worker strikes are a significant threat to universal access to care globally and especially in sub Saharan Africa. Findings suggest stark disparities in access to transplantation services both within and across Brazil’s regions. In a nutshell, the coun, ment with support from various stakeholders has, 010). This paper examines how SHI affects patient decision-making regarding when and where to seek care in Kenya and Ghana, two countries with established SHI systems in sub-Saharan Africa. Saving for healthcare as well as enrolment in health insurance can improve access to healthcare by building capacities at all levels–individuals, families and communities. The Constitution. Kenya has made tremendous progress in addressing pressing health priorities through the provisions of the Kenya Constitution 2010, Vision 2030 and the Big Four (4) Agenda. Ksh 9.2 billion for Moi Teaching and Referral Ho… Kenya Demographic Health Survey. (2010). Households were selected using simple random sampling and data obtained for all household members who reported having sought care for an illness in the 12 months preceding the study. For a country that all goods and services produced in this takes pride in providing its citizens with country cost more because of the cost of basic services, the extent to which many health care. Trial registration history: Registered with Protocol Registration and Results System (Protocol ID: AfricanPHRC; Trial ID: NCT04068571: AEARCTR-0006089; Date: 29 August 2019) and The American Economic Association's registry for randomised controlled trials (Trial ID: AEARCTR-0006089; Date: 26 June 2020). Universal Health Coverage (UHC), referring to access to healthcare without financial burden, has received renewed attention in global health spheres. (2012). Government Printers, Nairobi. Strategies for reducing this behavior include more adequate and timely remuneration within the public sector, educating patient populations of free or low‐cost services, and evidence‐based methods to increase provider motivation. In@W8, affeat concern of the federal and state over $2,000 per capita was spent on health governments, employers, providers and care, a 100 percent increase in per capita individuals. Being embedded within comparative institutional analysis the paper aims at providing a systematic framework for defining and explaining variations in reform dynamics highlighting the role of uncertainty. References We, therefore, conclude that this health policy in this urban resource-poor setting could be a viable solution to reach the neglected urban households in the Kenyan slums. than the young. 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). health care proving a perfect illustration. Infrastructure development and upgrading to support safe surgical services in primary health care facilities is an important step in the journey towards achieving Universal Health Coverage (UHC). This paper draws from two datasets collected under the African Health Markets for Equity (AHME) program. Additionally, patients may be unaware that they are being asked to pay more than the official cost of services. The question now turns to what Universal Health Coverage looks like for Kenya. I have allocated Ksh 7.9billionfrom the Sports, Arts and Social Development Fund to fund the universal health care initiatives 3. Inconclusive evidence exists on health-seeking and utilization of health facilities in the informal settlements in Kenya. Conclusion: Conclusion: The Com-can afford to absorb the spiralling costs. The specific objective was to were to investigate the effect of technology on implementation of Universal Health Coverage among Counties in Kenya. In this article, we argue that new platforms should be created that gather all stakeholders who hold pieces of relevant knowledge for successful policies. Since clients valued provider proximity and both Kenya and Ghana have a dearth of providers in rural areas, both countries should incentivize providers to work in these areas and prioritize accrediting rural facilities into SHI schemes to increase accessibility and reach. Under this backdrop, the current study helps in identifying the key enablers for the health supply chains which when present will contribute towards strengthening the health coverage and improving overall well-being. In total, 240 households from 24 villages in Kakamega will be followed to capture their health, health knowledge, health-seeking behavior, health expenditures and enrolment in health insurance over time. The framework is applied to the Kenyan case. • 4 out 10 Kenyans were at risk of getting into financial hardship or poverty because of out of pocket healthcare payments in 2014. Since its independence in 1963, the government of Kenya has initiated policy, reforms and strategies towards UHC for all, including those in vulnerable situations such as low-income mothers and children. For instance, reforms relating to the way, well as community involvement in service provisio, in 1996, the Ministry of Health with the suppor, lic health sector aimed at enhancing access to quality, es of fraud at facilities experienced (NHIF, to all Kenyans by introducing social solidarity mechanisms founded on, apse of health care delivery at the county level. Second, laws, for instance, the National Hospital Insurance Fund Act, are yet to be aligned to the Constitution and to design a suitable legal architecture of UHC. Ksh 2.9 billion for Doctors/Clinical Officers/Nurses internship programme 4. 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. The national hospital insurance fund’s (NHIF) mandate by the Ministry of Health (MOH) of Kenya to implement universal health coverage (UHC) generated controversy among stakeholders. of addressing all health needs under the goal of universal health coverage (UHC), 2 prominently featured in the Sustainable Development Goals (SDGs) adopted in 2015.3 The World Health Organization (WHO) defines UHC as coverage where all people and communities can use effective preventive, curative, and other much-needed health New & Innovative Initiatives. As the population ages lems, and what is a range of possible so-and lives longer, more dollars will nec-lutions. The implementation of policies remains a huge challenge in many low-income countries. This study aims to review the challenges facing UHC in Ghana, Kenya, Nigeria, and Tanzania, and to suggest program or policy changes that might bolster UHC. It is therefore important to understand how SHI enrollees use health insurance and how it affects their health-seeking behavior. Ksh 47.8 billion to activities and programmes geared towards universal health coverage 2. Results: The potential of social protection to contribute to inclusive growth has been increasingly recognized throughout the last two decades. 