How Big Four pillars can reduce cost of healthcare in Kenya

Saturday March 28 2020

Patients being attended to at Randburg Community Hospital in Nyando, Kisumu. The government has made bold strides towards achieving the envisaged universal health coverage. PHOTO | FILE | NATION MEDIA GROUP


While Kenya has made significant reforms in the health sector towards achieving universal health coverage, attaining quality and affordable healthcare needs aggressive progression of the three strategic pillars of manufacturing, food security and affordable housing under the Big Four Agenda.

The most urgent thing the government must do is to accelerate scale up the manufacturing sector by promoting development of local industries that manufacture drugs and provision of an enabling environment to support growth of existing but small manufacturers to boost their local output.


Increasing production of pharmaceuticals, lab reagents as well as other medical supplies in the local market will reduce the overall cost of healthcare and enable sustainability of Universal Health Coverage (UHC) as presently most of these items are imported.

What this means is the country will significantly lower importation costs especially on foreign exchange, with the money saved put into other essential use.

Subsequently, this will lead to a drop in direct cost of importing medical equipment and allowing the Medical Equipment Service lease to County governments at a lower cost, thereby freeing taxpayers’ money to providing essential drugs to health facilities across Kenya.


With a promise to construct five hundred thousand decent, and affordable housing units by 2022, the implementation plan to deliver mega housing projects across various counties has been gradual. 

Housing ranks high as a fundamental need and recognised in the Constitution as a right to accessible and adequate housing and sanitation. But with unplanned urbanisation in Kenya, and over 2.5 million slum dwellers in over 200 settlements, it poses a major public health challenge.

With no access to safe and clean water, sanitation, durable housing structures, the spread of infectious diseases are greatly increased contributing to the high prevalence of infectious diseases especially within informal settlements.


Similarly, lack of standardised housing climate adapted and ventilated homes lowers the chances of achieving 100 per cent health coverage. It should be noted that rapid urbanisation has caused lifestyle changes with sedentary lifestyles and pollution resulting in a great rise in chronic illnesses

We therefore need to see increased activities around Private Public Partnership to aggressively drive the affordable housing agenda towards provision of environmentally friendly houses to thousands of Kenyans.

Aspects like improved ventilation and sanitation must be the first consideration to ensure wellbeing of dwellers by reducing possibility and instances of infectious diseases and chronic illnesses.

Achieving provision of decent homes faster can help the country tame its susceptibility to chronic illnesses and make Kenya ready to fight off prevalence of deadly disease outbreaks like the dreaded Coronavirus that has taken away many lives and thousands infected in China.

Already, a cloud of fear hangs in the country over the level of the country’s preparedness to deal with such a calamity, despite current efforts to control traffic flow into the country from airports and border entry points.

One can only imagine the catastrophic effect that an outbreak of coronavirus would have presently due to our limited capacity to produce essential medical supplies, our unplanned and congested urban settlements.


Finally, the country’s growing population needs to have adequate food supply that is also nutritious to promote healthy living that can support development of a healthy economy.

Agriculture was once the backbone of the Kenyan economy.  While its significance cannot be overemphasised, agriculture accounts for 30 per cent of the Gross Domestic Product and a further 65 per cent of Kenya’s exports, many Kenyans still lack access to healthy foods.

To achieve 100 per cent universal health care, Kenya must not only feed itself, but feed itself well to ensure the citizenry do not slide to poor health on deficiency of essential nutrients.

According to the World Health Organisation, ensuring optimum nutrition at each stage of a person’s life is the foundation of attaining universal health coverage.


WHO further states that nutrition is the foundation for health and well- being as a key element of primary health care playing an essential role in prevention, which is better than cure. 

If advancements can be made in the pillars of manufacturing, food security and affordable housing, all Kenyans will be able to receive affordable health care without the risk of financial catastrophe.

In order to ensure that quality healthcare services are being offered to Kenyans, the government must accelerate Kenya’s intentions of being a globally competitive and prosperous nation.

However attaining UHC will mean advancing all key pillars of the Big Four Agenda owing to the inter-dependency of each.

The writer is a healthcare and management consultant, [email protected]