End of March, 2017, thirteen (13) Counties that form the Lake Region Economic Bloc (LREB) came together to hold a first ever post devolution Health Investment Conference in Kenya. The Conference was held on the Kisii University grounds in Kisii County.
LREB Counties can exploit their comparative advantages; joint effort from all players towards tackling common problems is possible; time is ripe for Universal Health Coverage (UHC) – Out of pocket expenditure are a deterrent to access healthcare and associated with catastrophic expenditure – leverage on National Hospital Insurance Fund (NHIF) to achieve UHC – NHIF uptake should be one of the measures of success for Governors; transparency in procurement of medical equipment and drugs in county governments key; health sector needs professional and sincere leaders; local specialist should be appreciated and acknowledged; priority shift from consumer to producer of pharma products
Hosted by the 13 Governors of the member Counties and opened by the Cabinet Secretary Health, Dr. Cleopa Mailu, the meeting was closed by the former Prime Minister and the current Official Leader of the Opposition in Kenya, Mr. Raila Odinga. The event brought together members of the Academia, Government Agencies from both the Central and Devolved Units, leading Professionals, International Development Agencies, Members of Civil Society, County Legislators, Private Sector Players both for and not for profit including Faith Based Organizations (FBOs).
In the Key note speech Professor Khama Rogo noted that the region was good and known for 2 key exports; the export of experts and that of patients. He challenged the Counties to exploit their comparative advantages to reap from the wider East African Economic Bloc with close to 200 Million population. He emphasized the strong need for Governors in the region to push and vouch for the uptake of NHIF which was the surest way towards increasing access to quality healthcare while cushioning the people from catastrophe of out of pocket payments for health care. One of the indicators of success for Governors should actually include % of population covered by NHIF. He challenged Counties to refocus health investments and invest more on preventive and promotive health for better health outcomes. There was a business case for and indeed more gain in investing in Primary Healthcare.
In the speech by the Permanent Secretary Health, Dr Cleopa Mailu, he observed that there was need for synergy in service delivery. Involving the private sector through PPP approach was essential toward achieving better healthcare. A lot had been done, however, he observed that more needed to be done in the region which accounted for more than 50% of the National HIV burden and was home to a third of the Kenyan Population.
Plans are underway to exploit and synergize on the basis of respective comparative strengths of the member Counties. It is important to share expertise and resources particularly experts. Kisumu is to be the regional host of Orthopedic Technologies, Kisii County is to Host a leading Cancer Centre in the Region, whereas Kakamega is to have a Center of excellence on Mental Health.
The Kisii Governor, His Excellence (HE) Mr. James Ogwae lauded the efforts of the players from academia and Kisii Level Five Hospital (now Level six through legislation by County Government) that have seen clinicians and academia work together through support from the University of Minnesota in the US. He also acknowledged and praised private sector efforts to advance healthcare making mention of a leading Optical Centre of Excellence, an investment of private Sector. The Kisii County also the Chair of the Committee on Health has the highest Per Capita Allocation on Health in the Country with over 50% of the County Budget allocated to Health
The LREB chair, and also the Chairperson to the Council of Governors Committee on Health, His Excellency, Governor Jack Ranguma, observed that priorities should be focused on Universal Health Coverage, Quality of Care and the implementation of the Community Health Strategy. He reiterated the economic bloc focus areas in addition to health based on seven pillars of development, others being agriculture, education, infrastructure, Information Communication Technology ( ICT) , financial services and tourism. “This event will be a milestone and game changer for our counties as we seek to promote universal healthcare” he concluded.
NHIF was advised to relook at the accreditation of facilities to include the lower level facilities and to promote elements that would foster preventive and promotive health.
Neglected professions in health including Bio-Engineering were specifically mentioned with an action that the Counties needed a common strategy to redress this gap.
Through a series of high level expert discussions key issues pertinent to the Health situation in the Region and in the Country, were discussed and panel recommendations on the way forward given.
Busia County through their County Executive for Health, Dr. Maurice Siminyu, mentioned the gains they had experienced from investment on ICT, making some of their health facilities paperless. Through Public Private Partnership (PPP) collaboration for example a digital village had been established in a collaboration between the County, AMREF Health Africa and Samsung.
On medical supplies, the central procurement agency – Kenya Medical Supplies Authority (KEMSA) was acknowledged as now a supplier to both public and faith based facilities.
Cuba was mentioned as a small Country with an estimated population of 11 million persons that Kenya could learn a lot from including a lean but effective and efficient Health System. Cuba has more than 30,000 medical doctors and is a leading destination for medical tourism and an exporter of health experts. Cuba also produces its own medicine.
Over 3000 delegates drawn from diverse stakeholder categories of the Lake Region participated in the conference.
GIZ Health Sector Programme seeks to improve “Access” to high “Quality Healthcare” particularly for the poorer population groups and members of the informal sector and their families. The Programme seeks to achieve this through support for the reduction of financial barriers to accessing healthcare through promotion of health insurance, promotion of information technology supported process and quality management in healthcare and support to devolution and sector governance particularly in the health sector.
GIZ has technical cooperation in health with three of the LREB 13 counties (Vihiga, Kisumu and Siaya).
The bloc (LREB) was established and launched in 2015, members are Kakamega, Busia, Migori, Kisumu, Homa Bay, Siaya, Vihiga, Nyamira, Kisii, Kericho, Bungoma, Trans Nzoia and Bomet counties.