UHC must take health workers plight into account

Charles Onyango 

Throughout recent decades, our objectives and pointers for the health-related goals have barely centred around expanding coverage of priority health services such as skilled birth attendance, and on improving health outcomes in relation to maternal health, child health and infectious diseases. 

Albeit genuinely consistent degrees of progress have been made towards accomplishing these objectives, successes have been bogged down by near absence of regard for equity, disregard of underlying sectorial issues, and the fragmentation of endeavours focused at the distinctive national health priorities.

The universal health coverage (UHC) was expected to be a multifaceted undertaking, midwifed by a cluster of activities to address particular requirements of every nation.

In Kenya, it’s a vital element of the emancipatory “Big 4 Agenda”, meant to broaden the affordable health services provided to the public.

To be efficient, access to compelling health coverage is generally reliant on the accessibility of adequate skilled, well-trained and motivated health workforce.

Maybe that clarifies why specialists underscore that the UHC must go past simple numbers and address gaps in distribution, competency, quality, inspiration, efficiency and execution, a thought upheld by the consequences of various econometric investigations which have affirmed that a satisfactory health labour force is important for the conveyance of basic health services and improvement in health results.

Experience has also indicated that only by overcoming structural deficiencies, including those related to governance, the health workforce, information systems, health financing and supply chains, will it be conceivable to improve explicit results for individual infectious or emerging neglected tropical diseases and population subgroups.

Yet locally, unmistakably no current public health targets appear to allude unequivocally to the health system actions needed to accomplish such objectives.

There are no compromises between the more extensive health labour force needs espoused in the UHC paradigm and the fiscal limitations faced by the government.

Even at the counties, the ineptness to build the cost-viability of an expanding health system by granting more noticeable roles to community and mid-level health workers is worryingly obvious.

Critically, there’s a woeful hard-headedness towards embracing suitable administration systems and impetus structures that could streamline the performance of existing health workers and decrease inefficient spending.

These maladies, coupled with the chronic lack of an appreciation of health workforce challenges other than numerical shortages, and of the potential contributions of cadres other than physicians, nurses and midwives in improving health service availability and accessibility, conceivably reflect in systemic failures of policy makers to integrate planning, forecasting, development and management of human resources for health into the UHC. 

However, that problem ought to extraordinarily concern us as it will most likely worsen the current unsatisfactory varieties in the distribution, capacity and performance of health workers, and subsequently a lopsided quality and coverage of health services.

The accomplishment of Kenya’s UHC strategy will, tremendously rely upon whether policy makers can incorporate a health-workforce-specific benchmark in the framework for UHC.

That ought to include key changes, particularly, corresponding to how health workers are trained, deployed, managed and supported — The writer is a Global Impact Fellow at MWI