Kenya is making commendable progress in the push to attain universal health coverage (UHC).
UHC is about financial protection and equity in access to quality health services that address the most significant causes of disease and death.
A pointer to the progress Kenya is making in UHC is increased National Hospital Insurance Fund (NHIF) enrollment. In 2018, for example, NHIF membership rose by 23 per cent to 7.7 million, with most of the new members coming from the informal sector.
Kenya National Bureau of Statistics data further shows that payouts by the national insurer increased by an impressive 41.4 per cent to Sh37.2 billion last year.
What this means is that there is a Jua Kali operator or mama mboga somewhere who would have previously been forced to sell household items to get treatment but is now able to access the treatment without financial strain.
To sustain this momentum, the government is setting aside Sh47.8 billion for UHC in the 2018/19 budget—more than half of the approximately Sh90 billion allocated to healthcare. Although UHC accounts for more than 50 per cent of the entire national healthcare budget, there is still a huge gap in terms of funding.
It is key to reiterate that UHC is not only about boosting insurance cover, but also ensuring access to quality services. Access, quality and financing of healthcare — the three key pillars of UHC — collectively require tremendous investment and expertise, which the public sector cannot provide alone.
Historically, this funding and technical skills gap has been bridged by donors. However, this is coming to an end. Today, due to demands for accountability as well as creeping nationalism in donor countries, donors are only willing to invest in programmes that can sustain themselves. In other words, there is a shift from aid led to enterprise-led development.
This has set the stage for the growth of social enterprises. These are basically organisations that combine their primary goal of driving positive social change with the efficiencies and profit-orientation of private sector. However, unlike fully-fledged capitalist businesses, profits generated in a social enterprise are not distributed to directors or shareholders but re-invested in scaling up solutions in order to achieve greater impact.
In Kenya, social enterprises can play a unique role in accelerating the attainment of UHC.
First, the increased public funding for UHC provides a powerful form of risk underwriting for private sector players keen on providing healthcare solutions. This is critical as very often private investors are unwilling to spend in areas where government support in the form of funding, policy and regulation is doubtful or lacking.
Second, Kenya has made considerable steps in advancing the ICT sector. In fact, ICT is currently the fastest growing sector of the economy, having grown 11.4 per cent last year. ICT is important when talking about private investment in healthcare because new technologies allow healthcare providers to scale solutions at a fraction of the cost while not compromising quality.
Third, more Kenyans are embracing entrepreneurship. Entrepreneurship is not about avoiding problems, but confronting them and getting rewarded for solving them. Fewer bigger problems exist in Kenya, and indeed Africa, than lack of access to quality and affordable healthcare.
In fact, Ministry of Health data indicates that the leading reason why Kenyans slide into poverty is medical bills.
Entrepreneurship lends itself well to solving the challenges in healthcare. The good news is that social enterprises provide room for entrepreneurs to solve problems, get rewarded, but still drive social impact. Scottish economist, Adam Smith, famously said, “It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest”.
When people are motivated to make money, they find a solution. When people are motivated to make money and transform lives, they find a lasting solution. The latter is what social enterprising is all about and why it is key in accelerating attainment of UHC in Kenya.
Credit Peter Waiganjo
Providing Affordable Healthcare in Nigeria Should Be Everyone’s Business
“It is my greatest desire that we improve the healthcare system in Nigeria and provide affordable healthcare for local communities at the grassroots so that people can have access to the care they need, when they need it, in ways that are user-friendly” – Adaku Efuribe
The 74th UN General Assembly took place in New York last September; high level meetings were held and Universal Health Coverage (UHC) was a hot topic for the week. As expected, Nigeria had a delegation of Government representatives, NGO’s and individual advocates who are working towards achieving SDG3 and UHC in attendance. So how do we implement new policies and what are the key drivers to providing UHC for all in Nigeria?
As an advocate for UHC/SDGs, I have been lending my voice over the years calling the Nigerian Government to action towards implementing UN SDGs agenda and achieving UHC.I have studied and participated in primary healthcare provision in developed economies and can say for sure healthcare provision is very expensive, but I believe we can up our game towards providing primary health care for everyone at the point of need.
Some developed economies have used the tax system to ensure their national health service does not run out of funds, a percentage of all earnings is taxed and put aside in a ‘pot’ to supplement the health budget. From a lay man’s point of view, just like the banking system, we all bank our money at different times and we withdraw money at different times, so for a contributory healthcare system, everyone will not fall sick at the same time, some will experience life threatening sickness at some point in their life, some would have long term conditions like CVDs, Diabetes, etc., while others would only go through emergencies or minor ailments/major diseases.
