Almost half (47%) of the respondents sought care from private facilities while about 33% and 20% used public and other facilities, respectively. DiscussionIn this article we evaluated the existing literature to examine the impact that SUS has had on an increasingly, Introduction (GNP). Government Printers. ment of Kenya has over the years initiated towards the, e reliable and economical in collecting; po, including governments. 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). Research permits were obtained from the National Commission for Science, Technology and Innovation (NACOSTI) agency of Kenya. 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. Nevertheless, access to quality health services is marred by substantial resource shortages creating service delivery gaps in low-and middle-income countries (LMICs), including Kenya. endstream endobj startxref Findings suggest stark disparities in access to transplantation services both within and across Brazil’s regions. 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. UNIVERSAL HEALTH COVERAGE (UHC) What does UHC mean? Key findings include commitment towards UHC; minimal solidarity in health care financing; cases of dysfunctionalilty of health care system; minimal opportunities for continuous medical training; quality concerns in terms of stock-outs of drugs and other medical supplies, dilapidated health infrastructure and inadequqte number of health workers. Health worker strikes are a significant threat to universal access to care globally and especially in sub Saharan Africa. This study indicates that between 2015 and 2019 there has been improvement in physical status of primary health facilities as a result constructions, upgrading and equipping the facilities to offer safe surgery and related diagnostic services. Satisfaction with the quality of care was associated with lower use of public facilities (aOR 0.31; CI 0.11 – 0.84) while satisfaction with cost of care was associated with higher use of public facilities (aOR 2.09; CI 1.01 – 4.29). Determining Equity in Household's Health Care Payments in Hamedan Province, Iran. There is considerable inequity in health care financing as well as households' health payments. The findings will inform stakeholders to formulate better strategies to ensure access to UHC in general, and for a highly vulnerable segment of the population in particular, including low-income mothers and their children. Building Health: Kenya’s Move to Universal Health Coverage. I.World Health Organization. Abstract The national hospital insurance fund’s (NHIF) mandate by the Ministry of The results suggest that those differences are partly explained by differences in preferences among agents or the institutional legacies within each domain. The available infrast, personnel or providers or alternative health care serv, may seek services from private facilities which may be relatively expensive thereb, facilities (both County and National govern, exhibits a robust public/private mix in healthcare servic, facilities, over-utilization the public fac, The pursuit of UHC has been a critical focus for many health care providers including governments, multilateral, of primary health care (PHC) and continued training of, the health sector in Kenya has operated in the con, shift from purely government provided for care to, government introduced cost sharing in public health in ”, Sector Strategic Plan (NHSSP) of 1999-2004 wherei, development, as well as healthcare service delivery were, was. This means that UHC is a potential goal in the post-2015 development agenda. According to the World Health Organization, Universal Health Coverage/Care (UHC) is defined as ‘the ability for persons to receive the health services they need without suffering financial hardship’. 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. Nepal faces the challenge of high levels of poverty, difficult access to health facilities and poor, though improving, health indicators. While evidence suggests that SHI is a promising strategy for achieving UHC, low-income countries often struggle to implement and sustain SHI systems. Interviews were coded and analyzed using an iterative thematic approach. The National Health Policy Strategy Plan 2014-2030 identifies universal health coverage … In 1952, President Truman's Commis-The health care financing system is al-Na-ready undergoing significant change as sion of the Health Care Needs of the governments, employers, providers and tion proclaimed that "access to the means individuals attempt to hold down costs or for the attainment and preservation of maximize profits in an era when no one health is a basic human right." Results: The study interrogates the following three interrelated issues: Is the ‗big four‘ agenda anchored on a policy framework that will realize the dream of universal health coverage? Results GoK. Kenya Health Bill 2015. Inconclusive evidence exists on health-seeking and utilization of health facilities in the informal settlements in Kenya. Where health systems are strong, we are better able to prevent, monitor, detect and respond to health emergencies, At the same time, univer- figures have uals without health insurance coverage is a very real effect on our everyday lives-also of great concern. 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 Likewise, in an attempt to design sustainable health supply chains, Kenya has unified the distribution of donor-funded medicines (Serem 2014). More in general, we consider these platforms as the way forward for knowledge management of implementation issues. 2.Delivery of health care - economics. Reports show that this is due to incentives for locating i, facilities country wide. The Constitution. 