Healthcare Financing For Universal Health Coverage In Kenya

Résumé

Background: Universal Health Coverage (UHC), a target of Sustainable Development Goal 3 (SDG 3.8) is driven by the need for access to quality and affordable healthcare and protection from catastrophic costs for all by 2030. Access to surgical services including neurosurgery is critical in the achievement of SDGs mainly through reduction in non-communicable diseases and trauma. In SDG 3 amongst other SDGs like promoting economic growth (SDG 8), poverty reduction (SDG 1), reducing inequalities (SDG10) and fostering partnerships (SDG 17), Health financing is key in UHC attainment since it greatly influences the performance of the other health system inputs. Solutions to UHC financing require evidence-based country-specific approaches. Although Kenya has had a gradual improvement in health status including neurosurgery, key health indicators have not met the recommended standards. Aim and objectives: The aim was to identify key factors for effective health financing for UHC in Kenya. The objectives were to assess health-financing mechanisms, identify gaps, and generate evidence-based recommendations. Methodology: The study used a pragmatic stance, deductive approach, qualitative methods, and a cross-sectional design. A non-probability sampling of participants was done, and semi-structured interviews were conducted. Data were transcribed, manually coded, and analyzed based on a conceptual framework. Institutional ethical approvals and informed consent were acquired. Data were stored in a password-protected database and destroyed according to institutional regulations. Results and Discussion: Government allocation, Out-of-Pocket (OOP) expenditure, Developmental Assistance for Health (DAH), and health insurance were the main sources of revenue. Government allocation was low at 11.3% of the total budget and 2.1% of GDP, health insurance coverage was low at 26.2% of the population, OOP expenditure was high at 24.4% of total health expenditure (THE), and a significant catastrophic expenditure of 8.7% of the population. DAH was high at 19.6% of THE. Only 18% of the poor and vulnerable populations were covered with government subsidies for insurance premiums. There was a need to strengthen health financing for UHC. Conclusions: Health financing mechanisms have been assessed and gaps identified. Effective methods of health financing for UHC have been established and recommendations made (for policy-making).