In Nigeria for instance, we have a few HMO schemes covering the organised private and public sector. The ‘common man’ on the street does not have any sort of health insurance whatsoever, which leaves them at the mercy of chance. In an unfortunate event of serious illness like cancer or organ failure, they find themselves in a situation where they cannot pay for medical services hence resorting to luck to stay alive. A lot of unavoidable deaths have occurred due to lack of funds to pay for medical treatment.
The public primary care providers are underfunded and the issue of corruption has eaten deep into the fabric of the healthcare system where funds allocated for medical equipment’s, pharmaceuticals etc. are diverted for personal use.
What plans does the present Government in Nigeria have to provide Universal Health Coverage and in so doing, contribute to the economic growth of the Country?
Sustainability can be defined as meeting the needs of today without compromising the needs of tomorrow.
‘As articulated in SDG 3, health is crucial for sustainable human development, both as an inalienable human right and an essential contributor to the economic growth of society. Health contributes to national development through productive employment, reduced expenditure on illness care and greater social cohesion.
We believe that universal health coverage (UHC), delivered through an adequately-resourced and well-governed health system, will be capable of addressing these and other health challenges. Universal health coverage must ensure equitable access to affordable, accountable, appropriate health services of assured quality to all people.
These must include promotive, preventive, curative, palliative and rehabilitative services. UHC must be supported by policies and services addressing the wider social and environmental determinants of health for individuals and populations’. Sustainable Developments solutions network
Key words for providing health systems that works!
- Well Governed Systems- Are there systems and policies in place that can be retained and continued
- Promotive- Do we have health promotion strategies in place to promote good health and wellbeing
- Preventative- Are we taking preventative measures seriously, screening, vaccination, reducing CVD risk through lifestyle management?
- Curative- When we fall ill or in times of emergency, do we have access to affordable healthcare, or does sickness lead to poverty?
- Palliative and rehabilitative services- For terminally ill patients, do we have plans for social prescribing and support? For people engaged in substance misuse, do we have plans for treatment, rehabilitation and integration back into the society
WHO uses 16 essential health services in 4 categories as indicators of the level and equity of coverage in countries: Where does Nigeria rank in the indicators?
Reproductive, maternal, newborn and child health:
- Family planning
- Antenatal and delivery care
- Full child immunization
- Health-seeking behaviour for pneumonia
- Tuberculosis treatment
- HIV antiretroviral treatment
- Hepatitis treatment
- Use of insecticide-treated bed nets for malaria prevention
- Adequate sanitation.
- Prevention and treatment of raised blood pressure
- Prevention and treatment of raised blood glucose
- Cervical cancer screening
- Tobacco (non-)smoking.
Service capacity and access:
- Basic hospital access
- Health worker density
- Access to essential medicines
- Health security: compliance with the International Health Regulations.
The Nigerian Government can do more to improve health outcomes and tackle poverty, by increasing coverage of health services, and by reducing the impoverishment associated with payment for health services. We can subsidise the payment for health services and provide emergency health care at the point of need by ensuring we are constantly reviewing our health policies and implementing proven international strategies. The Health budget does not in any way reflect the health needs of Nigerians, this needs to be reviewed.
As Individuals, if we take health promotion seriously, and change our lifestyle habits, then we can make changes that would reduce the cost of health as well.
Adaku Efuribe is an SDGs/UHC Advocate & Clinical Pharmacist with expertise in medicines management, integrated healthcare and health promotion.
GE Healthcare Launches Versana Ultrasound Machines to Drive Access to Affordable and Quality Healthcare in Uganda
GE Healthcare team displaying the Versana Premier and Versana Essential Ultrasound machines during the Uganda Society for Advancement of Radiology and Imaging Conference (USOFARI).
This innovative system is well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care
KAMPALA, Uganda, November 11, 2019- GE Healthcare has announced the launch of Versana Premier and Versana Essential for the first time in Uganda. The launch was announced during the Uganda Society for Advancement of Radiology and Imaging Conference (USOFARI).
Versana Premier is a world-class ultrasound designed for peace of mind, easy to use and easy to own. The Versana Premier ultrasound system can help deliver high-quality, personalized care, patient after patient, day after busy day. This innovative system is well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care. It also comes with local product and clinical training to help healthcare professionals gain comfort and proficiency with the system to enhance patient care.
Versana Essential is a complete ultrasound solution that healthcare professionals can learn to use quickly and productively. It enables confident clinical decision making for quick referrals and immediate clinical correlation to help scan a wide range of patients. The machine is designed with the growing medical center in mind, to provide the clinical capability and support they want without compromising the quality, reliability, and affordability needed.
Both Versana Premier and Versana Essential are part of the Versana ultrasound family, which comprises of solutions that help to empower care without compromise, balancing capability, affordability, and reliability. These innovative systems found within the GE Healthcare Primary Care Ultrasound Segment are well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care.
