UHC Policy

UNIVERSAL HEALTH COVERAGE POLICY
1.1 Introduction
The Kenya Constitution and Vision 2030 development blueprints require the country to provide
the highest attainable standards of healthcare to all her population. This together with the
Government's "Big Four" Agenda set the Ministry of Health to prioritize the need to develop and
operationalize a Universal Health Coverage policy (UHC) 2020-2030 that clearly outlines the
strategic direction for the sector. The UHC Policy gives direction towards ensuring significant
improvement in the overall status of health in Kenya in line with the Big Four Agenda, the
Constitution of Kenya 2010, Kenya Health Policy 2014-2030, Kenya Vision 2030, regional and
global commitments.
It demonstrates the health sectors commitment under the Governments stewardship to ensuring
that the country implements health plans in a manner responsive to the needs of the population.
UHC is an important pillar with the aim of transforming the country's health sector for enhanced
service delivery. A productive population is an impetus for greater economic development and
explains why Kenya is investing in UHC to ensure its people remain healthy. Besides health
financing, UHC implies putting in place efficient health service delivery systems, adequate
health facilities and human resources, information systems, good governance and enabling
legislation. This policy embraces the principles of equity, people centredness, efficiency, social
solidarity and a multi-sectoral approach. It focuses on four objectives and their related strategies
to support attainment of the Government's goal in health. It is cognizant of the functional
responsibilities between the National and County levels of Government with their respective
accountability mechanisms and frameworks. It is envisaged that the national and county
Governments will benefit from this policy as a guide for planning and budgeting for healthcare
services at all levels of care. The detailed strategies and programme packages will be elaborated
in specific strategic and investment implementation plans.
Recognizing the vital importance of UHC to Kenya's socio-economic development, key enabler
investments in the necessary infrastructure, skilled manpower, conducive legislative regimes,
transport, electricity and information communication technology will be necessary to achieve
these objectives that will lead to a robust and resilient health system.
The UHC initiative offers a paradigm shift for the Kenyan health system to improve the quality
of services in all public and private healthcare facilities while ensuring these services are
accessible, affordable and efficient with a focus on preventive and promotive health at the
household level through revitalisation of primary healthcare. Achieving UHC pillar will of
necessity, require strong collaboration between the public and our private sector providers.
Kenya needs to strengthen its efforts to ensure all Kenyans can access needed care of the highest
quality and standards for them to benefit without suffering financial hardship. Accelerating
progress towards UHC is even more necessary given the commitments that the country has made
to its citizens and to the world regarding meeting this goal in 2030. This policy provides an
overarching framework for the reorientation of the Kenyan health system to deliver UHC
through a person - centred primary healthcare approach which is consistent with other health
policies and strategic plans.
1.2 Objectives Of the UHC 2020-2020 policy
i) Strengthen access to health services
ii) Ensure quality of health services
iii) Protect Kenyans from the financial risks of ill-health
iv) Strengthen the responsiveness of the health system in Kenya.
1.3 UHC as a National and Global Development Agenda
Progress towards UHC is a means to realizing the right to health as enshrined in the Kenyan
Constitution, and ambitions set out in Vision 2030, the Kenya Health Policy 2014 – 2030,
Sessional paper No 2 of 2017, Health Act 2017 and the Big 4 Agenda. It is also in line with
Kenya’s commitment to the Sustainable Development Goals (SDGs). UHC is an investment in
human capital and a foundational driver for inclusive and sustainable economic growth and
development. Progress towards UHC will enable Kenya to protect the poor and vulnerable,
invest in its human capital and make progress in its overall goal of inclusive human
development. UHC as a goal is enshrined in various policies, strategies, plans and programmes
in Kenya (Table 1).
1.4 Principles of the Kenya UHC Policy 2020 – 2030
 UHC aims to move towards ensuring that the whole population shall progressively access
a comprehensive package of quality health services, while expanding protection from
financial catastrophe.
 Expansion of population covered by health services with focus on underserved,
marginalized and vulnerable populations. The expansion of the existing prepaid
mechanisms (insurance, direct funding, subsidies) for ensuring financial protection for
the citizens, shall remain the key priority of the health system. The spirit will be “leaving
no one behind” as a commitment to equity in access to services, that will be made readily
available to the primary and household level and that will be non-discriminatory and
based on a human rights approach.
 Expansion of a single essential health benefit package to ensure that the population
accesses a wide range of service areas including a renewed focus on primary health care.
 Establishment of financial risk protection mechanisms to ensure a unified financial
scheme with very clear resource mobilization, pooling and purchasing as delinked
functions
1.5 UHC policy is therefore based on the following principles:

i. Health as a human right: as enshrined in Article 43 of the Kenyan constitution
ii. Social solidarity: enhance the awareness of social interdependence and shared
values among the Kenyan people.
iii. Equity: ensure utilisation relative to need, with financial contributions based on
the ability to pay without imposing a barrier to access at the point of care (POC)
and additionally be effective in sharing of risks from healthy to sick, rich to poor
and young to old for the benefit of everyone. This principle is premised on
“leaving no one behind”.
iv. Effectiveness and quality: ensuring the services Kenyans access meet the
acceptable standards to deliver desired health outcomes.
v. Efficiency: pursue maximisation of people’s health and wellness through optimal
use of available resources.
vi. People-centred, appropriate, and responsive: account for people’s needs,
preferences and values including through an entitlement to the specified package
of health benefits.
vii. Transparency and accountability: support processes and outcomes of decision
making at all levels that are inclusive and explicitly assign duties, rights,rewards,
and sanctions to the various actors.
1.6 Organization of Service Delivery for success of UHC
i. Primary health care-oriented service delivery for greater quality, efficiency and equity:
Primary health care (PHC) is the point of first contact of care and provides a platform for the
continuum care. The health system has not optimised PHC and community health services to
improve health indicators for Kenyans. Recent reforms in the Kenya health sector have targeted
providing universal free access to public primary care services. However, evidence suggests that
levels of coverage remain low with Kenyans continuing to experience the catastrophic impact of
health expenditures. The hospital-centric orientation of the Kenyan health system was most
recently highlighted in the pilot counties. Higher-level facilities experienced significant increases
in patient utilisation in the absence of a robust PHC system to manage referrals. Access to
emergency medical care can also be enhanced since PHC is the point of first contact of care and
provides an entry point to the continuum care. Primary Health Care is critical if higher levels of
care are to be efficiently utilised. Prioritising PHC will also provide a platform for empowering
Kenyans to participate in the design and delivery of health services.
ii. Enhancing the quality of care and services provided:
The quality of care and services provided in the health sector has gained increased public focus
and medical litigation over the years. Multiple assessments have also demonstrated that this is an
area that requires great improvement. To enhance the quality of care and services provided in
public and private health facilities, the national Quality of Care Certification Framework for the
Kenyan Health Sector 2020 should be implemented to ensure a harmonised registration,
licensing, and certification process that facilitates continuous quality improvement. This will also
enhance ease of doing business, medical tourism, and strategic purchasing of health services. iii.
Strengthening capacity to prevent and respond to health security threats - an essential part of
progress towards UHC: Kenya has experienced major disease outbreaks such as cholera, dengue
fever, Rift Valley fever, chikungunya virus, anthrax, and SARS-CoV-2: the virus that causes
coronavirus disease 2019 (COVID-19). The pandemic highlights the adverse consequences that
these events can have on essential health service delivery and utilization. Investment in health
security, especially, disease surveillance systems through consolidation of public health
institutional arrangements, organizations and activities is therefore critical to making progress
towards UHC.
iv. Multisectoral approaches critical to addressing the determinants of health:
The health sector recognises that health is the result of many other factors besides health
services. As such, education, water & sanitation, housing, agriculture, energy, and infrastructure
are sectors that impact health. Coordinated and sustained action across multiple sectors is crucial
in ensuring that the gains made through expansion of health services, are sustained by the other
factors that have an impact on health.

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UNIVERSAL HEALTH COVERAGE POLICY

1.5 UHC policy is therefore based on the following principles:

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