277 0 obj <>stream The paper relied heavly on secondary sources of information although primary data data was collected. Evidence from LMICs has found user fees to be a barrier to health care utilization (Lagarde & Palmer, 2008). More than half of participants reported that solicitation of informal fees is common practice in health care facilities. 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. Overcoming this challenge is in the hands of the experts charged with designing public health strategies and policies. The empirical methodology employs a process tracing approach including primary and secondary data covering the time period between 2001 and 2017. The WHO call for ‘Leaving no one behind’ and ‘delivering the Triple Billion Together!’ found great resonance in Immaculate Otene’s words. Also, implementing improvement methodologies and international standards has created a strong culture that promotes excellence, ... On June 1st 2013, government abolished user fees in all public dispensaries, health centers and all maternal health care including deliveries in all hospitals, compounding their over-utilization. Im, Meessen, B., Kouanda, S., Musango, L. et al. This was partily attributed to enhanced, d equity issues. Ksh 14.4 billion for Kenyatta National Hospital 5. healthy Kenya. The sixty-year old Kenyan man fell victim to a violent attack in which he sustained a … Due to a lack of understanding of SHI benefits, clients rarely knew they had been charged inappropriately. 3.Financing, Health. UHC is a potential goal in the post-2015 development agenda. 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. 7 of 2012 on Universal Health Care. We conducted in‐depth semistructured interviews in 2015–2016 among a sample of 20 public and private‐sector Kenyan health care workers. with the United Nations high-level declaration on universal health coverage (UHC), which includes a commitment to strengthen legislative and regulatory frameworks for UHC.4 In this respect, measuring change in Kenya’s health reforms would contribute knowledge to advance UHC. 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 This study assessed the patterns and predictors of private and public health care utilization in an urban informal settlement in Kenya. Methods: 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. Kenya is among countries that have pledged funds for improving maternal and newborn health and social ... Kenya joins Sh2.3trn universal health coverage fundraising drive … The main concerns relate to wider systemic issues-in particular, understaffing in some key posts and areas, and dwindling general revenues for the facilities, especially through loss of wider user fee revenues. Whereas secondary data was largely collected through critical review of policy documents and commissioned studies by the Ministry of Health and development partners, primary data was collected through interviews with various stakeholders involved in UHC including policy makers, implementers, researchers and health service providers. In the Kenyan context, reduction of user fees at public facilities revealed increased health care utilization which in turn put pressure on the public health care system, ... Health system infrastructure ranges from the physical facilities, information systems to medical equipment and also involves construction of new infrastructure as a strategy to achieving UHC [4]. Some of these are, as well as a brief of the health situation and health, lth coverage. 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. Required data regarding households' health and non-health expenditures were collected through World Health Organization standard questionnaire by interviews and observation method. Below are allocations for health sector; 1. Interviews were coded and analyzed using an iterative thematic approach. The second dataset was collected internally by the AHME partner organizations. Mwaabi P (2017) Universal health care coverage: healthcare financing and access to health care services in Kenya Clin Case Rep Rev, 2017 doi: 10.15761/CCRR.1000378 Volume 3(10): 2-3 incurring catastrophic expenditure, which may further push them Several factors play a role in this, but improper management of existing knowledge is no doubt a major issue. Methods: 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). (2010). h�b```b``~��d. Infant mortality on the other hand, same period were 204 per 1,000 live births, 93, 134 and 77 respectively curr, quality of health workers at facilities. Universal health coverage (UHC) - World Health Organization Again, this raises equity issue, some of the latest efforts towards UHC. In lieu of these, various recommendations have been suggested. 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. Is the legal and policy framework aligned to define an appropriate architecture of universal health coverage? A, This situation is likely to be worse given the recent exodu, urban areas as opposed to rural areas. Leading Causes of Deaths and Disabilities in Kenya, critically review the various initiatives that the gov, Health and development partners, primary data was collected throu, health care system; minimal opportunities for contin, capitation, fraud at facility levels, low pay ou, Universal health coverage ensures that all peo, Universal coverage brings the hope of better health and. Kenya National Health Sector Strategic Plan (KHSSP) I. %PDF-1.5 %���� • The Universal Health Coverage index for Kenya was 52% in 2014. The large in-such as repairing roads and bridges or creases in health care costs and the rise providing better public education. Notable, i-PUSH fosters savings for health care through the mobile-phone based “health wallet”, it enhances enrolment in subsidized health insurance through the mobile platform–M-TIBA–developed by PAF, and it seeks to improve health knowledge and behavior through Community Health Volunteers (CHVs) who are trained using the LEAP tool–AMREF’s mHealth platform. There is precedent for moving Kenya towards Universal Health Coverage. Payments may be motivated by a combination of factors such as low supervision, weak sanctions, and inadequate provider salaries. Three hundred and sixty-four members from 300 households sought care for an illness in the 12 months preceding the study. Kenya Demographic Health Survey. Government Printers, Nairobi. Join ResearchGate to find the people and research you need to help your work. The focus of the Jubilee government is framed around free primary healthcare for all Kenyans, starting with women, expectant and breastfeeding mothers and persons with disabilities, by increasing health financing from 6% to 15% . Pour élaborer notre cas, nous capitalisons sur notre expérience dans notre domaine de pratique: le financement des soins de santé en Afrique subsaharienne. 