This year’s Mashujaa Day theme is premised on universal health care. The World Health Organization (WHO) defines universal health coverage (UHC) to mean all people having access to the full range of quality health services needed without financial hardship. It covers the full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.

President Ruto is determined to make UHC a success given its failed attempts in the former regime. Improving healthcare is among the five pillars of the Kenya Kwanza Manifesto. The manifesto outlines commitment to healthcare reforms which includes delivering a Universal Health Coverage (UHC) system built on three pillars namely;

1.     Publicly financed primary healthcare (preventive, promotive, outpatient & basic diagnostic services), that gives patients a choice between public, faith-based and private providers, based on a regulated tariff.
2.     Universal seamless health insurance system comprising mandatory national insurance (NHIF) and private insurance as complementary covers.
3.     National fund for chronic and catastrophic illness and injury costs not covered by insurance to be funded by a combination of insurance levy and the government.

President Ruto’s strategy for achieving his commitment to UHC includes institutional and policy reforms. The President’s proposed policy reforms in the health sector include repealing of the National Health Insurance Fund (NHIF) Act and replacing it with the proposed Social Health Insurance Fund (SHIF) Bill. In addition to the SHIF, there is the Primary Healthcare Bill, the Facilities Improvement Financing Bill and the Digital Health Bill.

SHIF seeks to realign healthcare systems, enhance the pooling of resources and risks, based on principles of solidarity, equity and efficiency and promote strategic purchasing of healthcare services. The Primary Healthcare Bill seeks to establish primary healthcare networks at the community level. Healthcare services in the community are two-pronged, that is community level which is accessible at the households and facility health services accessible at the health facilities.

The Facilities Improvement Financing Bill seeks to ringfence the retention of all monies raised or received by or on behalf of facilities on behalf of all public facilities. Monies raised by these facilities shall not be substitutes for budget appropriation from the county government but will serve as a supplement to their budget. The Digital Health Bill seeks to provide a framework for the provision of digital health services by establishing a comprehensive integrated digital health information system.

The President is expected to sign these Bills on Thursday ahead of Mashujaa Day celebrations on Friday, October 20, 2023. These Bills will align with WHO’s recommendation on reforming health systems using a primary healthcare approach which ensures access to healthcare services at the community level and provision of quality services hence improving coverage and financial protection.

Prior to the Mashujaa celebrations, systems had been in place to ensure the successful launch of UHC by President Ruto on October 20, 2023. The President recently flagged off 100,000 Community Health Promoters (CHPs) who shall play a critical role in decongesting hospitals in the country through early detection of health issues at the community level. KEMSA also announced that it had stocked kits to be used by the CHPs. International funding such as Global Fund has also announced support to the government’s UHC agenda through technical assistance to KEMSA whereas USAID has pledged to offer its technical expertise support to the CHPs.

The success of the UHC will not only be the government’s achievement in attaining its manifesto’s commitment to healthcare reforms but a step forward in achieving UHC which is one of the targets for UN sustainable development goals.