Free medical care in public health centres

In a bid to improve access to medical care for millions of poor Kenyans, the government on Sunday announced it would provide free health services in state-run dispensaries and health centres starting next month. "With effect from 1 July, 2004, all charges for prevention services, treatment, diagnosis in public dispensaries and health centres must stop," Health Minister Charity Ngilu told a news conference in the capital, Nairobi. Patients, Ngilu added, would only pay a minimal registration fee to get treatment in the clinics and dispensaries, and children under the age of five would be exempted from paying even that fee. She said the government had set aside Ksh 4.1 billion (US $51.5 million) to implement the free medical care programme in 2004/5. Kenya used to offer free health services in public hospitals and health centres since 1963, but in 1989, the state, under pressure to restructure its economy, introduced "cost-sharing" charges for medical and other services. Due to rising poverty however, an increasing number of Kenya's 31 million people could not afford healthcare even as services in public medical institutions deteriorated as a result of reduced government funding. "The absolute poor in Kenya, who number about nine million have no access to healthcare services," Ngilu said. "Even those who live 100 metres away from a health centre or dispensary die at home because they cannot afford to pay for healthcare," she added. To emphasise the deplorable state of healthcare in Kenya, Ngilu said that deaths among children under the age of five had risen by 30 percent during the past 10 years. Infant mortality rate increased from 60 in 1989 to 89 in 2003 per 1,000 live births, while the death rate among children under five rose from 89 in 1989 to 114 in 2003 per 1,000. "Close to 500 lives of young women are lost due to pregnancy-related causes per 100,000 lives births," said Ngilu. "Our country is classified by the [UN] World Health Organisation as one of the countries with the highest maternal mortality experience in the world," she added. She also said that to improve the provision of medical services and make them affordable to the majority of the people, the government had embarked on reforming the public health sector. Ultimately a National Health Insurance Fund would be established once parliament passed a law creating it and making it mandatory for all employed Kenyans to contribute to the fund. "As soon as the parliament passes the National Social Health Insurance Bill 2004, the government will also stop all charges in district hospitals for those who would be contributing to the insurance fund," Ngilu said.