OPINION: Leveraging partnerships to accelerate universal health coverage for Kenya

The prosperity of a nation is inextricably linked to the well-being of its people.

This belief was deeply rooted in the health care policies implemented in Kenya after gaining independence, leading to significant progress in reducing infant, child, and maternal mortality rates, crude death rates, and improving life expectancy.

These achievements are a testament to the importance of investing in health care to promote economic progress. There is a need to do more.

In 2015, countries committed to achieving the Sustainable Development Goals (SDGs), which included a specific target of universal health coverage (UHC).

UHC aims to provide all individuals access to a comprehensive range of high-quality health services, regardless of financial constraints, when and where they require them.

UHC covers the entire continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.

With the emergence of new health challenges, this commitment is more important than ever.

Country leadership for UHC

Kenya has prioritized UHC in its development agenda. This began with Vision 2030, which aimed to transform Kenya into a rapidly industrializing middle-income nation by 2030.

Within the social pillar of Vision 2030, Kenya joined the global campaign to achieve UHC and improve the country’s healthcare sector for better service delivery.

In principle, UHC aims to ensure that all Kenyans have access to comprehensive, high-quality healthcare services while providing financial protection against catastrophic healthcare costs.

The Kenya UHC Policy 2020–2030 aims to promote economic development by ensuring the efficient delivery of health services. This can be achieved by providing sufficient health facilities, human resources, and information systems, along with good governance and enabling legislation.

Although the delivery remains a learning journey, the UHC agenda and the push for primary health care (PHC) have enjoyed tremendous political, community, and partner support.

This resounding support underscores the crucial role that these initiatives play in addressing healthcare needs and ensuring better outcomes for citizens and society as a whole.

In the past few weeks, we have seen significant progress towards UHC led by President William Ruto and the Ministry of Health in Kenya.

President Ruto’s recent commissioning of 100,000 fully equipped Community Health Promoters (CHPs) was a positive demonstration of political commitment towards UHC from the country’s leadership.

To ensure the success, effectiveness, and efficiency of UHC in Kenya, it is crucial that county governments and health partners match the strong political commitment already in place.

Furthermore, successfully implementing UHC requires financial commitment from national and county governments.

Kenya’s health partner

As a long-standing health partner in the country, PATH Kenya is focused on developing and scaling up innovative solutions to the most pressing health challenges in Kenya, with a commitment to supporting a country-owned, country-driven health system–strengthening efforts aligned with government priorities.

PHC is the expressway to achieving UHC. At PATH Kenya, we have been working closely with our Advocacy and Public Policy (APP) arm to support the government’s efforts, in partnership with the Ministry of Health, to develop and implement strong PHC policies.

Our focus has been on translating policy frameworks into practical technical guidance, including the recent Primary Health Care Networks (PCNs) Guidelines (2021) and the Advocacy, Communications, and Community Engagement (ACCE) Framework for the years 2021–2024.

PATH recognizes that strong policies are effective only if they are properly implemented. Poor policy implementation hinders efforts to expand equitable access to health services.

Therefore, PATH collaborates with national and county governments to ensure policies are disseminated and implemented effectively, including county rollout PCNs.

Additionally, PATH advocates for adequate allocation of resources to ensure that communities have access to high-quality and affordable health care.

Using a person-centred approach to health care and strengthening the linkage of health services from the community to primary healthcare facilities can result in community members quickly accessing the required health services.

PATH worked specifically with the Ministry of Health and partners to support the training of master trainers of trainers (ToTs) designed to accelerate the rollout of PCNs in the counties.

It is anticipated that the master ToTs will be dispatched to the counties to scale up and improve the delivery of primary health care services.

Supporting digital health transformation

PATH recognizes that technology is crucial in achieving UHC. Therefore, we focus on digital health efforts that address the obstacles that hinder the adoption of digitally enabled health services in Kenya.

PATH and the Ministry of Health are working together through Digital Square, PATH’s flagship initiative on the digital transformation of health systems, to enhance the Chanjo Kenya system.

This self-service platform enables users to register for vaccinations, select their preferred vaccination centres, access vaccination schedules, and download and verify their COVID-19 vaccination certificate.

The Chanjo Kenya system is a breakthrough innovation that has been instrumental in managing the country’s COVID-19 vaccination program and monitoring vaccine uptake nationwide.

Digital Square at PATH is also working with the Ministry of Health and partners to expand the use of the Chanjo Kenya system for routine immunization purposes, ensuring that more people have access to life-saving vaccines as part of primary health care.

Digital Square at PATH is supporting the Ministry of Health to adopt and implement the Fast Health Interoperability Resources (FHIR) and Open Health Information Exchange (OpenHIE) architectures and standards within Kenya’s digital health system.

FHIR is a global health standard that enables the exchange of healthcare information between different computer systems regardless of how it is stored.

As a result, FHIR can quickly parse, integrate, and exchange data between applications, systems, and locations, enabling seamless and on-demand health information exchange.

PATH, with funding from the President’s Malaria Initiative (PMI), is providing support to the Electronic Community Health Information System (eCHIS) pillar in Kenya to aid in achieving UHC.

eCHIS is a standardized community health digital tool developed to improve community health service delivery, client referral, commodity management, reporting, and performance management for better health outcomes at level one.

As part of this support, Community Health Promoters and Community Health Assistants have been provided with phones, tablets, and intensive training on how to use the eCHIS application.

The application keeps Kenya aligned with environmental initiatives by reducing its reliance on paper and motivates community health workers by eliminating the need for data transfer across multiple paper forms.

The application digitizes data entry forms, making the process of upload and integration to the national framework seamless.

Ensuring health commodity security

With health commodity security being a fundamental building block for achieving UHC, it is imperative that Kenya’s regulatory system for medical products and manufacturing is strengthened.

Over the past few years, PATH has provided technical assistance and advocacy support towards this goal.

Recently, PATH, under the Accelerating Measurable Progress and Leveraging Investments for Postpartum Haemorrhage Impact (AMPLI-PPHI) project and other partners, supported the first-ever National Forecasting and Quantification (F&Q) activity for health products to prevent and manage postpartum haemorrhage.

The F&Q report was utilized by the Kenya Medical Supplies Authority to start the procurement process for heat-stable carbetocin, an oxytocin that helps in preventing postpartum haemorrhage among women at risk.

A robust regulatory system would improve access to essential health products for underserved populations, thus addressing health inequities, reducing catastrophic expenditures, and contributing to the achievement of universal health coverage, as called for in the Bottom-Up Economic Transformation Agenda (BETA).

PATH remains committed to the local manufacturing agenda by ensuring Kenya continues to advance and position itself as the region’s pharmaceutical manufacturing hub, taking advantage of the current opportunities and need to deglobalize production closest to where the need is.

Looking ahead

In summary, PATH Kenya believes that the most significant way to advance health equity is by achieving UHC by 2030.

Our strategic framework envisions a national presence promoting health equity and advocating for the community and Ministry of Health priorities to achieve universal health coverage.

PATH remains committed to working with partners, communities, and the government of Kenya to strengthen health systems, reduce disease burden, and achieve universal health coverage.

To achieve this goal, PATH is focusing on three strategic priorities.

These are: preparing for and responding to emerging health threats in Kenya; innovating in science and technology for health care delivery, including strengthening digital health; and increasing health system capacity and resilience to deliver primary health care in Kenya. By prioritizing these key areas, PATH is working towards a healthier future for all Kenyans.

Ms Carolyne Njuguna, East Africa Hub Director & Country Director, PATH Kenya