by Megha Rana
Since the early 2000’s, Kenya has made great progress in reducing child deaths, improving access to maternal healthcare, and expanding healthcare coverage. After many failed attempts, as discussed in our earlier blog, the Kenyan government has been working toward developing a healthcare system that can effectively provide high-quality care to the entire population. In 2017-2018, it was estimated that 72% of all county-level public health systems were more than 80% efficient. In other words, these systems were more than 80% successful in using their allocated resources for positive health outcomes of patients.
However, universal healthcare coverage, meaning all people have access to healthcare services when and where they need them without financial worry, is still out-of-reach. To-date, 50% of Kenya’s population or 25.5 million people do not have access to essential and affordable health services. It is an inequity leading to deep discontent among Kenyans.
What has created this inequity?
Current healthcare is Kenya is affected by exploitation for financial gains, creating inaccessibility to public healthcare services for poor and marginalized communities. A report completed and shared by the Global Initiative for Economic, Social, and Cultural Rights (GI-ESCR) analyses how strengthening public healthcare sectors has been disregarded in favor of strengthening private systems. Figure 1 illustrates the division of health facilities by public facilities, non-governmental organizations, faith-based institutions, and private practices.
Private practices take the largest share of health facilities in Kenya. The authors note that healthcare provided in private facilities is very expensive because private providers, who operate for-profit clinics and hospitals only provide treatment where they have revenue opportunities. This is compared to NGO and faith-based programs where revenue is low to non-existent.
Despite recent efforts, the Kenyan government is struggling to balance the need to generate earnings from patients while still making sure there are no barriers to healthcare access. In public healthcare settings, government funding is limited and, as a result, the main source of funding comes from user fees. This means that patients, a majority of whom live at or just above the world poverty level, are without health insurance and must pay out-of-pocket. This leads to millions of Kenyans ignoring health needs because they cannot afford care.
Stay tuned for Part 3
References:
Healthcare in Kenya remains elusive due to commercialization
Moses MW, Korir J, Zeng W, et al
Performance assessment of the county healthcare systems in Kenya: a mixed-methods analysis
BMJ Global Health 2021;6:e004707.
https://www.netherlandsandyou.nl/latest-news/news/2022/11/30/trade-mission-kenya
Mohajan, Haradhan. “Improvement of health sector in Kenya.” (2014): 159-169.
Moses, Mark W et al. “Performance assessment of the county healthcare systems in Kenya: a mixed-methods analysis.” BMJ global health vol. 6,6 (2021): e004707. doi:10.1136/bmjgh-2020-004707