The question to ask on universal healthcare
What you need to know:
- A simple intervention, such as the hugely successful ban on smoking in public places, can result in significant immediate improvements in the population health.
- Ensuring access to safe drinking water, mandating a centred design approach in all construction and civil design works, and entrenching a culture of safety in all our workplaces.
- Encouraging people to walk more, to select healthier diets, and to have more social connections would reduce the risk factors for many non-communicable diseases.
As the country trudges along the path towards Universal Health Coverage (UHC), we have lately been collecting mountains of data and “piloting” many interventions in the hope that we will stumble upon a miraculous solution.
We have benchmarked with countries in the world that are touted as having made the best progress towards achieving UHC, and we have retained experts from those countries to advise us on the best approach to emulate them.
PROVIDE POINTERS
The problem, however, is that our approach is generating ever more complex and complicated solutions to the problem of access to quality health care in this country. A simpler solution is possible, and perhaps even necessary, but it will not be attained by the complex methods we have adopted.
The first step towards a solution, in my opinion, lies in asking the right question. The fundamental question we should be trying to answer is: How can we ensure that most of our people become and remain healthy for a substantial portion of their lives? This is the question whose answer will provide pointers to what needs to be done in order for Kenya to achieve UHC. Using this approach, it is possible to fashion a frame of reference within which potential solutions can be crafted.
For instance, we can begin to ask ourselves if purchasing the same set of equipment for all public hospitals would be part of a solution to ensure that most of our people are healthy for a substantial portion of their lives. We can debate whether building more health centres, dispensaries and “County Teaching and Referral Hospitals” would help push us along that path, or whether they instead constitute a distraction and a barrier on our journey to UHC.
We can also interrogate whether importing health workers from Cuba and denigrating the local health workforce would accelerate our progress towards UHC.
REDUCE RISK
Quite obviously, even to a complete layperson, the answer to our health problem lies in a totally different set of interventions. The approach one would expect would definitely involve going back to basics. One would expect that we would spend quite a bit of our time and resources ensuring the environment is clean and safe for our people. A significant proportion of our health problems emanate from an unsafe environment, and simple, inexpensive measures can go a long way in addressing this.
A simple intervention, such as the hugely successful ban on smoking in public places, can result in significant immediate improvements in the population health, while reducing risk for future generations. Ensuring access to safe drinking water, mandating a centred design approach in all construction and civil design works, and entrenching a culture of safety in all our workplaces would go a long way in reducing health problems. Encouraging people to walk more, to select healthier diets, and to have more social connections would reduce the risk factors for many non-communicable diseases.
Regarding the existing disease burden, it is possible for us to generate a list of the top health problems that lead to the greatest disability or death, and to focus curative services on these conditions. UHC must be seen more holistically.
Lukoye Atwoli Associate Professor of Psychiatry and Dean, Moi University School of Medicine; [email protected]
