On December 12, 2022, the head of state made a significant announcement that changed the landscape of national public holidays in Kenya. From that point forward, all national public holidays would be celebrated with a specific theme, and these celebrations would extend over the course of a week. This new tradition was observed for the third time during the recent Mashujaa Day festivities on October 20, 2023, which was themed ‘Universal Health Coverage.’ The week-long celebration commenced with the UHC Expo held at Kapkatet Stadium in Kericho County, bringing together delegates and various stakeholders to showcase Kenya’s progress towards achieving UHC.
This thematic week was a momentous occasion for community health services in Kenya, marked by a 3-day conference, the enactment of crucial bills into law, and the official launch of the Universal Health Care program. Deputy President Rigathi Gachagua, who played a crucial role in launching the event, graced the opening of the UHC Expo on the first day. During the event, two community health pioneers, Professor Miriam Were and Professor Dan Kaseje were honoured and presented with awards for their commendable efforts in institutionalizing community health services across the country.
The deputy president visited Cheborge during his tour of the county, where he oversaw the process of transmitting data gathered by the Community Health Promoters (CHPs) through the electronic Community Health Information System (eCHIS), in line with the government’s efforts to digitize numerous programs.
Deputy President Rigathi Gachagua also launched the smart PCN (Primary Care Networks) during the expo. These networks are designed to enhance healthcare services through a person-centred approach, bringing essential health services closer to communities. The government plans to establish 315 PCNs across the country. The process is underway, and progress can be viewed on the PCN observatory dashboard.
On October 19, 2023, just one day before the official launch of the Universal Health Care program, the Head of State signed four critical bills into law to accelerate the achievement of UHC. These four bills are the Primary Health Care Bill, Facility Improvement Financing Bill, Digital Health Bill, and Social Health Insurance Bill.
- The Primary Health Care Bill provides a framework for the effective delivery and management of health services by utilizing Primary Healthcare Networks (PCNs) and Community Health Units (CHUs) while reinforcing the role of Community Health Promoters (CHPs) in the provision of community-based primary healthcare services.
- The Facility Improvement Financing Bill establishes an efficient, secure, and accountable mechanism for collecting, retaining, and managing revenue generated from services rendered at public health facilities in Kenya.
- The Digital Health Bill outlines the framework for the provision of digital health services, creating a comprehensive integrated digital health information system.
- The Social Health Insurance Bill establishes the framework for the management of social health insurance and the creation of the Social Health Authority.
The highlight of the week was the official inauguration of the UHC program by the president during the national Mashujaa Day held at Kericho Green Stadium, attended by dignitaries, heads of state representatives and over 2000 CHPs from different counties across the county.
Speaking during the event, the president reiterated the commitment of the national government to deliver UHC. These commitments encompass fully publicly funded primary healthcare, the implementation of a digital health management information system, and the establishment of a fund to enhance healthcare facilities.
The government has undergone a significant shift towards preventive and promotive health, prioritizing these aspects over curative measures. This approach also has economic benefits. Community health reports indicate that for every KSh1 invested in community health, KSh9.40 is realized in economic and social gains.
In the government’s plan, the provision of primary healthcare services at the community level will commence with Community Health Promoters (CHP). Their responsibilities will include basic preventive and promotive health measures, health education, basic first aid for minor injuries and household ailments, and facilitating referrals for facility-based healthcare.
Each community health promoter is assigned 100 homes within their respective neighborhoods nationwide. Recognizing the crucial role of community health in achieving UHC, the long-term financial sustainability of community health relies on increased domestic resources for health.
The National Government committed to collaborate closely with county governments to bolster the delivery of community health services by providing stipends for 100,000 Community Health Promoters on a 50:50 matching basis. The national government has allocated Sh3 billion annually for stipend payments.
High-quality community health data is vital for planning, resource allocation, and progress monitoring towards Universal Health Coverage. The government is resolute in implementing the digital health agenda, beginning at the community level. The electronic community health information system (e-CHIS), currently operational and utilized by promoters across the nation, is a user-friendly mobile health application designed to collect real-time, accurate household data, facilitate health service delivery planning, and link individuals to healthcare facilities. In conjunction with the CHP kits, the government has provided 110,000 smartphones for use by the promoters and Community Health Assistants (CHAs).
The shift from curative to preventive healthcare will be further fortified by the promotive services offered by community health promoters at the household level and the integration of preventive services at the primary healthcare level.