The National Government and the 47 County Governments have agreed to roll the Universal Health Coverage (UHC) in the country with immediate effect.
In an agreement signed between the two levels of governments, National Health Insurance Fund (NHIF) will now be reformed to a Social Health Insurance Fund (SIF) through a thorough stakeholder engagement process.
In the new arrangement, the funding for Level One, Two, and Three healthcare facilities will be financed through a publicly financed mechanism and individual capitation. On the other hand, Level Four and Five Hospitals will be financed through Social Health Insurance. Additionally, Level Six facilities will be financed through a critical illness fund and Social Health Insurance.
The joint communique was read by Council of Governors (COG) chair Ms. Ann Waiguru at the end of a two-day meeting in Naivasha on Thursday. The purpose of the meeting was to review intergovernmental relations and engagements between the national and county governments, with a particular focus on the Health and Social Protection sectors.
Health Cabinet Secretary (CS) Susan Nakhumicha Wafula stated that after the two-day sensitization of the Governors and the County Executive Committee Members (CECM) in charge of health, they were prepared to launch the Universal Health Coverage (UHC) in earnest.
The Ministry of Health, on behalf of the National Government and the counties, has signed the Inter-Governmental Participatory Agreement (IPAs). The ministry has also been authorized to enter into service-level agreements with county governments to ensure healthcare services are provided at the county level. UHC is a key component of the Kenya Kwanza manifesto.
The CS mentioned that the IPAs have resolved the conflict between the national and county governments that arose from the previous system known as Medical Equipment Management Service (MEMS). MEMS has been replaced by National Equipment Support (NES) in the counties. MEMS was unpopular with the governors as they felt they were not adequately involved in its acquisition and it presented challenges such as a lack of manpower to operate the equipment.
The meeting aimed to strengthen Health Sector-specific intergovernmental collaboration and address emerging issues, including Community Health Promoters (CHPs), the operationalization of Primary Healthcare Networks (PCNs), sustainability of UHC, medical equipment and related services provided by the National Government to counties, NHIF reforms, and more.
It also aimed to enhance a shared understanding of Social Protection between the two levels of government, including the role of County Governments, financing social protection interventions, opportunities for County Governments in the social protection ecosystem, and provide updates on the unbundling of functions.
The forum brought together Governors, the leadership of the Ministry of Health, Ministry of Labour and Social Protection, County Executive Committee Members in charge of Health, and Development Partners.
Waiguru stated that the two levels of government had agreed to jointly facilitate the payment of stipends to Community Health Promoters (CHPs). Furthermore, the CHPs would be provided with a kit to enhance medical response at the community level, which the Ministry of Health would replenish every three years.
The COG chair, who is also the Kirinyaga Governor, mentioned that the operationalization of the Primary Healthcare Networks (PCNs) model had been agreed upon by the COG and the Ministry of Health. The financing model for PCNs would be agreed upon by the two levels of government at a later date. A joint facility assessment would be conducted across the country to determine the number of primary networks to be established in the counties.
Waiguru also noted that the Facility Improvement Financing (FIF), a model bill developed by the Council of Governors, Ministry of Health, and health policy stakeholders, has been passed in 27 counties. The COG will work to sensitize the remaining 20 County Assemblies to expedite the passage of the bill in the next two months.
Regarding social protection, Waiguru stated that the two levels of government had agreed to convene a technical team comprising the Council of Governors, State Department for Social Protection, United Nations Children’s Education Fund (UNICEF), World Food Programme (WFP), and sector partners. The team