Role of Population in Provision of Universal Health Care

Population growth puts pressure on adequacy of social services including health care. As the population grows, so does the demand for health care.

Background

The disease burden among adults in the most economically productive ages is rapidly increasing in Kenya due to increased poverty, poor health services, poor nutrition and increased number of older persons. Communicable, nutritional, maternal and neonatal (infants less than 28 days old) conditions persist while non communicable diseases are rapidly increasing the frequency of disability and death. By ensuring that health insurance is universally available, the government can eliminate a lot of needless pain and suffering.

 

The World health Organization (WHO) defines UHC as all people receiving the health services they need, including health initiatives designed to promote better health, prevent illness and to provide treatment, rehabilitation, and palliative (relieving pain) care of sufficient quality to be effective while at the same time ensuring that the use of these services does not expose the user to financial hardship. Two critical features of UHC are: quality, essential health service coverage and financial coverage

 

In response to 67^th session of the United Nations General Assembly, Kenya has embraced the issue of universal health coverage. UHC is one of President Uhuru Kenyatta’s ‘Big Four’ agenda and is meant to give all Kenyans access to quality healthcare that is financially sustainable and consistent with the needs of the population.

 

The government is seeking to manage the explosive costs of health care so that these expenses can go towards expanding and creating more jobs to grow the economy. It intends to test (pilot) UHC in some 4 counties of Kisumu, Nyeri, Isiolo and Machakos to get feedback to guide the countrywide roll out later.  55 years after independence, some parts of Kenya do not have basic health facilities and sometimes sick people have to be transported for 20 or 30 kilometres to reach a health facility

 

 Why is UHC Needed?

Health is a right and should never be a privilege based on one’s race, age, gender or where one lives and how much money they earn. Health is anchored in the Kenyan Constitution and makes Sustainable Development Goal (SDG) number 3.
Good health is necessary for the happiness and well-being of the population. A healthy population will be able to contribute a lot towards a country’s economic progress because healthy people are likely to live longer, be more productive and educated hence earn more income, save more and consequently invest more.

 

UHC is needed because nearly 20 million Kenyans are not able to receive needed health services and only about 10 million people have health care insurance thus most patients have had to pay for health services from their pockets. This situation if unchecked can very likely contribute to the increase of poverty especially when people suffer from prolonged or chronic illnesses. Money that families spend on health care can be spent on educating children or starting businesses.

 

The National Hospital Insurance Fund (NHIF) will play the central role in achieving UHC by giving mandatory cover to the population in formal employment and voluntary cover to those in the informal sector.

Population Factors in UHC

Demographic, cultural, social and economic characteristics affect the way healthcare services are used by the population. Age and sex are important factors in the risk of illness and death and hence use of health care services. For example, death is higher in the first year of a child’s life and frequency of illness more during early childhood. The frequency of illness drops sharply in the late childhood and youth but rises again in the middle and old age.

 

On sex, women more frequently suffer from minor and nonfatal chronic diseases while men suffer more fatal chronic illnesses. Enhancing the health of women will most certainly result into healthy families, communities and nation.

 

Younger people have more risk of communicable diseases, middle ages more risk of injuries while the elderly are more at risk of non-communicable diseases. Changes in the structure of the population therefore normally have a major effect on the future of illness. Increase in the number of population at older ages for example increases the general frequency and extent of non-communicable diseases, thus increasing the change in patterns of disease.

 

Population size is a key determinant of the number of health facilities and health care service providers needed to provide quality health care. Currently Kenya has slightly under of 76,000 health and needs about 110,000 more health care workers to adequately serve the estimated population of 47 million well.

 

About 33 million of Kenya’s population is below 24 years of age while the elderly aged over 60 years are about 2.5 million hence the Government as it plans for UHC has to take into account the increasing frequencies of both communicable and non-communicable diseases. Changes in the size and age structure of the population are therefore necessary to bring about significant change for short term and long term health planning and financing needs. Innovative solutions are needed to ensure adequate health infrastructure and enough health care workers for the growing population.

 

Managing population growth will also ensure our environment is well sustained and hence promote public health by providing a clean environment for all and contribute to food security which will promote good nutrition necessary for the well-being of individuals.

 

UHC is attainable but population issues must be given a higher ranking in the Kenyan development agenda.

 

 

For more information contact Wambui Kungu on wkungu@ncpd.go.ke