Governors express doubts in UHC plan ahead of launch

Thursday, October 29th, 2020 00:00 |
Then Health Cabinet Secretary Sicily Kariuki (third right) with her Devolution counterpart Eugene Wamalwa (second left) and some governors on Janaury 15 when they signed the UHC agreement. Photo/PD/File

Governors have expressed doubts about the manner in which the National government plans to roll out the Universal Health Care (UHC) across the country.

The county bosses have since outlined a number of proposals they want incorporated for the success of the programme.

Governors are holding a four-day meeting, starting today in Mombasa, with senior government officials, medical experts and other stakeholders. 

The Council of Governors (CoG) wants the government to allocate adequate resources to the project. 

The government is set to roll out UHC nationally; almost a year after the programme was implemented in Isiolo, Kisumu, Machakos and Nyeri counties on pilot basis.

CoG is now poking holes in the project, based on the outcomes from the four counties where it was tried out by highlighting a myriad of contentious issues that need to be addressed if the forthcoming rollout was to succeed.

County bosses presented their grievances to the national government to evaluate the successes and challenges of the pilot project. 

President Uhuru is expected to have a round-table meeting on Saturday with the county chiefs, to deliberate on the way forward for one of his pet projects that he has touted to be part of his legacy. 

The county chiefs cited lack of a clear UHC policy as a hindrance to allocation of financial resources by the national government to the sector, in which they acknowledged to have aired their views in the first draft.

Hybrid system

Based on the challenges experienced in the four counties, the governors now want the programme funded through a hybrid system of insurance and tax based financing model, which essentially necessitates reforms in the National Hospital Insurance Fund (NHIF).

“This insurance model is incumbent upon a reformed and restructured NHIF with adequate county representation that would enable county health facilities to receive funds through capitation and improve quality service delivery,” the governors said in a memorandum presented to Health Cabinet Secretary Mutahi Kagwe on October 12.

According to the report compiled by CoG, and seen by People Daily, county governments want to transfer the burden of paying salaries for doctors on postgraduate training to the national government through the Ministry of Health.

However, the doctors on post-graduate training would be free to seek employment in counties based on availability of opportunities once they finish their training.

Governors have also suggested immediate hiring of more health professionals albeit on condition that recruitment  be undertaken by County Public Service Boards. 

This, CoG says, would help bring harmony amongst the health professionals and avert a looming conflict pitting those serving under devolved units and are county employees versus those under Afya House.

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