Health for All campaign

Meeting my predecessor

There he was: Kenaw! I was seeing him in person for the first time. Kenaw is a friendly guy; we greeted like we’d known each other awhile. I hear from my Health for All: Campaign for Universal Health Coverage in Africa (Health for All) colleagues that he was wonderful to work with and got along with almost everyone in the office within a few weeks of arriving. Although I hadn't had the opportunity to work with him, I sprinted from the foundation he laid to further the campaign’s activities as I joined MSH and Health for All in January 2013.

Staff contributors at Management Sciences for Health (MSH), a founding member of the UHC Day coalition, are blogging this week about universal health coverage, including sharing fresh videos, photos, and analysis, inspired by the five reasons to support health for all. Each day we also include how you can take action right away to support health for all.

Today, we highlight reason two ("Because UHC is attainable") with video and stories from Ethiopia, Kenya, and Nigeria--countries working toward UHC.

Because Universal Health Coverage (UHC) is Attainable

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“I wish I had called this event,” said Mr. Simone Ole Kirgotty, CEO of Kenyan National Hospital Insurance Fund (NHIF). This came as a surprise to many since the CEO was bombarded with critical questions and comments about the activities of the organization he has been leading for the last two years. “If it was new for me to lead such a controversial organization, I would have run away after all these comments,” added Mr. Kirgotty cheerfully.

It was during a public debate in Nairobi, organized by the Health for All: Campaign for Universal Health Coverage in Africa (Health for All Campaign), that the CEO of Kenya NHIF made these remarks. The debate, entitled: “Improving Communications to Scale up Public Engagement with NHIF: Challenges and Prospects,” was part of a series of debates being conducted in seven counties in Kenya. As highlighted by Dr. Daraus Bukenya, Country Representative for MSH Kenya, the major objective of the debates is to get clarity on NHIF activities, to create a platform for community engagement, and to identify and put together recommendations to NHIF to work toward universal health coverage in Kenya. The first debate was held on November 17, 2014 in Nyeri.

In a health clinic outside Nairobi, Kenya, Janet* waits to see a doctor. Janet is a 32-year-old widow and mother of four from Kibera, a neighborhood of Nairobi. Her 11-year-old daughter, Jane*, isn’t feeling well. Both mother and daughter are HIV-positive.

Janet and Jane are lucky to live walking distance to the Langata Health Center, where they receive high-quality health care for free. Jane has been on antiretroviral medication for more than two years. Janet hasn’t paid a shilling. Around the world, millions of people living with HIV struggle to pay for care, or receive none at all. But Janet and Jane are among the 600,000 Kenyans whose HIV care is free through programs from the Government of Kenya, US President's Emergency Plan for AIDS Relief (PEPFAR) program, and The Global Fund to Fight AIDS, TB and Malaria.

Janet wishes everyone could receive the same care that she does at Langata. But even for her, the system just barely works. She explains:

The doctor is only one, and we are many.

Patients at Langata face long waits to see a doctor or pick up their medications. Patients like Janet spend hours away from work and may have to arrange for child care.

We will sprint in the last round like our athletes. That is the Ethiopian style.

So says the famous Ethiopian comedian Dereje Haile. His team is lagging behind in the first round of the popular Ethiopian Television (ETV) game show, Question and Answer Competition.

Haile is the source of constant laughter since before the filming of the show, when he performed a quick physical exercise, as if about to enter into a boxing ring. His teammate, Kora Music Award winner and pop star, Tsedenya Gebremarkos, confirms Haile’s words, and promises the audience they will do better in the second round.

On the other side of the stage stand the other two contestants: the well-known Ethiopian poet, Tagel Seifu, and the famous journalist and actress, Haregewoyn Assefa.

They look confident, leading in the first round.

I felt like I had traded my mother’s health for my children’s schooling. It was a tough choice, and I cried every day.

This emotional remark was made by Lucy Njoki, a Kenyan mother and grandmother, at the Health for All Campaign Launch Event on April 28, 2014, in Nairobi. She had been forced to choose between paying for her children’s education or her mother’s urgently needed medical treatment. She could not afford both. Affordable and accessible health care remain an unrealized dream for many Kenyan citizens.  

Unfortunately, Lucy’s story is not uncommon. Lucy represents millions of people who are pushed into poverty due to catastrophic health expenditures in Kenya. The Health for All: Campaign for Universal Health Coverage in Africa is building awareness and advocating for universal health coverage (UHC) in Nigeria, Ethiopia, and Kenya. Implemented effectively, UHC ensures that all people have access to the quality services they need, without suffering financial hardship.

In Nigeria, the Health for All: Campaign for Universal Health Coverage in Africa is effectively collaborating with stakeholders to support the government move toward universal health coverage (UHC).  Led by MSH and funded by The Rockefeller Foundation, the Health for All Campaign co-hosted a National Stakeholders Meeting on UHC in conjunction with the National Health Insurance Scheme (NHIS), International Finance Corporation (IFC) and PharmAccess Foundation on March 9, 2014. The prior day, March 8, the campaign hosted a media forum on “Effective coverage of progress towards universal health coverage in Nigeria.”

This post originally appeared on The Lancet Global Health Blog.

A strong civil society is essential for realizing the lofty goal of achieving universal health coverage (UHC). While the ongoing global discussions around UHC have largely focused on the role of government and development partners in designing and implementing risk pooling mechanisms that have the potential to improve access to essential health services, there has been little discussion on the key role that local civil society organizations (CSOs) play to ensure various communities support UHC and hold governments accountable.

It was sudden and unexpected. It was also funny: the ball exploded and deflated right under Teferi's foot. But everybody started to worry when the director screamed: “We can’t shoot the next scene without the football! Somebody get me a new one!”

I looked at the young boy actor. Tears were about to wash his gloomy face as the ball changed into a useless piece of flat plastic right before his cloudy eyes. "This is bad!" I said to myself. "The kid might not be willing to act anymore; we might be forced to start the production all over again!"

We were shooting one of the scenes for a TV public service announcement. Producing the TV spot is one of the major activities for the Health for All Campaign–the campaign supporting the popularization of Ethiopia’s New Health Insurance Scheme.

It was ironic: the TV spot promotes preparing for unforeseen emergencies. Yet, once the ball became useless, we realized that we were not ready for an emergency ourselves.