Advancing Community Health Services Legislation in Kenya 

Advancing Community Health Services Legislation in Kenya 

Prioritizing health and equity, as well as healthcare systems that safeguard everyone, is a political decision. Political goodwill and emphasizing the importance of primary healthcare are essential prerequisites for attaining Universal Health Coverage (UHC). Remarkably, in the history of Kenya, primary health and community health have never received the kind of political prioritization they are receiving currently. 

Recently, His Excellency, President Ruto, assented to law four crucial bills to underpin the realization of Universal Health Coverage in Kenya, preceding the imminent launch of the UHC program in the country on 20th October 2023, at the Kericho Green Stadium. These pivotal bills include the Primary Health Care Act, the Facility Improvement Financing Act, the Digital Health Act, and the Social Insurance Health Act.

Community Health Units for Universal Health Coverage Support for CHS Bill 

As a platform, one of the CHU4UHC’s primary objectives is to strengthen community health leadership and governance structures at the community, county and national levels. In this regard, the platform has been a staunch advocate for the legislation of community health services at both the county and national levels.  During the previous administration, the CHU4UHC platform co-developed legislation with 8 counties and advocated for the enactment of Community Health Services (CHS) legislation in all counties, with direct support in 5 counties that enacted the CHS acts.  Additionally, the platform lent its support to the enactment of the Community Health Services Bill at the national level, although it, unfortunately, wasn’t enacted due to time constraints at the National Assembly but formed the basis of the PHC Act enacted in 2023. 

A public participation meeting in Trans Nzoia advocating for the enactment of the CHS Bill in June 2022.

The CHS bill, brought to parliament by nominated Senator Agnes Zani, aimed to formalize and regulate community health services, recognizing their critical role in ensuring universal access to healthcare. It underscored the importance of community health volunteers, now known as community health promoters, and sought to provide them with the recognition and remuneration they deserve for their invaluable contributions to the healthcare system. By paving the way for the standardization and coordination of community health services, this bill represented a significant step towards improving community health and service delivery at the grassroots level, ultimately contributing to the achievement of Universal Health Coverage in Kenya. 

Primary Health Care Act 

The recently enacted Primary Health Care Bill establishes a framework for the effective delivery and management of health services through the use of Primary Healthcare Networks (PCNs) and Community Health Units (CHUs) while reinforcing the role of Community Health Promoters (CHPs) in community-based primary healthcare services. The act calls for a standardized, digitized, compensated, kitted, protected and safeguarded community health workforce. 

Digital Bill Act 

As a strategic decision aligned with the current Kenya Community Health Strategy (2020-2025), increasing the availability, quality, demand and utilization of data for community health services has always been a priority for the platform. The platform works to foster collaboration and accelerate the uptake of the eCHIS platform in different counties. Quality community health data is useful in informing decision-making and resource allocation for community health. 

In collaboration with the Ministry of Health, the CHU4UHC platform has supported the deployment of eCHIS in different counties that the partners work in in a phased approach. This digitization is backed by political commitments from the national government to achieve health for all. H.E. President William Ruto fulfilled the government’s commitments on 25th September 2023 during the launch of the 100,000 CHP kits and phones to enhance service delivery for community health services.  

The recent enactment of the Digital Health Act establishes a framework for digital health services, aligning with the government’s commitment to establish a digital superhighway for health service digitization. This development is timely and holds great promise for the advancement of healthcare in Kenya. 

This legislation will play a crucial role in financing community health services by providing mechanisms for the establishment, funding, and operation of the community health program in Kenya through the Social Health Insurance Act and the Facility Improvement Financing Act. 

Social Health Insurance Act 

Social health insurance aims to provide a mechanism for financing health care through the pooling of funds from the entire population. This pooled fund will be used to cover the healthcare costs of those in need. A well-designed social health insurance system could contribute significantly to community health by ensuring that a broad segment of the population has access to essential health services. It promotes financial risk protection by reducing out-of-pocket expenses for individuals seeking health care services. 

Facility Improvement Financing Act 

The Facility Improvement Financing Act likely focuses on providing financial support for the improvement of health facilities. This can involve upgrading infrastructure, enhancing equipment, and ensuring the availability of necessary resources. Investments in facility improvement can positively impact community health by providing better access to quality healthcare services. Upgraded facilities are better equipped to handle various health issues, leading to improved health outcomes for the community. 

The CHU4UHC platform is delighted to be a part of the movement advocating for positive change in the delivery of community health services in Kenya. What was once only a dream at the platform’s inception has now become a reality. This success serves as a testament to what can be achieved through teamwork, collaboration, and a shared commitment to a common goal. 

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