Uniting for Health: Uasin Gishu Zuri Health

On 12th December every year, the world marks the Universal Health Coverage (UHC) day. This year’s UHC day marks one year since the launch of the Government of Kenya’s Big Four Agenda that targets to achieve universal health coverage. UHC aims to make quality health accessible to all at a price affordable to them. Significant steps towards that goal have been made among county governments country-wide who have taken the initiative to launch their UHC plans.

In a small location in Uasin Gishu (UG), Turbo sub-county, David prepares to attend a community screening event in the local health dispensary called Murgor Hills. The screening event, organized by UG County and the Academic Model Providing Access to Healthcare (AMPATH), follows a door-to-door insurance enrollment sweep and aims to get everyone covered through the National Hospital Insurance Fund (NHIF) product within the UG health system. Seventy-one-year-old David is armed with his UG Zuri Health card as he attends the screening event. He will be screened for high blood pressure, diabetes, obesity, HIV, TB and mental health disorders. Women attending the screening event will also receive both cervical and breast cancer screening. The UG health card has a unique identifier linking them to their electronic health record, which is accessible on a tablet during health visits in the health facilities.

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Door-to-door health insurance enrollment, screening, health facility improvement and economic empowerment are all part of what makes UG Zuri Health a responsive approach to universal health coverage and makes UG Zuri Health a great example of this year’s UHC day theme calling for collective action for the achievement of UHC. Partnering with an academic health center (the AMPATH partnership), the National Hospital Insurance Fund (NHIF) and the UG County government has pooled valuable resources necessary to make UHC a reality. The result is a health system with the expertise in delivering care, a comprehensive and affordable insurance package and a network of health facilities delivering this care.

The stakeholders are piloting this population health model with UHC in UG County with the hope of demonstrating a sustainable and replicable model. Preliminary results indicate that out of the 1,717 households already reached in the door-to-door sweep, we have increased enrollment to NHIF from 32 percent to 69 percent active families. People such as David who had heard about NHIF during our community mobilization campaigns were able to be enrolled in the comfort of his home. Community enrollment has proven to remove barriers to enrollment and helped achieve higher enrollment rates. As expected, we found that some households (less than 10%) could not afford to pay the NHIF cover and required assistance. A subsidy system is offered that enables such households to partially pay for their insurance as they are enrolled into income generating initiatives including community groups with microfinance to improve their financial security.

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The community screening events are an important aspect of a strong primary health care and prevention system. Finding diseases early lowers the cost of care and improves outcomes by lowering complications and deaths resulting from advanced disease. The existence of a good referral system from the dispensaries to the national referral hospitals together with health facilities that are appropriately staffed and equipped to provide quality primary care are major priorities of UG Zuri health system.

Because of the unity and commitment of stakeholders, models like UG Zuri health network make it possible for individuals like David to access insurance and ultimately quality care. We can celebrate our achievements on UHC Day.