• The County Commissioner, Siaya County
• Honourable Speaker, Siaya County Assembly
• Honourable Members of the County Assembly
• County Executive Committee Members
• Development Partners
• Other National and County Government Officers present
• Members of the Media
• Distinguished Guests
• Ladies and Gentlemen
1. First and foremost, I wish to take this opportunity to welcome to Siaya County all our guests who have come from outside the County to join us on this special occasion of the official launch of Universal Health Coverage (UHC) Scale-up for Siaya County. You will recall that on 7th February this year His excellency President Uhuru Kenyatta presided over the National Launch of UHC Scale-up at a ceremony which was held in Mombasa County. Consequent to the National Launch, it was agreed that all Counties except Mombasa would thereafter organize and hold their own County Launches. I am glad that today we are gathered here to officially launch our County’s UHC Scale-up.
2. As we are all aware, health is one of the functions which is shared between the National Government and County Governments by dint of the provisions of the Fourth Schedule of the Constitution of Kenya, 2010 with the National Government taking the function of health policy while counties handle all county health services. Besides delineating the health functions, the Constitution makes health one of the economic and social rights by providing that every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care, emergency medical treatment and reasonable standards of sanitation.
Ladies and gentlemen,
3. The above constitutional dictates and aspirations shaped my vision in the health sector when I took over the leadership of this great County as Governor in 2013. From the onset of my administration, I embarked on a journey towards making health services accessible, qualitative and affordable in Siaya County; the three most important pillars of Universal Health Coverage. I, in particular, focused in taking health services closer to the people within their communities by strengthening and deepening primary health services. In this regard, from 2013 to-date my government has constructed and operationalized 51 new Dispensaries thus increasing the number of public health facilities in Siaya County from 120 in 2013 to 171. Besides the public facilities there are 19 Faith-Based health facilities and 79 private facilities in the County making a total of 269 health facilities. In addition, we have 221 Community Health Units supplementing provision of primary health care services. These Units are supported by a robust team of 2128 Community Health Volunteers (CHVs).
4. In the same period, my government also constructed and operationalized 43 Staff Houses to provide accommodation for Health Care Workers within the health facilities. In order to improve on Mother and Child Health, my government has constructed and operationalized 25 Maternity Units and to further improve curative interventions, we constructed 10 Wards and 3 Laboratories at our existing health facilities. The health facilities are all served with an elaborate road network and most of them are equally served with other basic amenities like water and power.
5. Besides the above investments and improvements at our Level 2 and 3 health facilities, my government has also invested immensely in key specialized services mainly at our Level 4 Hospitals to further improve our health outcomes. Key interventions in this regard include the establishment of an Oxygen Plant, Diagnostic services, Renal services, Modern Maternities with Theatre, Radiology services including modern X-Rays and CT Scan, Endoscopy services, Intensive Care Unit among others.
6. These massive infrastructural investments in new facilities and improvements in existing ones have cumulatively improved access to health services by the general population in the County and we are presently operating within the World Health Organization requirement of 5 kilometers radius on access to health service. As a consequence of these deliberate and targeted interventions, the County has experienced improved outcomes in a number of key health service delivery indicators since 2013. For instance, major surgical operations conducted increased from 695 in 2013 to 2781 in 2021. HIV prevalence declined from 23.7% to 16.2% with HIV positive pregnant mothers receiving Preventive Anti- Retroviral (ARVs) improved from 60% to 100%. Similarly, Malaria prevalence declined from 38% to 18.9%.
7. On Mother and Child Health, children under one year who received full immunization improved from 60% to 90%. Pregnant women completing 4th Antenatal Clinic Attendance improved from 17% to 70% while skilled births also improved from 31% to 94%. The number of women screened for cervical cancer also improved from 1,498 to 30,160. Cases of cholera outbreaks which used to be rampant have been eliminated courtesy of improved public health promotion and sanitation. Indeed, Siaya County has achieved Open Defecation Free (ODF) status. Clients cured from Tuberculosis increased from 84% to 89% thus illustrating good TB intervention and treatment outcome. On the other hand, trends on non-communicable diseases like Diabetes and Hypertension indicate an upsurge over the period under review which is attributed to investment in diagnostic equipment which enabled early detection of the conditions.
Ladies and gentlemen,
8. The above achievements could not have been realized without the services of a committed health workforce. I wish to thank our health care workers for their dedicated service to our people. During my administration, my government has periodically invested in the recruitment of different cadres of health care workers. To-date we have recruited over 451 additional health care workers besides those who transited to the County Government from the National Government at the commencement of devolution and those supported by some of our development partners. However, there are still glaring staffing gaps in our human resource for health which call for continuous interventions in the future.
9. While the above positive indicators are a confirmation that we have done extremely well in terms of accessibility and to acceptable extent on quality of health services, the main challenge remains the cost of health care. Bearing in mind that Siaya County still ranks as one of the Counties with high disease burden in the Country as a result of high prevalence of Malaria, HIV, Tuberculosis the situation is not made any better with the emergence of new yet more lethal non- communicable diseases such as Cancer, Hypertension and Diabetes within our population. To address the challenge, the National Government has mainstreamed Universal Health Coverage as one of the President’s Big Four Agenda towards the economic and social development of the country. This calls for concerted and collaborative efforts and investments by the two levels of governments. In this regard, a number of interventions have been jointly and mutually undertaken. These include offering health services at primary level facilities free of charge while management of key conditions, such as HIV, TB and malaria are equally free of charge in all public facilities.
Ladies and gentlemen,
10. To further augment these efforts the National Government working together with County Governments through the Council of Governors came up with a strategy for a homogeneous implementation of the UHC agenda through a phased-out implementation programme. The first Phase was a pilot phase involving four counties namely Nyeri, Machakos, Isiolo and Kisumu and was geared towards input-based financing support for purchase of medicines, recruitment of human resource for health and training of community health volunteers in the four counties. The second Phase focused on health systems strengthening through input-based financing for basic equipment, medicines and human resource and all the 47 counties were beneficiaries. The third Phase was a transition from input-based to out-put based and involved the support for initial 1 million indigent households in Kenya. Siaya County benefitted with an allocation of 19,456 indigents. Of this number 11,084 has been biometrically registered and are currently beneficiaries of NHIF medical scheme. The fourth Phase envisions a full transition to UHC Insurance Scheme which shall be progressively expanded to cover all the 5.1 million poor households.
11. Away from the above collaborative efforts by the two levels of governments, it is worthy of note that my government has always been committed to the UHC course. In 2018-2019 Financial Year my government allocated Kshs. 10 Million for increasing access and quality of health care for the vulnerable group through Universal Health Care on a pilot initiative which targeted 3000 indigents in the county. However, the implementation of this initiative was constrained by lack of a policy framework. We have since developed a Universal Health Coverage Policy whose overarching goal is to ensure that all residents of Siaya County obtain health services they need without any barriers while ensuring that the quality of health services meets the minimum required standard. The Policy provides a sound framework for implementation of UHC Scale-up in the County.
Ladies and gentlemen,
12. With increased distress in the country’s economy it is becoming abundantly evident that a number of people cannot afford the cost of health services. My office routinely receives requests for waiver of medical charges on a trend that is mind boggling and outrightly unsustainable. It is for this reason that I wish to recommit towards the UHC initiative and implore the incoming government to prioritize it in its health sector programme. In the same vein, I wish to appeal to all our people to register with NHIF to cushion their families against the high cost of out of pocket medical expenses.
13. As I conclude, I wish to thank all our development partners who continue to work with us in the health sector and indeed in all other spheres of our development towards improvement of the health and welfare of the people of Siaya. In the same vein, I appeal to other partners to come forth and join hands with us in initiating programs that will improve the lot of the ordinary citizenry of Siaya County.
Thank You! God Bless.
H.E. CORNEL RASANGA AMOTH, EGH
GOVERNOR, COUNTY GOVERNMENT OF SIAYA