While governments in developed economies such as the United States of America that spends USD4,437 or the UK, which spends USD 2,928 per person per year, are able to maintain comparably better government allocations to healthcare, most other countries have a lot less to spare for healthcare.
In Kenya, for example, budgetary allocation for the 2011/2012 financial year was KSh 31.6 billion (USD 368.9M), which at a population of 39.5 million, translates to only Ksh. 800 (USD 9.3) per person per year.
This simply puts healthcare beyond what most of the country’s citizens can afford. In addition to prevalent self-medication, because medicines especially are not available free, poor families often go without treatment when they are ill. Common diseases also take their toll on the health of children, lowering their ability to do well in school and to make a living later on.
A major consequence of the high cost of healthcare in primary health is the sacrifice of preventive healthcare, with the little resources available being left for curative healthcare. In Kenya, for example, non-communicable and lifestyle related diseases, which can often be arrested in regular medical checkups, contribute more than half of the top twenty morbidity cases, with the prevalence of high blood pressure estimated at 37% among those aged twenty-five years and above.
Public financing of healthcare through national insurance funds is a common model that could significantly lower the cost of healthcare, but which is most times faced with many challenges relating to governance, management, reach and the underlying conflict with private healthcare insurance providers.
Still, national health insurance schemes remain the only way to sustainably make healthcare affordable, without burdening governments. In this regard, the reach and operational efficiency of such schemes is critical, and must remain a priority in considering affordability of healthcare.
The National Health Insurance Fund (NHIF) in Kenya, for example, has grown its revenue base to Ksh. 9.4B (USD 110M), reduced administration costs to 32% from 50%, and achieved a payout ratio of 62.5%.
Today, the Fund provides affordable health insurance cover for 20% of the country’s population at monthly contributions of between Ksh. 80 (USD 0.9) and Ksh. 320 (USD 3.7).
Despite its relative affordability, majority of Kenya’s population, like in most other African countries remains excluded from both access and affordability of healthcare.