Report reveals struggles Kenyans face in accessing quality healthcare
The recent shift from National Health Insurance Fund to Social Health Authority has been met with confusion and frustration among Kenyans.
What you need to know:
- The annual Ibrahim Index of African Governance report reveals the struggles citizens face in accessing quality services, shining the spotlight on the government's Universal Health Coverage plan.
Despite the widespread presence of health facilities across Kenya, access remains out of reach for many citizens, not because they cannot get to a clinic, but because the quality of care they receive once there is often wanting. The annual Ibrahim Index of African Governance (IIAG) report reveals the struggles citizens face in accessing quality services, and puts the government's Universal Health Coverage (UHC) plan on the spotlight.
The 2024 IIAG report shows that Kenya's quality of healthcare has deteriorated to a worrying level over the past decade. The report highlights a drop of 15.8 points between 2014 and 2023, ranking Kenya 43rd in Africa with a score of 31.5 per cent.
However, it also notes a promising trend in access to healthcare, which has increased by 8.2 points to a score of 63.3 per cent.
Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes. It encompasses the effectiveness, safety, patient satisfaction and reliability of care.
For many Kenyans, this struggle reveals a painful reality: access to healthcare is only the beginning. Poorly equipped facilities, overworked staff and inconsistent quality of care create a healthcare experience that falls short of meeting basic health needs.
According to Dr Vincent Nyangweso, a general doctor based in Nairobi, the quality of care can be compromised by outdated equipment, untrained or overworked staff, inconsistent standards and poor patient-provider communication. This gap between access and quality leaves many Kenyans in a situation where getting care doesn't necessarily mean getting care that heals, which he says has serious consequences.
"Poor quality care can lead to misdiagnosis, medical errors, inadequate treatment and lower patient satisfaction, even when access to healthcare is adequate," says Dr Nyangweso.
The report also reveals a worrying trend in public perception of healthcare, which has fallen by 6.5 points over the past decade to a score of 53.9 per cent in 2023. This indicates that the public has a negative view of the healthcare services available to them, including accessibility, affordability and quality, as well as a lack of trust in healthcare providers and institutions.
Dr Nyangweso notes that understanding public perception is crucial for policymakers and healthcare providers because it can influence healthcare outcomes, patient satisfaction and engagement in preventive services, all of which are essential for a healthy society.
In terms of health expenditure, catastrophic out-of-pocket expenditure remains a major burden in Kenya, with over 20 per cent of health expenditure paid directly by citizens. The report states that reducing this to below 15 per cent is critical to achieving UHC and protecting households from financial hardship. However, it shows that the country’s health sector has improved slightly overall, with a 2.2-point increase to 62.7 per cent, ranking 15th in Africa.
The positive trend in Kenya's health sector is mainly driven by significant progress in child and maternal health, which increased by 7.9 points to reach 73.2 per cent; control of communicable diseases, with the highest change of 15 points; and access to water and sanitation, which increased by 4.4 points.
The report came against a backdrop of continuing confusion with the new Social Health Authority (SHA), highlighting the plight of patients unable to access medical services and health providers reporting various challenges with the system that is supposed to help manage claims.
Medical facilities have continued to experience difficulties in submitting claims through the SHA portal despite assurances by Health Cabinet Secretary Deborah Barasa that the glitches have been resolved.
Since the transition from the National Health Insurance Fund (NHIF) to the SHA on October 1, the new system has come under heavy criticism, with some Kenyans sharing their challenges and others expressing scepticism about whether they will receive sufficient healthcare benefits in return.
Unlike the NHIF, where salaried Kenyans contributed up to a maximum of Sh1,700 per month and the self-employed Sh500, under the SHA all workers will contribute 2.75 per cent of their gross salary to the health fund.
