The time for an India-Africa partnership is ripe. Governments must be put to task to ensure that health stakeholders and all partnerships remain committed to the core principles of Universal Health Care.
‘Health’ refers to a state of complete physical, mental and social well-being — it is not merely the absence of disease. There are many local and global mandates including the Kenya Health Policies (2012-2030), the Kigali Global Dialogue of 2019, and the Kenya Health Act, among that oﬀers guidelines to ensure improvement in the state of healthcare. Specifically, the India-Africa partnership for accessible health is a topic of great interest, considering the current movement of patients from Africa seeking treatment in India. NHIF statistics indicate that about 10,000 or more Kenyans are seeking treatment in India annually, citing quality and aﬀordability in comparison to other countries.
In an attempt to find a balance between access and quality, costs become an integral aspect of health equity and financial protection. With reference to Kenya, accessibility should not be a topic for discussion in a country where the health system is divided into levels of care. These range from those that are very much grounded in the community all the way to the referral centres. However, accessibility has taken a diﬀerent shift.
Access to health services is dependent on the financial status of the state, and quality of healthcare is guaranteed only in specific hospitals that serve the elite. Needless to say, these are restrictive to many ordinary Kenyans. Accessibility cannot be discussed independent of access to all essential services which is aﬀected by human resource, procurement, management, training and most importantly — medical technology.
Health being a human right, the government has an obligation to partner with stakeholders to ensure accessible and affordable healthcare.
The current disconnect between policy makers, health service providers, and the consumers of these services needs to be addressed urgently.
In the current state, millions of Kenyans are driven further into poverty by medical bills. <2> Every family is one sickness away from poverty. The health system is designed to respond to disease, with little focus on prevention.
Over the years, the health system has changed. It has adopted business models that arm twists its clients/patients desperate to access healthcare, which should be based on the need for a required services rather than the ability to pay for a service.
Universal Health Coverage, if adopted as a process that incorporates public education and participation into its agenda, will be a step towards a health system model that operates on the core principles of equity.
For Universal Health Care to be achieved, there has to be good will from governments. The Kenyan government’s reduction in funding healthcare systems, aﬀects over 80% of the country’s population, who depend on this fund. This is a dramatic setback for a nation that is already plagued by a severe health crisis.
Given this context, the time for an India-Africa partnership is ripe. The historical relationship between Africa and India have had, and the similarities in the health challenges makes it possible to develop a partnership with mutual benefits. However, governments must be put to task to ensure that health stakeholders and all partnerships remain committed to the core principles of Universal Health Care.
However, as we go along, some questions also must be asked: is the Africa-India medical tourism sustainable? Does it address the challenges of financial protection and equity? Focusing on primary healthcare and partnering to improving health systems leveraging on our strengths and best practices will not only make it possible to attain universal health coverage, but will also shift the focus of all discussions to the people. This will make it possible to creatively shape and come up with a partnership model that addresses the concerns of all stakeholders.
Refocusing on quality of care and increasing demand for services; Essential elements in attaining universal health coverage in Kenya: Dr. Wangia Elizabeth, Dr. Kandie Charles.
<1> Medical doctors are constantly in a limbo carefully balancing clinical judgement on one hand and financial ability of the patient on the other. The fact that patients have to buy essential medication, pay for the required investigations and the specialist services/procedures puts the pressure on the doctor to do the much that they can in one visit because a second visit will be more than the patient can aﬀord. It is often a daunting task to make a diagnosis and implement the best treatment plan under such circumstances,thus compromising the quality of services to this group of patients.
<2> I remember my interaction with this single mother who did not have a steady income and therefore considered the National Health Insurance Scheme (NHIF) to be a luxury she could not aﬀord. She had presented with an incisional hernia following a caesarian section but she did not show up on the scheduled day for the elective surgery because she had not raised enough to pay for the surgery. Many months later she is admitted through the accident and emergency department with a diagnosis of intestinal obstruction, a life threatening complications that would have been prevented if the hernia had been surgically repaired. She still has no insurance and no money but the surgery has to be done anyway because this time its an emergency. She would need critical care after surgery, and because there was no Intensive Care unit in the facility, a decision to refer her was made. Unfortunately the surgery was done a little too late, she died of sepsis a few days after the surgery.The family had no choice but to raise money from every source to pay for hospital bills, mortuary services and cover funeral expenses. This was not the first time for this family, and it will not be last unless Universal Health Coverage is achieved.
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Faith Mugoha Orinda is director at Africa Trade &: Investment Group (ATIG) Ltd.Read More +