Universal Health Coverage and Its Impact on Equity on Health Care in Kenya

Kenya like many world economies adopted and implemented universal health coverage as evidenced in the various policy initiatives and reforms. In the chapter, a critical review of the various initiatives that the government has over the years initiated towards the realization of Universal Health Care and how this has impacted on health equity. To realize this, both primary and secondary data were collected. Whereas secondary data was largely collected through critical review of policy documents and commissioned studies by the Ministry of Health and Development partners, primary data was collected through in-depth interviews with various stakeholders involved in UHC including policy makers, implementers, researchers and health service providers. Notable findings include political commitment towards UHC; minimal solidarity in financing; dysfunctional health care management; disruption by COVID 19; lack of continuous medical training; supply side rigidities that contribute to stock-outs; dilapidated health infrastructure. Other findings include weak governance at NHIF coupled with inadequate skilled labour, high operational costs, low capitation, and investment in non-priority expenditures, among others. In lieu of these, various recommendations are suggested including promotion of solidarity in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, involvement of various stakeholders at both county and national government; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources.