<h1><br></h1><h1><a href="http://www.globalhealthcheck.org/?p=1407" rel="bookmark" title="Permanent Link to Dying to live: Kenya’s search for universal healthcare" target="_blank">
Dying to live: Kenya’s search for universal healthcare </a></h1>
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Posted by <a href="http://www.globalhealthcheck.org/?author=47" title="Posts by Tabitha Mwangi" target="_blank">Tabitha Mwangi</a> excepts <br><a href="http://globalhealthcheck.us5.list-manage.com/track/click?u=1cf4b203990bc28d05e9f0295&id=360ad40401&e=8990abdd17" style="color:#336699;font-weight:normal;text-decoration:underline" target="_blank">http://www.globalhealthcheck.org/?p=1407</a><br>
<br>The question of how to raise domestic revenue for health is something
that policymakers across Africa continue to grapple with. In recent
decades different options have been tried and tested –user fees,
small-scale community based health insurance, private insurance schemes,
and taxation. Today Kenya, like many countries in the region, is left
with a complicated patchwork of different schemes offering different
levels of coverage to different population groups. Merging these into a
single national risk pool which uses public financing to provide for all
citizens will improve access to healthcare and reduce administrative
costs.</div>
<p>One way of raising more money for health would be to introduce an
earmarked tax on diaspora remittances. “According to the Central Bank of
Kenya, money remitted by the diaspora is growing monthly,” says Dr Jane
Chuma, a health economist and senior research scientist at Kenya
Medical Research Institute in Kilifi. “Last year, over $1 billion (Sh85
billion), higher than the revenue earned from coffee or tourism, was
remitted to the country. Putting a little levy on foreign transactions
could raise significant money for health. In 2009, Gabon raised $30
million (Sh2.6 billion) from diaspora remittance tax, which they put
into health care.”</p>
<p>Another option is to merge existing funds to create a single National
Social Health Insurance Fund which pools all the resources that are
currently available for health into one pot and stop the duplication of
effort. “Tax funds allocated to health, NHIF contributions, community
health insurance schemes and donor money, if pooled together, can create
a large enough single pool. This will ensure that both the rich and the
poor are covered while reducing administration costs. As there will
only be one organisation buying services, it will have bargaining
power.”</p>
<p>There was some discussion about starting a National Social
Health Insurance Fund in Kenya. It was passed by Parliament but the
president did not sign it. ‘The big boys’ ‘shot it down’ including private health insurance schemes and private
hospitals.</p>
<p>What Kenya needs are leaders who are willing to put the private
sector to task. What we lack is
political will and leadership.</p>
<p>Whatever the means of raising money, people need to be confident that
the money will not be misused. With corruption there is little trust in the public. <br></p>
<p>Public health facilities need to be closer to the people, be well
equipped and charge no fees. In this way, each citizen in the country
will be able to walk into any health facility, get whatever treatment is
required and walk out without paying a shilling. However, removing
charges alone will not be enough to keep patients coming. The public
health facilities have to be fully staffed and well stocked with
medicines. It is not enough, for example, to say that giving birth at a
maternity ward is free and then expect mothers to buy gloves, cotton
wool and drugs because there are none available at the facility.</p>To reduce costs of payments for treatments, the government will need
to invest heavily on preventive measures to reduce the heavy burden of
infectious diseases. At the moment more money is going to curative
rather than preventive health care. Providing safe water and improved waste disposal is key. The provision of essential vaccines and use of
insecticide-treated bed nets are key as well. <br><p>Politicians
make appealing promises during campaigning. The
situation is urgent, as annually, about 1.5 million Kenyans are pushed
below the national poverty line due to health payments.</p>
<p><font size="1"><i>Tabitha Mwangi is a freelance science journalist based in Kenya.
Her articles have appeared in The Daily Nation and The East African. She
has a PhD in epidemiology and worked in the Kenya Medical Research
Institute for 10 years before becoming a writer.</i></font></p>