Partnerships to Combat the Impacts of COVID 19 on Universal Healthcare Coverage (UHC) in Kenya

 Most countries in the Eastern and Southern Africa sub region, Kenyan included have integrated UHC as a goal in their national health strategies. Whereas there is notable commitment in translating these strategies into an equitable and quality health service delivery, there is still much to be done to ensure increased financial protection and access to services. The low investment in health, inadequate and inequitably distributed human resources for health, fragmented health information systems, weak infrastructure and medicines stock-outs are hurdles to overcome.

Unfortunately, the determination to achieve UHC by 2030 has been threatened by the outbreak of the COVID-19 and  pandemic in 2020. The devastations on the economic and social pillars of the society were almost unbearable for the greater part of the past 2 years. In 2022, the government and its people have been putting in place parameters for recovery of the sectors and the social fibre as we know it. Indeed, the government provided some stimulus and buffers to ensure there was no total collapse of the health sector and the businesses which were affected adversely directly and which translated to the family and social sector having a great strain.

Now, even before the dust has settled and the country has started recovery from the adverse effects of COVID-19, the country has come on high alert for another wave of the pandemic. One can almost sense a state of panic as the thought of what happened last year and 2020 glares at the people. Despite the alert, recovery initiatives must continue with greater determination even as the country ensures the devastations previously encountered do not recur.

Mr. Jayesh Saini observed that there is no one-size-fits-all approach to achieving UHC nor of curbing the devastations of the COVID-19 pandemic. The strategies to achieving the same will depend on local circumstance and national dialogue. He observed that Kenyans resilience and unity of purpose has always played out in times of adversity saying this has once again been portrayed in fighting the pandemic and its effects.

No doubt the health sector was taken through shock therapy, where all the missing links, assumptions, weaknesses and shortages glared at the government and the people of Kenya. Gratefully, the casualties and deaths were not as had been predicted especially by the western world. Despite some initial challenges of un-coordinated interventions, finally there was some sanity in the sector when all involved in the health sector realised no single entity could handle the pandemic on their own even in so far as their facilities were concerned.  Multi-stakeholder and multi-sector engagement that has included the private sector and civil society to the government’s efforts has fostered solidarity and an effective community response to public health interventions. The importance of an inclusive, multi-stakeholder response remains critical in the context of COVID-19. This is in line the Universal Health Coverage (UHC) Movement (UHC2030) Ask 6 - ‘Move Together’ - which requires establishing multi-stakeholder mechanisms for engaging the whole of society for a healthier world. To successfully face such challenges, and now the threat of the sixth wave of COVID-19, the parties that are tasked to ensure maximum protection of the citizens life, properties and economic wellbeing must work together and ensure accountability which has been found wanting. At the same time resources must be utilised correctly without undermining other areas. For example, fighting HIV/AIDS and other chronic diseases must continue side by side and resource allocation should not be diverted because doing so would create another pandemic which is counterproductive.

So, as the government comes up with containment measures against the purported 6^th wave, concerted and multisectoral, multi-stakeholder efforts are critical to ensure the recovery gains made are protected and that the country remains on that trajectory to ensure sustained recovery. Gratefully, both government and private health facilities have been in an upgrading cycle  as have been the other sectors.

In so far as healthcare is concerned it is important that a major chunk of health service provider facilities, insurers medical products suppliers and civil society are included in the discussions by governments of what needs to be done and agree on priorities and who steers the different activities. For example, recognising the role that the National Health Insurance Fund (NHIF) is playing in Universal Health Coverage, they must bring factual, evidence-based experiences alongside service providers who have been dealing with the COVID-19 cases at different levels to give a complete picture for decisions on interventions. Lessons learnt by both private and public financiers is also very important even as options for medical packages are considered, not just for the COVID-19 pandemic but for other conditions, seeing that the virus has impact on many organs and aggravates some conditions, especially comorbidities and drug supplies. Though it may sound far-fetched, the impact of lack of specialised transportation to access services during the pandemic was noted and there was great anxiety as either ambulance services were not enough and PSVs were reluctant to take suspected cases to hospital. During the discussions the issue therefore of telemedicine and how it will be delivered must be included. In a nutshell every sector and its impact on healthcare service delivery must be considered and strategic decisions made to ensure there is no shutdown of the economy again.