5.Cost of illness. These have partially contributed to increased, ven this scenario, although NHIF is seen as a way of, ecially doctors from public health facilities, as well as, Kenya National Union of Nurses KNUN) have voiced, erns range from scheme of service, discrepanc, un health system is a key ingredient towards UHC as, re services in public health facilities. Kenya has recently adopted universal health coverage (UHC) as one of the ‗big four‘ priority agenda. The incidence of impoverishment due to out-of-pocket payments for health care was 2.8% among studied households. The study presents the first empirical estimates of the mean willingness-to-pay (WTP) for setting up a social health enterprise that will simultaneously run a health center and provide health insurance scheme in an urban resource-poor setting and explores whether the benefits outweigh the costs. Of these 115 health facilities, only 20 (17.4%) were offering the CEMONC services with all 9 - signal functions and only 17.4% had facilities that are offering safe blood transfusion services. Discussion: People in LMICs often suffer from high out-of-pocket healthcare expenditures, which in turn, impedes access to quality health services. Abstract The national hospital insurance fund’s (NHIF) mandate by the Ministry of Among these include promotion of solidarty in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, engagement of various stakeholders at both county and national government in fast tracking the enactment of Health Act; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources, enhanced awareness amongst members, enhanced benefit package among other recommendations. Situation Analysis 3. Access to health care is now enshrined as a constitutional right for all. L’implémentation des politiques reste un énorme défi dans les pays à faibles revenus. Kenya has recently adopted universal health coverage (UHC) as one of the ‗big four‘ priority agenda. 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. For instance, following the dwindling, articulated. Despite the achievements, still there is a high demand for good physical statuses and functioning of primary health facilities with capacity to offer essential and safe surgical services in the country also as an important strategy towards achieving UHC. figures have uals without health insurance coverage is a very real effect on our everyday lives-also of great concern. This study adopted the descriptive research design targeting 291 … The system for reimbursing facilities is operating without undue delay and there is satisfaction with the flexibility of use of resources which it allows and the additional incentives for staff. The enabling environment of health supply chains will include the broad structure within which individuals and organisations function. Access scientific knowledge from anywhere. Methods health. Whereas this is positive step and much, ship have been identified as Formal, Informal and, hy accreditation process of healthcare provi. This study aims to review the challenges facing UHC in Ghana, Kenya, Nigeria, and Tanzania, and to suggest program or policy changes that might bolster UHC. While evidence suggests that SHI is a promising strategy for achieving UHC, low-income countries often struggle to implement and sustain SHI systems. Conclusions: Lastly, the international and socio-economic context provided focal points facilitating coordination on targeted or vertical interventions such as cash transfers or fee waivers. This has seen, although there are still no reliable statistics, the scheme which seems to have had a negative impact on enrollment levels. iii “Universal health coverage is the single most powerful concept that public health has to offer” Dr Margaret Chan, Address to the Sixty-fifth World Health Assembly, May 2012 “Another lesson is the importance of long-term investment in This was lauded, s and in-depth interviews revealed increased utilization, icy dialogue. Building Health: Kenya’s Move to Universal Health Coverage. approach that can be replicated in Kenya. (2015). The of the underinsured and uninsured pop-United States spends more on health care ulation should cause us to address the than any other industrialized country. However, the value for money associated with setting up a social health enterprise in sub-Sahara African countries has been relatively unexplored in the literature. Draft Health Po. The end goal is to enhance the capacity of sex workers to actively participate in the UHC implementation process and benefit from it, accordingly. The National Health Policy Strategy Plan 2014-2030 identifies universal health coverage … Th, workers. While shifts more costs to employers and indi-this was not the federal government's first viduals while attempting to hold provid-foray into health policy, the Commission's ers responsible for adding to the price es-vision was an important catalyst shaping calation. Background: The National Free Delivery Policy in Nepal: Early Evidence of Its Effects on Health Facilities, Health Systems Financing: The Path to Universal Coverage. Interpretations of the concept of social protection and complexity of 'insurance' facilitated processes related to cash transfers whereas providing impediments to social health insurance. For this article examines the latest efforts towards UHC CEMONC services study assessed patterns. 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