State leaves out key players from in high-profile health summit

Key stakeholders were notably excluded from a high-profile summit convened yesterday by Deputy President Kithure Kindiki on the ailing health sector in the country.

The summit became a one-sided discussion between heads of state agencies, with no input from private hospitals, health advocates, or healthcare workers—key players in implementing health policies.

The Rural and Urban Private Hospitals Association of Kenya (RUPHA) Chairman, Brian Lishenga, said the decision to sideline them undermined the summit's purpose.

Dr Lishenga noted that private hospitals, despite offering services across all 47 counties, were not invited. At least 91% of private hospitals in Kenya are Level 2 and Level 3 facilities.

“They did not invite us. Why hold a summit without stakeholders? It is absurd; we were completely left out,” said Dr Lishenga. RUPHA represents 55% of private hospitals in Kenya.

The summit, convened by the Deputy President, sought to address critical issues affecting the health sector, including the digitalisation of health facilities, mass registration for Taifa Care, and human resources for health.

Other key issues on the agenda included the Taifa Care experience, health commodities, health financing, and managed equipment services.

“We provide more than half of primary healthcare services in this country. When it comes to Level 4 hospitals, faith-based and private hospitals account for 60% of the total services. How can such a crucial discussion take place without our input? We are essential stakeholders, yet, regrettably, we were excluded. This oversight means they are missing key feedback on the implementation of SHA, among other issues,” he said.

Dr Lishenga further emphasised that his members have first-hand experience with primary healthcare challenges, particularly in handling NHIF services, Linda Mama, and EduAfya programmes before the scheme changes.

“We understand the sector’s challenges and have viable solutions. We have been offering proposals since 2023. If they were genuinely interested in addressing SHA’s teething problems, they would have invited us. Unfortunately, it seems they do not want to engage with key stakeholders. Nevertheless, we remain ready to contribute,” said Dr Lishenga.

Nurses' representative Seth Panyako also lamented their exclusion from the summit.

“Where is this summit? I am not aware of it. If we had received an invitation, we would have attended or sent a representative, depending on the level of engagement,” said Panyako.

On his part, Clinical Officers’ Secretary General George Gibore said he tried to reach out to the organisers of the summit but was met with silence.

“We were not invited. When we found out about the summit, we tried to reach out, but no one responded. We are therefore not participating,” said Gibore.

Gibore criticised the composition of the panellists, arguing that the discussions were dominated by government officials with little representation from healthcare workers and service consumers.

The moderators of the summit were Presidential Health Advisor Thuranira Kauguria, Tharaka Nithi Governor Muthomi Njuki, Health CS Dr Deborah Barasa, and Deputy President Kithure Kindiki.

Panellists included SHA Chairperson Dr Abdi Mohammed, Presidential Health Advisor Daniel Mwai, and Medical & Public Health Principal Secretaries Harry Kimtai and Mary Muthoni, among other top ministry officials and governors.

“The summit appears to be the government talking to itself. We hoped for broader representation so that frontline workers could contribute to the conversation. Excluding clinical officers and other healthcare workers defeats the purpose of such meetings,” observed Gibore.

Panyako questioned the validity of discussions that exclude key stakeholders.

“If they are discussing without involving us, what exactly are they talking about? If they leave out key players, then their discussions are meaningless.”

The nurses' representative further criticised the manner in which major healthcare decisions are made, citing past instances where changes were implemented without consultation.

“They attend these conferences and make pronouncements that end up destabilising the health sector. Take the issue of UHC, for example. They went for a meeting in Naivasha, overturned previous agreements, and decided that certain workers should not be placed on permanent and pensionable terms, despite earlier promises. Such decisions are made without engaging stakeholders and only serve to disrupt the sector.”

During the summit, the Deputy President reiterated that health is one of the pillars for delivering essential services to Kenyans.

Kindiki acknowledged that achieving UHC is a complex, costly, and politically sensitive endeavour due to the resources required. However, he affirmed the government’s commitment, in collaboration with county governments, to ensure its successful implementation.

Speaking during the health summit, Kindiki lauded the ongoing rollout of Taifa Care, which is being implemented in partnership with the Ministry of Health, governors, and economic advisor Moses Kuria.

“The summit was convened to assess the status of healthcare in the country, address key concerns, and strategise on scaling up the rollout while mitigating initial challenges,” he noted.

Since the launch of the Social Health Authority (SHA) on 1st October 2024, replacing the National Health Insurance Fund (NHIF), at least 19.5 million people have registered.

Kindiki said that SHA registration is progressing better than NHIF, which had only 9 million registered members.

However, Kindiki noted that there is a need to ensure those registered are also making contributions.

“We must have a robust means-testing tool to ensure an objective, data-driven approach that is not susceptible to manipulation,” he said.

He added: “Currently, while all 19.5 million registered individuals benefit from free primary healthcare, many have not started making contributions. We must find a way to encourage them to contribute in order to access the full healthcare package beyond primary care.”