KEMSA Urges Government to Establish Central UHC Funding Mechanism for Counties

The Kenya Medical Supplies Authority (KEMSA) is urging the national government to establish a central Universal Health Coverage (UHC) funding mechanism that would enable counties to access health products and technologies (HPTs) without financial constraints. KEMSA, tasked with ensuring the efficient supply of essential medical commodities across Kenya, faces increasing financial strain as counties struggle to meet their payment obligations. The situation threatens the smooth implementation of the country’s ambitious UHC program, a cornerstone of Kenya’s healthcare reforms.

On October 1, 2024, during the flagging off of medical commodities to various counties ahead of the rollout of the Social Health Authority (SHA), KEMSA Board Chair Samuel Tunai highlighted the urgency of addressing this issue. His appeal to the government and county administrations to establish a central funding mechanism reflects broader challenges that the Kenyan healthcare system faces as it seeks to provide equitable, efficient, and sustainable healthcare services to its citizens.

The Need for a Central UHC Funding Mechanism

Kenya’s healthcare sector has undergone significant changes in recent years, with the government prioritizing UHC as part of its Bottom-Up Economic Transformation Agenda. However, financial hurdles, particularly at the county level, have impeded progress in the sector. KEMSA has been grappling with a growing debt from counties that are unable to pay for the medical supplies they order. This debt burden hampers KEMSA’s ability to restock essential medicines and supplies, thus jeopardizing its capacity to fulfill its mandate.

Tunai’s proposal for a central UHC funding mechanism is a direct response to these financial pressures. Such a system would pool resources into a centralized account that counties can draw from to pay for medical supplies, eliminating delays and inefficiencies. By streamlining the payment and supply processes, this model would ensure that counties have uninterrupted access to essential healthcare products, thereby improving service delivery.

Tunai explained that the pooled funding approach would relieve counties of the responsibility of individually managing and budgeting for health supplies. Currently, many counties operate on tight budgets, and healthcare often competes with other pressing needs. A centralized fund would allow counties to access the medical products they need without being constrained by their local financial limitations. This could help stabilize the supply chain, minimize stock-outs, and ultimately improve the overall healthcare experience for Kenyan citizens.

Financial Strain and Debt: A Growing Challenge for KEMSA

The financial strain facing KEMSA is not a new problem, but it has become more pronounced as counties struggle to manage their healthcare budgets. According to Tunai, the rising debts owed to KEMSA by county governments have crippled the authority’s cash flow, leaving it unable to adequately restock its inventory of essential drugs and medical supplies. This, in turn, threatens the timely delivery of healthcare services in many regions across the country.

As a solution, Tunai called on counties to clear their outstanding debts to KEMSA to improve its cash flow. This would not only enable the authority to replenish its stocks of essential supplies but would also ensure the continuity of medical services in county hospitals and clinics. The ability to maintain a consistent supply of drugs and medical equipment is crucial, especially in rural and underserved areas where access to healthcare is already limited.

The debt problem also underscores the need for better financial management at the county level. While the national government has made significant investments in healthcare through initiatives such as UHC, the devolution of healthcare responsibilities to counties has created new challenges. Counties, which now oversee the management of healthcare facilities and budgets, often lack the financial resources and expertise needed to manage these responsibilities effectively. The result is a growing backlog of unpaid bills to KEMSA and a healthcare system that is increasingly under strain.

Exploring Grants and Incentives for Counties

In addition to advocating for a central UHC funding mechanism, KEMSA is exploring grant opportunities to support counties that have been diligent in paying their debts. Tunai noted that these grants would ensure that compliant counties continue to receive top-tier services, rewarding them for their financial discipline. This approach aligns with the authority’s commitment to improving service delivery while encouraging counties to meet their payment obligations.

By offering grants and other incentives, KEMSA hopes to encourage more counties to prioritize healthcare spending and clear their debts. This could also foster a more collaborative relationship between the national government, counties, and KEMSA, ensuring that all stakeholders are working toward the common goal of improving healthcare access and quality across the country.

Moreover, Tunai applauded counties that have successfully implemented the Facilities Improvement Fund (FIF), a mechanism that has played a key role in upgrading healthcare infrastructure and services. Counties that have adopted the FIF have been able to modernize their health facilities, expand service offerings, and improve the overall quality of care. These successes demonstrate the importance of sound financial management and the potential for further improvements if a central funding mechanism is established.

The Role of the Social Health Authority in Strengthening UHC

KEMSA’s vision for a more robust healthcare system is closely tied to the government’s plans to establish the Social Health Authority (SHA). The SHA, as part of Kenya’s broader health insurance framework, aims to provide broader access to health insurance for all Kenyans, offering financial protection while also strengthening healthcare coordination.

Tunai expressed KEMSA’s commitment to working closely with the SHA to ensure that their systems are integrated and efficient. This integration is essential for the success of UHC, as it will allow for better coordination between healthcare providers, insurance schemes, and supply chains. By working together, KEMSA and the SHA can create a more seamless healthcare system that delivers better outcomes for patients and providers alike.

The establishment of the SHA represents a significant step forward in Kenya’s efforts to achieve UHC. By expanding health insurance coverage to more Kenyans, the government hopes to reduce the financial burden on individuals and families who face high out-of-pocket healthcare costs. The SHA will also play a critical role in improving healthcare equity by ensuring that vulnerable populations have access to the care they need without facing financial barriers.

KEMSA’s Role in Achieving UHC

KEMSA has been a key player in Kenya’s UHC agenda, providing the medical supplies and technologies that are essential for the functioning of healthcare facilities across the country. However, the financial challenges it faces threaten to derail these efforts. Tunai’s call for a central UHC funding mechanism is a recognition of the fact that KEMSA cannot fulfill its mandate without the necessary financial support from both national and county governments.

The authority’s commitment to UHC is evident in its efforts to collaborate with both levels of government and development partners to ensure the continuous supply of essential drugs to counties. KEMSA’s ability to meet the growing demand for healthcare products will be critical as Kenya moves closer to achieving its UHC goals.

In addition, KEMSA is exploring new partnerships and collaborations to strengthen its supply chain and ensure that counties receive the medical supplies they need. The authority has already established partnerships with development partners and other stakeholders to improve its operations and expand its reach. By continuing to build these relationships, KEMSA can enhance its capacity to support the UHC program and deliver better healthcare outcomes for Kenyans.

Conclusion

The push for a central UHC funding mechanism by KEMSA is a timely and necessary step toward improving healthcare delivery in Kenya. With counties struggling to meet their payment obligations and KEMSA facing financial strain, a centralized fund would streamline the procurement and payment processes, ensuring that counties have uninterrupted access to essential medical supplies.

KEMSA’s appeal to the national government to establish this mechanism is a reflection of the growing challenges facing Kenya’s healthcare system. By addressing these financial issues and strengthening partnerships with the SHA and other stakeholders, Kenya can move closer to achieving its UHC goals and building a healthcare system that is equitable, efficient, and sustainable for all.

The proposed funding mechanism, combined with better financial management at the county level, grant opportunities for compliant counties, and continued collaboration with the SHA, will play a pivotal role in ensuring that Kenyans can access the healthcare services they need without facing financial barriers. As the country continues to implement its healthcare reforms, KEMSA remains a crucial partner in the journey toward achieving UHC and improving the overall health and well-being of the population.