President William Ruto Pledges On Human Resources Reform

• Promises Made - Kenya President
• 2 Years, 9 Months ago
• 493

President William Ruto Pledges On Human Resources Reform

Human Resources

Our health professionals feel shortchanged by devolution of health services. They are of the view that they, and health services in general, would be better served by a centralised system similar to that of teachers, noting that the Teachers Service Comission (TSC) is entrenched in the Constitution.

They have proposed a similar Health Service Commission that should also be entrenched in the Constitution. But county governments consider it very important that the health professionals should be accountable to them. Moreover, the centralised system that preceded devolution was associated with very inequitable distribution of health professionals because they could influence their posting to favourable locations. Many of the historically marginalised counties did not have a single specialist. Both positions have merit.

In fact, county governments acknowledge that they do not have the resources to sponsor doctors for further education, or money to pay both the doctor on study leave and the replacement. They also acknowledge that the county health services need specialists. We, in Kenya Kwanza, believe that this conundrum is solvable. What it requires is goodwill and honest mediators. Well will be that honest mediator. We pledge to work together with the health workers and county governments to find a solution within the first 100 days of our administration.

Community health is the bedrock of preventive healthcare. Doctors estimate that 70 per cent of cases seen in our hospitals are preventable. It is estimated that Sh1 invested in community health has a return of Sh9 saved in curative health costs. Kenya Kwanza is committed to ensuring that our primary healthcare has, at the very bottom, a well-resourced community health system. Consiquently, the Kenya Kwanza national government will contribute to the stipends paid to community health workers by county governments on a matching basis.

Health Information Technology

We will leverage on information technology to drive responsiveness, efficiency, seamlessness between providers, transparency and fraud prevention. We will procure, as soon as practically possible, a state-of-the-art health integrated information management system that will enable every Kenyan to own and control access to their health records and provide them with all the information they need to access health services on their phones.

NHIF Reforms

Contribution structure

We are aware of a new contribution structure gazetted by the Treasury Cabinet Secretary. People earning Sh100,000 will contribute 1.7 per cent amounting to Sh1,700. Under this structure, a couple earning a combined Sh200,000 will be deducted Sh40,800 a year while a single payer earning Sh100,000 will contribute Sh20,400. The two families will get the same benefits. This is highly inequitable. We have proposed to change the contribution to family/household, rather than individual, as is the case with private insurance.

If the Sh150 million out-of-pocket payments were converted into contributions to NHIF, each Kenyan would have to contribute Sh3,000 a year, or Sh12,000 for each of the 12 million households. To raise Sh200 billion required to cover both the secondary and tertiary pillars works out to an average of Sh4,000 a person which totals Sh16,000 a household. Our preliminary analysis shows that a progressive contribution system can achieve the Sh200 billion requirement with contributions ranging from Sh300 to Sh3,000 a household a month (Sh3,600 to Sh36,000 a year).

Enrolment

We recognise that even though enrolment to NHIF is now mandatory by law, there are practical challenges of enrolling self-employed Kenyans who are the majority. A number of initiatives will be deployed to make enrolment easier for self-employment Kenyans, including:

• Leveraging on the proposed Primary Healthcare Funds as platforms for community-based group schemes;

• Leverage on the Hustler Fund and farmer organisation initiative to set up occupational schemes for trades such as, boda boda and market women saccos;

• Affordable and flexible premium financing schemes such as, contributions financed quarterly in advance, while contributors repay the loans weekly or other interval aligned with their income streams.

Governance

Insurance is a business built entirely on trust. For the NHIF to fulfill the mandate of the social health insurer we need, it must enjoy the confidence of all its stakeholders, in particular contributors and health service providers that it serves directly. We recognise that at present, the NHIF falls considerably short. Kenya Kwanza is committed to implementing the reforms required so as to build this trust as recommended by stakeholders. Consideration will be given to unbundling the NHIF along the lines of the pension fund system. This would entail separation of the Fund management, claims, administration and regulatory functions.

SOURCE: Citizen Digital

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