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." h�l��+�Q��s�)Y��%�b��! 270 0 obj <>/Filter/FlateDecode/ID[<3770272F7967C74B9FE1138A591257DB><49D43A366D6AC543B2C941A5EEDED025>]/Index[146 132]/Info 145 0 R/Length 312/Prev 436167/Root 147 0 R/Size 278/Type/XRef/W[1 2 1]>>stream 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. (PDF) Analysis of Universal Health Coverage and Equity on Health … health care proving a perfect illustration. ISBN 978 92 4 156402 1 (NLM classification: W 84.6) ISBN 978 92 4 068480 5 (electronic version) More importantly, setting up the social health enterprise will yield a positive net profit, and investors could expect US$ 1.11 in benefits for each US$ 1 of costs of investment in setting up the social health enterprise. 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. supply chain, telemedicine GoK. Government Printers. Financial protection of household against the consequences of the health care expenditures is one of the most important functions of health care systems. Government Printers, Nairobi. 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. Kenya has recently adopted universal health coverage (UHC) as one of the ‗big four‘ priority agenda. Methods: This is a cluster randomised controlled trial (RCT) study that uses a four-pronged approach –including year-long weekly financial and health diaries interviews, baseline and endline surveys, a qualitative study and behavioral lab-in-the-field experiments–in Kakemega County, Kenya. However, there are glaring inconsistencies and incoherence in the legal, policy, and institutional design to realize the dream of universal health coverage. Preventive and promotive health services 1 Kenya Demographic Health Survey 2014 2 Global Burden of Disease Study, 2015. 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). 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. In terms of secondary data, a review of, nsitution and the Draft Health Bill, 2015. 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 unified benefit package, without the risk of financial catastrophe. More than half of participants reported that solicitation of informal fees is common practice in health care facilities. • 4 out 10 Kenyans were at risk of getting into financial hardship or poverty because of out of pocket healthcare payments in 2014. Since the study was conducted in Kenya, it is recommended that similar studies be This cross-sectional study used data from the Lown scholars study conducted between June and July 2018. 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. For context, in some counties, salary delays were as long as five months, Kenya National Health Sector Strategic Plan (KHSSP) I. Key words: Universal health coverage, health insurance, informal sector, health financing 1.1: Introduction Many countries have been seeking for ways of how their health financing systems can provide sufficient financial risk protection to all of the population against the costs of healthcare Methods -This booklet is an easy tool that is designed to sensitize and create awareness about Universal Health Coverage (UHC) in Kenya. 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. Social protection reforms involve comprehensive processes of long-term institutional change. Monitoring of progress towards achieving UHC is thus critical at both country and global level, and a monitoring framework for UHC was proposed by a joint WHO/World Bank … The model is further investigated with Kenya as a case study to understand the impact of the enablers on quality of life and improved well-being. Several factors play a role in this, but improper management of existing knowledge is no doubt a major issue. Knowledge of health care utilization is particularly crucial in low-and middle-income countries where inequalities in burden of disease and access to primary health care exist. Universal health coverage is a construct shaped profoundly by processes of sensemaking, naming and storytelling around health financing reform in Kenya. This study adopted the descriptive research design targeting 291 respondents made up of 7 specialist UHC is a potential goal in the post-2015 development agenda. Universal Health Coverage (UHC), referring to access to healthcare without financial burden, has received renewed attention in global health spheres. 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. The survey was conducted between June and July 2018 on 300 households. The specific objective was to were to investigate the effect of technology on implementation of Universal Health Coverage among Counties in Kenya. It is therefore important to understand how SHI enrollees use health insurance and how it affects their health-seeking behavior. 0 �aK Kenya Demographic Health Survey. It will be challenging to build on the gains of the past few years and sustain them, at the same time as merging the separate free care funding streams. Declines in facility-based mortality during strike months was noted when compared to a non-striking facility, where mortality increased. Ksh 9.2 billion for Moi Teaching and Referral Ho… Government Printers, Nairobi. 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. Methods: Health care utilization was influenced by enabling and need factors. 