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Fast-Tracking Universal Health Coverage in 2023: It’s time to focus on innovation and knowledge partnerships

by Basil Malaki, Knowledge Transfer Manager for Kenya at Innovate UK KTN Global Alliance Africa

As the leading economy in East Africa, it is no surprise that Kenya often ranks top across several developmental indicators. In terms of economic growth, the country has maintained an annual GDP growth rate of 5% with GDP per capita almost doubling in the decade between 2010 (Ksh135,641) to 2021 (Ksh258,252)[1]. At the same time, life expectancy has increased from roughly 51 years in 2000 to about 66 years in 2018[2] with inequality slowly but surely decreasing on the Gini index[3]. Together, these indicators paint a promising picture of a state on the rise, especially when considering the vastly different growth trajectories of its neighbours such as Somalia and South Sudan.

But while good progress has been made to uplift the Kenyan economy and its people, the crisis resulting from the COVID-19 pandemic as well as limited fiscal reserves to finance the rollout of additional healthcare facilities – combined with Kenya’s reputation as a source of emigrants and host country for refugees – is weighing heavily on an important indicator: access to healthcare.

Access to healthcare has for several years been a priority of the Kenyan administration. In 2017, the former President of Kenya unveiled Universal Health Coverage (UHC) as one of the Big Four priorities for his administration. With it came various reforms including increasing the allocation of resources from both national and county coffers to finance growth in the healthcare sector. This was founded on the aspiration that “all persons in Kenya would be able to use the essential services they need for their health and wellbeing through a single unified benefit package, without the risk of financial catastrophe”[4].

However, as the Kenyan economy now grapples with a post-pandemic recovery exacerbated by rising inflation, mass unemployment, and fears of a global recession, analysts predict that the Kenyan government will have to limit its spending on health in the short term, while they wait for the economy and fiscal reserves to grow[5]. In the meantime, they recommend that those responsible for Kenyan healthcare explore methods of increasing the efficiency, effectiveness and equity of their allocated budget, in a move to maximise the impact of public spending.

According to the World Bank[6], there are five important steps that need to be taken in the short-term:

First, concerted efforts need to be taken to tackle the largest sources of inefficiency within the health sector and increase the value for money of public spending. Second, emphasis should be placed on ‘effective’ care by incentivising and enabling healthcare workers to provide better treatment. Third, there needs to be a continued prioritisation on investing in solutions tailored to disadvantaged areas and population groups. Fourth, there is a need to implement systems that can properly monitor health targets to guide future spending. And finally, for government leaders to consider introducing reforms to accelerate investment into healthcare facilities.

While it may be easy to list these steps on paper, in practice they each present significant tasks at hand and will no doubt find themselves intertwined with other developments in both Kenya’s internal politics and external affairs. However, as a starting point, it would be wise for those responsible for advancing healthcare in 2023 to consider the role that innovation can play in achieving both these short-term recommendations and longer-term aims of UHC.

The potential for innovation to accelerate Africa’s socio-economic development is well-known, with pundits at the African Union[7], United Nations[8] and Kenya National Innovation Agency[9] all agreeing that advancements in science and technology are key to preparing for a future where Africa is home to the largest, youngest and arguably most vibrant market on Earth.

In the field of healthcare, we have already seen how innovation has enabled access to care in places like Rwanda, where drones air-drop vital medication to communities in hard-to-reach areas, or in Uganda, where mobile phone penetration is being harnessed to help remote families test for malaria using digital apps that do not require blood samples[10]. Examples can also be found in Nigeria, where health-technology is helping doctors and care facilities modernise record-keeping to better manage patients and operations[11], as well as South Africa, where startups are empowering healthcare workers with tools to support the business feasibility and technical skills of independent care providers[12].

As a concept, innovation is limitless and can help us achieve the five short-term goals that encompass efficiency, value-for-money, enhanced and accessible care for the under-served, and better oversight of how care is provided. However, innovation on its own is not enough and can only be unlocked if three key ingredients are present: knowledge, skills, and resources.

Providing all three are knowledge partnerships – collaborative vehicles that bring together a diverse range of stakeholders around a common interest, and in doing so, collate their knowledge, skills and resources with the aim of spurring growth in their shared field.

Knowledge partnerships are already active in Kenya, with initiatives such as Global Alliance Africa – a project under the stewardship of Innovate UK KTN – having successfully brought together leaders from across the public, private and civil sectors to explore several issues facing UHC. This includes unlocking the commercialisation of health-related research; an exploration into the various opportunities for potential public-private partnerships; an assessment of the various levers that the Kenyan government could use to unlock greater market competition; possible solutions to current challenges facing intellectual property; and methods to increasing the availability of financing for innovative enterprises.

Looking ahead to 2023, Global Alliance Africa is now in the process of establishing a Global Innovation Network on Health – a multi-stakeholder group connecting experts in Kenya, Nigeria, South Africa and the UK with the aim of creating opportunities for participants to collaborate on research, introduce ideas to new markets, and fund solutions to key challenges facing healthcare in Africa. However, for this network to effect change on the healthcare prospects of Kenyans, it requires their participation, and in doing so, we can all play our part in taking UHC one step further in 2023.

If you would like to play your part in driving UHC in 2023, I urge you to join our Global Innovation Network on Health by contacting basil.malaki@iuk.ktn-global.org.

[1] https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=KE

[2] https://blogs.worldbank.org/africacan/remaining-ahead-curve-what-should-kenya-do-achieve-its-universal-health-coverage

[3]https://www.statista.com/forecasts/1165143/gini-index-forecast-in-kenya#:~:text=The%20gini%20index%20in%20Kenya,to%2040.77%20points%20in%202028.

[4] https://www.health.go.ke/wp-content/uploads/2019/01/UHC-QI-Policy-Brief.pdf

[5] https://blogs.worldbank.org/africacan/remaining-ahead-curve-what-should-kenya-do-achieve-its-universal-health-coverage

[6] https://blogs.worldbank.org/africacan/remaining-ahead-curve-what-should-kenya-do-achieve-its-universal-health-coverage

[7] https://au.int/en/documents/20200625/science-technology-and-innovation-strategy-africa-2024

[8] https://sustainabledevelopment.un.org/content/documents/publication.pdf

[9] https://www.innovationagency.go.ke/

[10] https://edition.cnn.com/2019/10/15/tech/tech-africa-healthcare/index.html

[11] https://heliumhealth.com/

[12] https://noosi.health/

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