The Council of Governors (CoG) plays a significant role in coordination of county governments. Recently, they convened a 2-days consultative meeting for County Directors of Health to discuss the status of key Universal Health Coverage (UHC) reforms and development of priority areas for follow up to support the UHC reforms in the counties.
Working in collaboration with other USAID mechanisms, USAID HERO supported CoG to bring together County Directors of Health, Ministry of Health officials, Kenya Accreditation Services (KENAS), Kenya Medical Practitioners and Dentists Council (KMPDC) and the Social Health Authority (SHA).The forum was critical to review action points and status from the previous meeting held in March 2024. At the center of these was the status of implementation of the four UHC enabling legislations: Digital Health care Act, Social Health Insurance Act, Primary Health Care Act and the Facility Improvement Fund (FIF) Act all passed in 2023.
Spotlight on Elgeyo Marakwet County
Elgeyo-Marakwet one of the 10 counties supported by the USAID HERO project made a presentation about the county health status and how it has been able to implement the UHC laws. – The county acknowledged how USAID HERO project technical assistance led to adoption of a tool used by health facilities to asses county preparedness for SHA.
Elgeyo Marakwet highlighted the role of County leadership from the top to health facilities even as they put in place measures for roll out of the Digital Health care Act and the Primary Health Care Act.
On FIF, Elgeyo Marakwet spoke of its roadmap and decision to adopt the national FIF model Law which now awaits approval. In terms of facility registration by KMPDC the County has a total of 69 health facilities registered and those that have not been registered are 39 that’s 64% and 36% respectively.
What next for USAID HERO?
Notably, most health facilities across all the 47 counties have not been registered by KMPDC and those registered still do not have the required annual licensing. These are essential requirements on the preparedness to roll out SHA. Therefore, County Directors of Health were taught the benefits of SHA and what they need to do to ensure all their health facilities are compliant.
Already, USAID HERO has developed a SHA County Health Facility preparedness assessment tracker. This tracker will provide a quick snippet of where the 10 supported counties are and the information used for advocacy efforts within the counties. Key-takeaways and recommendations from the Directors meeting in July 2024 were as follows:
- There is an urgent need for high-level political goodwill from the County Governors and County Assemblies for the implementation of health reforms such as FIF, establishment of PCNs, and improvement of own-source revenue generation.
- There is an urgent need for sensitization of County Governments at both the high level of leadership and all facility managers on the four UHC laws.
- County Governments through the Directors of health must urgently move to have all their health facilities inspected, registered and licensed by the KMPDC as part of preparedness to reap benefits envisaged by the Social Health Insurance Act.
- There is need for integration of inspection and licensing by different regulatory Authorities into one process to cut down on the cost implications for county governments.
- County Governments must invest in the public health facilities especially in terms of health products and technologies to be able to compete with private and faith-based health facilities for the resources that will be available from SHA.
- County Governments should align their FIF laws to the national FIF Act to reflect the following broad uniform norms and standards.
- County Governments to mobilize their residents for registration under the Social Health Insurance Act system.
- County Governments to appropriately sequence the implementation of the four UHC laws as they are interdependent (i.e. Digital Health Act, Primary Health Care Act, Social Health Insurance Act, and Facilities Improvement Financing Act).
- County Governments should finance the Offices of County Directors of Health to enable them to effectively discharge their constitutional and statutory functions under the Health Act of 2017.
- The County Directors of Health urgently require a face-to-face meeting with the Director General of Health at national level.