CSU: Health workers can help reduce zeros on medical bills

Medical Benefits Claim Form Rejected. [Getty Images]

Among President Uhuru Kenyatta’s “Big 4 Agenda” was affordable healthcare achievable through Universal Health Coverage (UHC).

UHC refers to an individual’s ability to access safe and quality medical services, including access to essential medicines and vaccines without suffering financial hardship or worse, being pushed into poverty.

Such sad stories are common, with a 2014 survey showing that four in 10 Kenyans were at risk of financial hardship due to out-of-pocket payments for health services. This highlights the importance of achieving UHC.

To achieve 100% UHC, many actors must be involved. These include government, NGOs, donors, key players in the private sector, policy makers, the insurance industry, health professionals and citizens.

Among these, healthcare professionals can play a critical role in the successful implementation of UHC by adopting a patient-centred approach to care, educating patients, advocating for well-functioning healthcare systems and by carrying out health policy reforms.

According to the World Health Organization (WHO), the two fundamental goals of UHC are to provide quality essential services and to protect people from financial hardship. Healthcare professionals play a unique role in achieving the first objective, through their immediate contact with patients. They can adopt a patient-centered approach to care in their practice, which means that the needs of the patient determine the care provided and that patients are actively involved in the development of their own health plan.

Previously, the conventional mindset was that the healthcare professional decided for the patient. Although this method always has the best interest of the patient at heart, it is a narrow perspective where the only objective is the disease.

Moving to a patient-centred approach means the perspective is holistic; taking into account the illness, the patient’s financial capacities, available resources, origin and socio-cultural background. This helps to ensure the quality of health services that patients have access to, even at the basic level.

Second, healthcare professionals can promote UHC through patient education. Many people are unaware of the essential health services they can access for free or at subsidized costs. A good example is the Free Maternity Package – Linda Mama which is provided to all women of childbearing age.

Despite its success, many women are still unaware of it. Healthcare professionals educating their patients on such programs could be a game-changer, as patients are made aware of the service, which then increases their care-seeking behavior and increased demand prompts government and stakeholders to take action. to increase service delivery, ultimately leading us towards achieving UHC.

Third, health professionals can help achieve UHC by advocating for health systems that work effectively.

Major reforms of our health systems are needed for us to achieve our UHC goals. It sounds like healthcare professionals advocating for equity in the allocation of healthcare resources, quality medical products, increased budget allocations and safer healthcare infrastructure – challenging the government not just to build hospitals , but well-equipped structures.

According to the WHO, the recommended doctor-to-patient ratio is 1:1000. In Kenya however, the ratio is 1:16,000, which means the population is underserved and we cannot talk about achieving UHC without addressing this disparity.

Finally, health professionals can steer the country towards UHC by leading health policy reforms. When health policies and bills are being discussed, health professionals must not only actively participate, but lead them.

Health professionals specializing in UHC should hold leadership positions in government agencies to lead the implementation of health policies.

The Global Burden of Disease reports that Kenya has achieved 50% UHC and predicts that by 2030 we will rise to 60%.

If all healthcare professionals could adopt these aforementioned practices, we would accelerate the journey towards achieving 100% UHC and realize our vision of affordable healthcare for every Kenyan.

The author is a student, University of Nairobi, School of Medicine

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