5 Universal Health Coverage: Critical Drivers Critical drivers 100% universal coverage Populaon Coverage Financial protec’on Access to quality Services 100% populaon covered by an essen*al health benefit package 1 2 Vulnerable populaons 3 Hard to reach areas 5 Strengthen & broaden Primary Health Care System 8 Digi*ze health e.g. Plus en général, nous considérons ces plates-formes comme la voie à suivre pour la gestion des connaissances sur les questions d’implémentation. Providers should be monitored and held accountable for charging clients inappropriately; in Ghana this should be accompanied by reforms to make government financing for SHI sustainable. Background: Universal Health Coverage (UHC) ensures access to quality health services for all, with no financial hardship when accessing the needed services. Kenya has recently adopted universal health coverage (UHC) as one of the ‗big four‘ priority agenda. According to the findings, 20.7% of households experienced catastrophic health expenditure. Kenya Demographic Health Survey. 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. This paper seeks to understand why reforms aiming at extending social protection coverage to the poor might differ across different pillars of social protection within the same country. Clients also noted that the coverage gave them access to a wider variety of providers, but rarely sought out SHI-accredited providers specifically. Background: 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. 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. Im, Meessen, B., Kouanda, S., Musango, L. et al. The WHO call for ‘Leaving no one behind’ and ‘delivering the Triple Billion Together!’ found great resonance in Immaculate Otene’s words. 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. (2014). The study applies the doctrinal research methodology to identify and examine whether the laws, policies, and institutions critical to universal health coverage can support its realization in Kenya. 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. Social Health Insurance (SHI) is widely used by countries attempting to move toward Universal Health Coverage (UHC). The different enablers are grouped into four broad categories namely (i) people and processes, (ii) systems and data, (iii) investments, and (iv) policies. Due to a lack of understanding of SHI benefits, clients rarely knew they had been charged inappropriately. 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. While the reform has set forth the redefinition of the medical professions, Background Evidence from LMICs has found user fees to be a barrier to health care utilization (Lagarde & Palmer, 2008). This study aims to evaluate the impact of i-PUSH on maternal and child health care utilization, women’s health including their knowledge, behavior and uptake of respective services, as well as women’s empowerment and financial protection. This has seen, although there are still no reliable statistics, the scheme which seems to have had a negative impact on enrollment levels. 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. The failure of the market and government to provide quality healthcare services have been the motivation to set up social health enterprise. 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. Draft Health Po. 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. 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. The study objective was to understand the effects of the policy on health facilities. or underinsured individuals in this coun-While there are no magic solutions, as try. Conclusions: The incidence of impoverishment due to out-of-pocket payments for health care was 2.8% among studied households. 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). 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]. 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. The world health report: health systems financing: the path to universal coverage. Our work touches lives around the world every day – often in invisible ways. The World Health Organization (WHO) is building a better future for people everywhere. In response, in the past 5 years it has been experimenting with a range of approaches to removing user fees. Ministry of Health. In lieu of these, various recommendations have been suggested. Three hundred and sixty-four members from 300 households sought care for an illness in the 12 months preceding the study. %%EOF 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. This study argues that the absence of a clearly defined legislative, policy, and institutional framework has contributed to the failure to realize the dream of universal health coverage in Kenya. The paper relied heavly on secondary sources of information although primary data data was collected. Below are allocations for health sector; 1. The study attempts to delineate an integrated model of health supply chain enablers and their role in improving overall well-being. The E-Health Strategy is anchored on the achievement of Vision 2030, whose overall goal in health is to have an “equitable Building Health: Kenya’s Move to Universal Health Coverage. Universal Health Coverage In Kenya Ministry of Health IEA-Kenya Forum, 28th March 2019 . 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). Figure 1: Universal Health Coverage Cube • 6 out of 10 Kenyans did not have access to essential healthcare services in 2014. We recently adopted a community of practice strategy in the region. 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. 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. Dans cet article, nous soutenons que de nouvelles plates-formes devraient être créées afin de réunir toutes les parties prenantes qui détiennent des parts de connaissances pertinentes pour des politiques efficaces. 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. Framing improves on approaches to understanding the health policy process by accounting for agency, emotion and social values. 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