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In recent years, the term “Universal Health Coverage” (UHC) has become increasingly visible and prominent on global and national agendas of numerous countries. What is UHC and why is this concept so attractive for countries and development partners?

Apart from having a well-designed health system, UHC equally depends on a health financing system which assures adequate financial resources for health and their equitable use. It exists when all people receive quality health services they need without suffering financial hardship. According to the World Health Organization (WHO), there are about 1 billion people around the globe without any access to health care. While access to quality health care is a constitutional right, millions of Kenyans still struggle to afford payment of health services at either public or private clinics even citizens with public health insurance. Such barriers to accessing health services does not only impact the health status of people but contributes to societal inequities and undermine sustainability of social and economic gains. Nearly 1 million Kenyans fall below the poverty line because of health care related expenditures every year and expanding health care access will reduce this burden – about 20% of Kenyans have access to some sort of medical coverage.

Moving toward UHC is a political process that involve negotiations between different interest groups such as government, private sector and community. Civil society organizations (CSOs) frequently hold critical roles in representing communities, the disease-laden and key populations/vulnerable pushing for a more equitable distribution of health resources and services.


Stimulating dialogue on Enhancing Social Accountability among health stakeholders in Kenya
Photo credit: AMREF Health Africa

March 14th and 15th, under the leadership of Health Rights Forum (HERAF), WACI Health and many CSOs herald the first ever conference on Enhancing Social Accountability in Kenya’s health sector. It provided a platform for key stakeholders to share experiences, challenges, lessons learnt including progress towards UHC. Social accountability is a key element in the Kenya Community Health Strategy and it accentuates the need for strengthening communities in realizing their rights for accessible and quality health care. In order to improve quality, access and demand for health services; public participation is crucial in that it offers citizens the opportunity to engage with government in decision-making processes, community feedback, health sector investments planning and budgeting. This also ensures that government adopts a people-centred approach in their programs and social accountability mechanisms in planning and delivery of healthcare services as highlighted in the Kenya Health Policy 2014 – 2030.

With the devolved system of health, Kenya has seen an increase in use of social accountability tools including community or county score cards, public hearings and civic education to mobilize and empower citizens to participate effectively and ensure accountability is integral in management of both national and county government resources – much still needs to be done.

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