CSOs and Communities to Send Letter to the President Over UHC.
Representatives of Kenya CSOs and Communities at a past meeting.
Kenyan CSOs and community leaders last week joined the global community to commemorate the universal health coverage day (https://universalhealthcoverageday.org/) usually marked on the 12th December each year. As we stated in our last week issue of the Bulletin, the focus shifted to the announcement by President Uhuru Kenyatta appearing in a section of the media that the UHC Pilots in 4 counties have been successful and generated lessons to inform the upscaling of the same in the other 43 counties by June 2020? https://www.the-star.co.ke/news/2019-12-04-uhuru-promises-full-rollout-of-universal-healthcare-by-june/.
The reflections on the progress and plans for the rollout of UHC was inspired by the UHC Day theme and campaign calls on leaders across sectors to Keep the Promise of the High-Level Meeting political declaration—the most ambitious and comprehensive on health in history. See: https://undocs.org/en/A/RES/74/2. For Kenya, communities focused on President Kenyatta’s statements and commitment on Health for All and made community leaders reflect on the statements made by President Uhuru Kenyatta at the UN high-level meeting (HLM) on UHC in New York in September.
It is upon this reflection that a decision was reached to send a letter to the President with specific asks. As a collective body of people who expect and use affordable health services expected to come with UHC, the community leaders drawn from networks of people living with diseases and CSOs that support them; have expressed concern that the president’s assertion on the UHC pilots is not being accurate. It should be noted that communities and beneficiaries of the UHC pilots have been monitoring the progress of the pilots in the four counties. The monitoring by communities, for example, confirmed that, in Kisumu which was supposed to answer the most expensive question for the UHC pilots, the cost of finding and providing service to Kenya’s citizens living with HIV only took off in as far as the registration of people and free consultation. PLHIV, therefore, did not benefit from the UHC as HIV and related coinfections like TB were excluded from the UHC package of services. Worse, the monitoring revealed that much of the duration of the UHC pilot in Kisumu has coincided with a countrywide industrial unrest by frontline health care workers in public health facilities.
The other concern by communities and patients in the UHC pilot counties is the fact that whereas the President pledged that UHC is supposed to cushion the most vulnerable from the high cost of healthcare, this has not been the case and there has never been any statement on how to realize this. Once or twice, the Cabinet Secretary came up to state that UHC did not mean that all health services were going to be free and Kenyans would have to still pay for service delivery.
The CSOs and networks of communities living with the diseases are therefore working to put in place a communique which will include that the timelines for the roll-out of UHC be reviewed and that a full audit of the current pilots to establish the actual use of the funds allocated by the World Bank for Kenyans be undertaken. Communities will also be following up with the Council of Governors and county governments on the need to enhance social participation as a pillar that will guarantee community engagement in the achievement of UHC goals.
The need to factor in social participation in the implementation of the UHC is informed by the WHO Handbook on Social Participation for Universal Health Coverage (UHC) and which recognizes the important role of civil society and communities, in addition to governments, by responding to this recommendation, and aims to strengthen systematic and meaningful government engagement with populations, communities, and civil society in national policy, planning and review processes. The term social participation is used to encompass the active engagement and involvement of CSOs and communities in the advocacy and implementation of UHC interventions. It is expected that the Kenyan CSOs will strategically plan for an empowered, informed and capacitated engagement through a roadmap to be unveiled during the UHC Day 2019.
While it is not clear, communities think that the assessment of the UHC may be based on the Service Coverage Indices (SCI) and which may have very little to do with the uptake and utilization of services and even the quality of services. The concern is around infectious diseases where HIV and TB fall. The response to these two diseases and Malaria which remain the leading causes of sickness and death has suffered immensely in the last five years as donors have been cutting back on their support. Ironically, the UHC pilots excluded the three diseases on the account that they have donor funding. It is therefore not clear what the UHC pilots are prioritizing. It is also not clear how the Kenya government will step forward to cover the gaps being left by donor budget cuts.
Young People’s Network Peg Hope on ODSS for Sustainability and Resilience
The Y+ Kenya Board members during the introduction to ODSS approach in Machakos last week.
The Adolescents and Young People’s Network, the Organization of Young People Living with HIV in Kenya (Y+ Kenya) is pegging their hope on organizational development and systems strengthening (ODSS) for their sustainability and resilience. The network’s leadership team was last week undergoing training and mentorship as part of the initial stages of the ODSS approach. The training and mentorship in Machakos was supported by the Aidsfonds International.
Y+ Kenya is an umbrella network comprised of adolescents and young people led organizations working to ensure the HIV response in Kenya works for adolescents and young people. They engage adolescents (11 – 19years) and young people (20 – 30years) living with HIV through their individual organization. The Member organization of the network include: Sauti Skika, Building Lives Around Sound Transformation (BLAST), Positive Young Women Voices (PYWV), Ambassador for Youth and Adolescents Reproductive Health Programme, Alfajiri, and Mentor Chica.
The group is now engaged in a number of initiatives to put their membership at the center of the HIV response and to ensure that young people are not left behind in the national efforts geared towards the acceleration of the delivery of the 90-90-90 targets and achievement of the Universal Health Coverage goals. The need for the network emerged after a review revealed that adolescents and young people are being left behind in the response to HIV. One way of ensuring that young people are not left behind is to nurture and support their leadership. This is why young people have come up with a network to serve as a platform for their operations and engagement.
As part of the initial stages of ODSS, the Y+ Kenya was last week taken through leadership, governance, and management capacity building workshop where the Y+ Kenya Board members and respective member organization staff were taken through their specific roles and responsibilities. With that training, it is expected that the board members shall make informed decisions that will enable the organization to grow and move forward as a strong network that will be geared towards the achievement of Y+ Kenya vision, which is to create healthy and productive lives of Adolescents and young people living with HIV in Kenya. The young people’s network is now expected to institutionalize their governance in accordance with ODSS aspirations.
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