Cause Marketing
Let ’ s Prioritize Surgical Care In Implementing The Social Health Insurance Fund
By Emily Manjeru
On New Year ’ s Eve as I was slicing through a half-thawed chicken , my right hand slipped from the handle to the blade , leaving a deep cut between my thumb and the rest of my hand . The cut needed stitches for sure . It usually never sinks in how valuable stitches are until you need them yourself . Thankfully , the nearest clinic was about 300 meters from home and open ! On a Sunday ! On New Year ’ s Eve !
The clinical officer gathered his tools and we proceeded to the dressing room . It was small with a basic examining table and thankfully , he had the sutures ( surgical thread and needle ) and local anesthesia . The minor surgery , as excruciating and semi-professional as it was , got me thinking how worse it could have been if the clinic wasn ’ t there , or if it was , but lacked basic surgical instruments . Where I hoped he could have done better was the workmanship , better-maintained tools and offering better guidance on caring for the wound at home other than applying iodine solution and going back the following Sunday for review .
Kenya ’ s healthcare system has been rated among the best in Africa , but as glorious as it sounds , we are still so close to addressing access to emergency surgery and anesthesia . Kenya is one of Africa ’ s countries yet to implement its National Surgical Obstetrics and Trauma Plans – well - it ’ s there on paper . It has lightly been covered under the controversial Social Health Insurance Act 2023 under the government-funded Emergency and Chronic Illness Fund , with a fine print that the beneficiary must first exhaust their Social Health Insurance Fund .
Let ’ s take a step back . Why do you and I need to care about surgical and anesthesia policy ? Have you or someone you know been through surgery ? It ’ s nerve-wracking to both the patient and caregiver . The
Lancet Commission estimated that 143 million people in Sub-Saharan Africa and South Asia need additional surgical procedures per year . Yet , according to the report , investing in surgery is more affordable than Malaria and Tuberculosis combined .
In 2015 at the 68th World Health Assembly , Member states passed resolution 68:15 on Strengthening Emergency Surgical and Anesthesia Care as a Component of Universal Health Coverage . Resolution WHA76.2 Integrated Emergency , Critical , And Operative Care for Universal Health Coverage and Protection from Health Emergencies in 2023 followed this . These policies seek political goodwill in prioritizing surgical and anesthesia care by member states .
In July 2023 , the first-ever Pan-African Surgical Healthcare Forum ( PASHeF ) brought together Ministries of Health from across Africa , Kenya included , to discuss strategies to strengthen Africa ’ s surgical systems and improve patient outcomes bringing brighter futures including children living with clefts . It interrogated the formulation and implementation of the National Surgical Obstetrics and Anesthesia Plans ( NSOAPS ) which , among other critical factors , mitigate against mortality or permanent disability from easily preventable surgical conditions .
The forum which was hosted in Rwanda featured strategic partners including the Ministry of Health Rwanda , University of Global Health Equity , and Smile Train , the world ’ s largest cleft-focused charity . Smile Train traditionally partners with local medical professionals to provide safe , timely , and quality cleft care . Its scalable and sustainable model is proof of concept in supporting countries looking to implement their surgical obstetrics trauma and anaesthesia ( SOTA ) plans . Smile Train is part of the success in the implementation of NSOANP in Nigeria and NSOAS in Zimbabwe .
PASHeF is a great platform for African countries to learn from one another in surgical policy formulation and implementation , including investing in infrastructure , training , and funding for surgical services , to make them equitable and accessible .
As the Kenya government implements the Social Health Insurance Fund , how much of it covers surgery ? How educated is the public about their right to surgical care ? How well-equipped and trained are our medical professionals to handle basic emergency surgical services ? As communicators , we need to ask these questions as part of public participation . On the other hand , the Ministry of Health has a heavy task of sensitizing the public on how the new act works more than how much it costs . It is critical to develop awareness campaigns that encourage and show the value of paying the premiums and how they translate on the ground .
As I continue to regain a grip on my dominant hand , I think about children born every three minutes with clefts . They need safe and timely surgery that saves them from a lifetime of stigma and isolation . We all deserve quality surgical care as close to our doorsteps as possible , that is covered by national insurance . I hope that as we walk into 2024 , the PASHeF 2.0 coming later in the year will see Kenya being more vocal about its prioritization of surgical care . Until then , be careful around sharp objects !
Emily Manjeru is the Communications Manager for Africa at Smile Train . You can commune with her via mail at : Emilymanjeru @ gmail . com .
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