The State of Health Care in Kenya
Francisca
Recently, Global Hope has been confronted with a few children under our partner’s care who’ve been very sick. One is a 14-year-old girl living at HOREC, Francisca. She was diagnosed with cancer after having found a lump under her armpit late last year. She began chemotherapy in February and continues to undergo treatments. Then, just this month, a 4-year-old boy at Spring Valley, Petronella, was found to have a tumor in his brain. It is growing so rapidly that the doctors want to get him into surgery right away.
In talking with our partners about the help these children need, it is obvious just how different Kenya’s health care system is from ours in the U.S. It is also apparent that the expenses for medical care can be very high and cripple a family’s (or organization’s) budget. We write this article to share with you the state of health care in Kenya. Please pray that the Lord will provide everything that is needed to bring Francisca and Petronella back to health again.
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According to the World Health Organization, a large percentage of poor households in Kenya cannot afford health care. In fact, nearly 1 million Kenyans are pushed below the poverty line each year because of unaffordable health care expenses. This is because families rely on discretionary income to cover health care services since only one in five Kenyans has access to medical insurance. And, discretionary income, if a family even has it, gets depleted extremely fast.
Petronella
For a typical Kenyan family, when someone gets sick, the first stopping place is the local government-run dispensary staffed by nurses. They can help with very basic care for such things as the flu, uncomplicated malaria or skin conditions. If the nurses cannot help with a problem, the patient is referred to a government-run health center. These centers provide primary care and focus mainly on preventative care such as vaccinations. Unfortunately, a sicker patient will find that these centers are not equipped to help with more serious ailments. The next step would be to go to a hospital where more specialized care can be found. For many poor Kenyans though, just getting to a hospital can be an insurmountable hurdle since travel by itself can be costly.
The quality of health care in Kenya is another issue. Most healthcare facilities are below international standards with limited resources and limited capabilities. The public hospitals are understaffed, poorly equipped and lack supplies. There is quality care to be found in Kenya, but more often it is by private healthcare facilities and private hospitals, and the problem is that most cannot afford this.
Kenya’s government is trying to change all this through a universal health plan for the country. One solution they have been investing in is the state-run National Hospital Insurance Fund (NHIF). This is primarily insurance provided through businesses to the employees, but in the past few months, negotiations have been taking place within various counties to provide this insurance to the poorest of the poor–most of whom are not employed and therefore not eligible for this insurance.
Many applaud expanding access to NHIF and feel it is a move in the right direction. It doesn’t cover all medical expenses but will make a difference for many families who currently have no coverage. Maybe they won’t need to use their life savings, sell valuable assets, or borrow, just to pay for out of pocket health expenditures!
But is this enough? In 2001, the African Union countries met and pledged to set a target of allocating at least 15% of their annual budget to improve the health sector. To this day, most have not come close to 15%, which in itself is still a very small allocation. Kenya is just over 5%, although with NHIF’s coverage growing, this will likely increase. (Healthcare expenditure per capita in Kenya is around $157–the U.S. expenditure per capita is $9,536 as a comparison). The other unanswered questions are can the government sustain an expensive program like this, and what other investments will be made to improve the quality of overall care? Time will tell.