OPINION PIECE - NCD focus key to universal healthcare

April 05, 2018


This article was originally published by Kenya’s leading newspaper, Daily Nation (Read my other opinion pieces on both national and international media outlets here )

Recently, the World Bank convened a stakeholders meeting in Kenya on Non-Communicable Diseases (NCD) to discuss how to better include the issues into the country’s broader plans of achieving universal health coverage.
This is timely and important. According to the Health Cabinet Secretary Sicily Kariuki, NCDs are responsible for more than 55 per cent of deaths in Kenya and account for half of hospital admissions.
Globally, the affordable healthcare priority falls under the universal health coverage goal, something which the world aims to achieve by 2030.
BIG FOUR AGENDA
In Kenya, the Constitution lists the attainment of the highest quality of healthcare service as a right for every Kenyan. 
Also, President Uhuru Kenyatta listed affordable healthcare for all as one of his government’s four main priorities for his second term in office — dubbed ‘Big Four’ agenda. 
From health financing to service delivery, a lot needs to be done to meet the target by 2022, when President Kenyatta’s term ends.
To help meet the goal, at the World Bank meeting various organisations launched the integrated Delivery of Care for NCDs Kenya Country Initiative. 
This is a guideline that adopts a multi-sectoral approach towards combating NCDs that will be piloted in Trans Nzoia, Uasin Gishu and Busia in the next three years before being scaled up to other counties.
PARTNERSHIPS
The Ministry of Health has been using a bottom-up approach of working with community health workers and primary health centres. 
This is especially needed for preventative exercises, given that the cost of treating NCDs far outweighs prevention.
During the meeting, CS Kariuki advocated for leveraging technology and increasing access to medication, which accounts for over 40 per cent of treatment costs, through partnerships such as Global Vaccine Alliance (Gavi).
The public–private global health partnership makes pneumonia vaccines available at $5 (Sh500) instead of the $100 (Sh1,000) market rate.
She also pointed out that unless concerted efforts towards preventing and treating NCDs in an affordable manner are made, universal health coverage is unlikely to be attained.
CONSULTATION
Also present at the meeting were people living with various NCDs. 
Some of them shared their healthcare experiences, which included a lack of access to services either due to cost or unavailability, and highlighted the power of information, support systems and self-advocacy.
Given the multi-sectoral and bottom-up approach the Kenyan government has taken in its quest to achieve universal health coverage and its attention to the burden of NCDs in cost of delivery and the need to do more and better and faster, the affected people should be part of the planning, delivery and assessment of services.
NAMES
Stakeholders should also understand that meaningful involvement of these people is not just about photo ops and media sound bites and token involvement at forums but including them in decision-making and execution.
To be more inclusive, the language used to refer to people living with NCDs ought to change.
Referring to them as “patients” gives the impression of sickness and using words like “epileptic” or “schizophrenic” reduces them to the characteristics of their illnesses.
They are people, above everything else, who just happen to have an illness; any reference to them should list the person before the illness sequence, such as a “person living with epilepsy” instead of an “epileptic”.
PARTICIPATION
For their part, the affected people need to prioritise participating in local, national and international forums. 
They need to learn their rights and hold government and other parties that are involved in service delivery accountable to their promises.
They can also promote healthcare and awareness activities and share their personal stories — which, often, can be more relatable than just facts and figures.
It is promising to see the various efforts under way by the government and other stakeholders to improve health coverage in Kenya.
The next priority must be to involve people living with NCDs as strategic partners and equal players in the quest to reduce the burden of these diseases and increase the chances of achievement of universal health coverage. 
Ms Wafula is a mental health crusader, TED speaker and Aspen New Voices fellow based in Nairobi. sitawaf@gmail.com

(Read my other opinion pieces on both national and international media outlets here)

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