Health access is a human rights issue and UHC will level the field

by Amref Health Africa


There is a good chance that you have in the past few months attended a fundraiser or sent money to cover medical expenses for someone you know.

The grim reality for a majority of Kenyans is that a prolonged medical condition often results in the sale of productive assets to offset medical bills.


Financial barriers continue to hinder access to quality healthcare, with many individuals and households falling into poverty from seeking healthcare.

The first global monitoring report, ‘Tracking Universal Health Coverage’, indicates that in about half of African countries, including Kenya, 40 per cent or more of the health expenditure is constituted of household out-of-pocket payments, which is the most regressive way of funding health care.

In Kenya, it is estimated that a third of health expenditure is paid out of pocket at the time of seeking care.


The reliance on this payment mechanism creates financial barriers to access health services and puts people at the risk of impoverishment.

Evidence shows that catastrophic health expenditure and impoverishment remain low in countries where out-of-pocket expenditure is less than 15 per cent of the total health expenditure. In addition, few households are shown to be impoverished where out-of-pocket cost is less than 20 per cent of their health expenditure.

Insufficient investment in the health sector and slow response to addressing the environmental and social elements impacting health will continue to affect health outcomes if drastic measures are not taken to improve the overall health of our people.

The first step towards addressing our health challenge is for our people is to understand and appreciate that health is a basic human right. It is unacceptable that millions of individuals still face death, disability, ill health or impoverishment for reasons that could be addressed at limited cost.


The globally accepted ‘Right to Health’ approach requires that healthcare goods, services and facilities be available in adequate numbers; that they be financially and geographically accessible, as well as accessible on the basis of non-discrimination; that they are respectful of the culture of individuals, minorities, peoples and communities, sensitive to gender and life-cycle requirements; and are of good quality sufficient to deliver desired outcomes.

Universal health coverage (UHC) is a critical aspect of realising individual’s right to health. Its core principle is that everyone receives the needed health services without financial hardship.

It is, therefore, a critical and often cost-effective element in any strategy seeking to address poverty and social exclusion.

An effective UHC system requires adequate human resources — including community health workers; adequate facilities that are fully provided with essential drugs, equipment and other supplies; and adequate financial resources so all people — regardless of wealth can obtain needed services without experiencing financial hardship.

All this focusing first on primary healthcare and on those most left behind because UHC is decidedly pro-poor.


UHC anchored in the right to health requires that authorities take a bottom-up approach by engaging with those who are excluded and devise policies to include them in the health system and the social system more broadly.

UHC must be supported by policies and services addressing the wider social and environmental determinants of health for individuals and populations, and a national commitment to universal health coverage must be embedded in a rights-based framework.

The government needs to prioritise and move away from vertical interventions that just tackle individual diseases and focus more on improving broader health systems.

If well implemented, UHC will stimulate economic growth by ensuring a more productive workforce; facilitating educational gains by ensuring healthier children; and empowering women and reducing poverty associated with health costs.

UHC can dramatically improve health outcomes, reduce inequality and generate sustained economic growth.

This article was first published HERE by the DAILY NATION, on 16 July 2018.

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