Today, as we commemorate Universal Health Coverage Day, the spotlight is on the birth of Primary Healthcare (PHC), which dates back to 1978. More than a mere framework, PHC ensures every individual has access to essential healthcare services without facing financial hardships.
Primary Healthcare (PHC): A Foundation for Universal Health Coverage (UHC)
In Kenya's informal settlements, providing essential healthcare faces challenges like poor sanitation and overcrowding. These urban areas struggle with inadequate sanitation infrastructure, leading to waterborne diseases and increased community health risks. Overcrowding worsens these issues, hindering effective health interventions and making residents vulnerable to various health concerns.
To curb this, it is crucial to provide essential healthcare services. These services encompass health education (such as Fafanuka, a health information platform by Savannah Informatics, Safaricom and NCDAK), water, sanitation, hygiene (WASH), maternal healthcare, family planning, control of diseases, treatment of common conditions, immunization, essential drugs, nutrition, and food security. They are delivered through community participation, infrastructure development, and intersectoral collaboration.
Community Voices: Empowering the Unsung Heroes
At the heart of community participation lie the unsung heroes, community health promoters (CHPs), who act as a crucial link between the community and the healthcare system. Each CHP oversees a community health unit comprising 100 households. Formerly unpaid community health volunteers, recent government initiatives in Kenya now provide these dedicated individuals with a token of appreciation.
Building Bridges: The Role of Infrastructure
Infrastructure, often a game-changer, plays a pivotal role in supporting healthcare in these communities. This includes clear referral systems for linkage to care, with healthcare facilities categorized into tiers. CHPs operate in tier 1 healthcare facilities and refer patients to tier 2 facilities, such as dispensaries and health centres. Additionally, CHPs leverage information systems like the electronic Community Health Information System (eCHIS) to track their work and digitize the referral process.
Unity in Diversity: Intersectoral Collaboration in Action
Intersectoral collaboration, both at national and county levels, brings together efforts from diverse sectors beyond healthcare, including education, finance, and social services, to work in partnership towards a common goal. By fostering collaboration, these sectors provide leadership, governance, and resource mobilization efforts. This approach ensures a holistic healthcare strategy, addressing not only medical needs but also the social determinants of health.
The primary healthcare system is the foundation for achieving universal health coverage. It emphasizes early intervention and community engagement in healthcare, making it an effective way to improve health outcomes.
Embracing Health for All: The Big Picture of Universal Health Coverage (UHC)
Today marks the anniversary of the United Nations’ unanimous endorsement of universal health coverage in 2012, recognizing its significance in promoting global health equity. Universal health coverage entails all individuals having access to quality health services where and when they need them without facing financial hardship. This involves increasing health coverage in terms of population, service, cost, and the pooling of funds. In the pursuit of averting financial strain, PHC emerges as the most efficient and cost-effective way to achieve UHC, thanks to its people-centred approach and optimization of healthcare resources.
The recently launched Social Health Insurance Fund (SHIF) in Kenya, aimed at supplanting the 57-year-old National Health Insurance Fund (NHIF), is strategically positioned as the executor of UHC. The impact of Universal Health Coverage (UHC) can be measured by assessing the proportion of the population that can access essential, quality health services. Additionally, evaluating the proportion of the population spending more than the recommended 10% of household income on out-of-pocket health expenditure is crucial for understanding the effectiveness of UHC initiatives.
The Collective Responsibility: Navigating the Journey to Universal Health Coverage
The interplay between PHC and UHC is integral to the establishment of a resilient and inclusive healthcare system. The financial protection afforded by PHC aligns with UHC's goal of ensuring that individuals can access essential services without facing financial hardship. Furthermore, the integrated service delivery model of PHC, spanning preventive, curative, and rehabilitative care, contributes to the comprehensive service coverage objective of UHC. As these two concepts converge, they mutually reinforce each other, paving the way for a healthcare landscape that is not only efficient and cost-effective but also prioritizes equity, preventive care, and community involvement, ultimately fostering health for all.
On this Universal Health Coverage Day, we are committed to strengthening these foundational elements, fortifying healthcare systems undergoing the triple transition, and inviting collective action to realize a future marked by universal access to quality healthcare, fostering global well-being and equity.