“We are excited to participate in this year’s USOFARI conference together with other private and public partners in an effort to continue providing the latest imaging solutions to enhance early detection of diseases and ultimately the most appropriate treatment for patients,” said Andrew Waititu, General Manager, GE Healthcare East Africa. “The launch of Versana Premier and Versana Essential is a testament of our continuous investment in innovations that help to drive access to affordable and quality healthcare for all across Uganda.”
Also Read Meet Mariatheresa S. Kadushi, Founder of M-afya, A Mobile App Providing Health Information In Native Languages In Africa
Universal Health Coverage (UHC) is part of the United Nations sustainable development goals, to ensure that every person, everywhere, should have access to quality healthcare. As part of its vision 2040 and the health sector development plan, Uganda seeks to accelerate movement towards UHC with among others, essential health and related services needed for promotion of a healthy and productive life.
Understanding Nutrition History For A Healthier Life
Pounded yam with vegetable soup (Image: Simplinatural)
“We are less healthy today than our ancestors. By disregarding traditions, we’ve predisposed ourselves to genetic damage.” Catherine Shanahan M.D author of Deep Nutrition.
It’s the 21st century and the machines, computers, social media and tech drivers are here. Giant strides in medical science, engineering, technology has made life better and easier for us. We were supposed to be a very healthy and wealthy generation but instead we started to get sicker and unhealthier. Over the last 50 years cardiovascular related health issues is the number one killer of men and women worldwide according to a WHO report.
Our diets changed and so did our bodies and health. We deciphered so many hypotheses of what could be the problem. We thought it was inadequate exercise, so we exercised more but nothing changed. Whenever we thought we knew the answer to what was happening to our health decline, we realised we were right back where we started from. We continued to grapple with modern diseases medical science seems unable to mitigate.
What does history have to do with our health?
The year is 1901 and my maternal Grandmother is preparing dinner of Amala and ewedu soup (Yam flour and a vegetable). She prepares the dinner just before sun down and gives her large family to eat. Three times in a week, she prepares the same type of meal. However, unknown to my grandmother was the fact that the fermentation process during yam flour processing had converted the starch present in the yam into more complex nutrients like minerals and vitamins by the help of a bacteria called lactobacilli.
Fermentation converts starch(sugar) to lactic acid leaving by-products like beneficial minerals, vitamins that the gut uses to produce important neurotransmitters like serotonin. Serotonin is responsible for regulating sleep, appetite, moods and pain inhibition in the brain but its production is influenced by the billions of friendly bacteria like lactobacilli in the gut. She knows nothing about the science behind what she prepares for her family but from observation over time along with thousands of other women, she knows that a good meal of amala was easily digestible, filling and kept everyone happy.
It’s the 21st century and we no longer sprout our grains for their beneficial vitamins and minerals but cart them off for processing and our diet high in refined sugar and processed oils have now started to harm our brain. Our cells are weak from oxidative stress and inflammation but we continue to eat these modern diets.
We see a spike in suicide rates and depression amongst young people all over the world with no end in sight. Maybe this is the right time to begin to study nutrition history. What worked in the past? What did our ancestors eat that made them strong and healthy? More evidence in nutritional psychiatry are starting to show a connection between what we eat and how we feel.
A critical look into traditional African diets show a rich healthy source of nutrition based on what is now known as the four pillars of the human diet according to Catherine Shanahan author of best-selling book, Deep Nutrition. What is fascinating is how African dishes combine every aspect of the four pillars of the human nutrition making it one of the most nutritious and earlier diet in the world.
Fermented food: delicacies like kunu (fermented millet drink) masa (fermented rice fried in oil) beautifully incorporate food techniques like fermentation ensuring adequate gut health and microbial balance in the body.
Organ meat: Organ meat known to contain vital vitamins are extensively used in preparing soups broth popularly known as pepper soup in southern Nigeria. It is also eaten with other delicious dishes.
Meat on the bone: dishes with meat containing bones are known to provide collagen and body building nutrient and a Nigerian dish that incorporates this is miyankuka dish(a favourite) from northern Nigeria.
Sprouted foods: sprouting known to convert carbohydrate in grains to complex nutrients like vitamins and mineral was on e of the ways our ancestors could successfully grind their grains to powdery usable forms. A traditional African dish that incorporate the technique is Eyin drink from the north central part of Nigeria.
Healthy nutritious diet is delicious, natural and better. Our generation advanced in technology, science and knowledge but needs to pay attention to a vital part of history- our nutritional history. History tell us what’s worked in the past and what’s not working now. It’s time we change the trend once again and return to our roots.
Deborah Ogwuche is the creative director and founder of Food Channel Africa, a 24-hour television channel dedicated to showcasing African cuisines. She is a published author, a food blogger and a healthy food advocate.
Email: [email protected]