Judith Shitabule has been a Community Health Volunteer (CHV) in Kibra slum for 12 years now. I spoke to her in an attempt to evaluate the success of Universal Health Coverage (UHC) initiative in Kenya, three years later following its launch by President Uhuru Kenyatta.
Shitabule is also a member of the Maternal and Newborn Health (MNH) Coalition of Kenya, a grassroots civil society organization that aims at improving maternal and neonatal health in Nairobi. She points out that UHC is not a success because its vital components have not been given attention.
“I would rate the performance of health services at 20%. We only have beautifully painted buildings at our hospitals but there are no drugs in them,” she laments.
Accordingly, patients are forced to source drugs away from the hospitals.
“Lab services are rarely offered in most public hospitals. Women going for ANC visits on some occasions ask me why they cannot seek services at a private clinic where everything is offered under one roof,” says Shitabule.
Mildred Malwa, another CHV, is a resident of Makina Ward in Kibra. She has worked here as a CHV for 11 years now.
Malwa, who is in charge of 100 households in the locality, observes that a sharp focus should be on teenagers who are faced with early pregnancy cases if UHC is to succeed in these times of Covid-19.
“Teens who sought my advice on family planning when Covid-19 struck in 2020 were unsatisfied. As much as we are advocating for vaccine Uptake, we are neglecting family planning services which are against the vision of the UHC,” says Malwa.
She stresses that the provision of family planning services is already affecting poor neighborhoods like Makina.
The 2019 Kenya Population and Housing Census report shows that the number of poor persons in Kenya stands at 19.5 million out of a total population of 47 million.
Health and women’s rights advocates have recently raised an alarm that the ongoing pandemic is delaying an adequate response to a growing sexual reproductive health crisis.
Data from the Ministry of Health shows that more girls (2,379 known cases) aged between 10 and 14 have been impregnated in the past 10 months. Nairobi is leading other counties. This comes at a time when Kenya had committed to the International Conference on Population Development 25 to ending teenage pregnancies by 2030.
The problem, according to Malwa, is that teenagers trust medical practitioners more than their parents. As such, they are discouraged when they visit hospitals only to be told that family planning services are not available.
The World Health Organization (WHO) boss Dr. Tedros Adhanom Ghebreyesus in a recent statement to newsrooms urged governments to accelerate efforts to ensure every one of their citizens can access health services without fear of the financial consequences.
“This means strengthening public spending on health and social support, and increasing their focus on primary health care systems that can provide essential care close to home,” said Dr. Tedros.
A report launched by WHO on December 12 during the UHC day paints a worrying picture of the healthcare system in developing countries like Kenya.
The findings revealed that a majority of citizens, teenagers included, are pushed into extreme poverty because they have to pay for health services out of their own pockets.
The Government of Kenya made the promise in 2018 that Kenya will be in a state of Universal Health Coverage by the year 2022.
Among those who were set to benefit from the government’s UHC scheme once the National Health Insurance Fund (NHIF) bill is passed into law are 66,000 vulnerable households that were registered through Nairobi Metropolitan Services in collaboration with the Ministry of Health.
“Between 22nd and 23rd of January, the bill will be in the National Assembly and once it is passed it will be presented to the President for assent. Once the bill becomes law, by the end of January, the listed families will start receiving free medical care,” Sabina Chege, the chairperson of the Parliamentary Committee on Health said.
Shitabule and Malwa insist that the failure to implement the Jubilee government’s Big 4 Agenda is the greatest hindrance towards the realization of UHC. Attaining UHC will be a mirage if the government shall fail to address the challenges being experienced at the moment, the two CHVs opine.