According to the World Health Organization (WHO), Universal Health Care (UHC) is aimed at ensuring that all people are able to receive medicine and treatment without suffering financial hardships. Kenya is working to implement this healthcare strategy, with the goal of allowing more Kenyans access to healthcare in public health facilities. Additionally, Kenyans will be able to access the same services in private hospitals without digging very deep into their pockets. Despite this bold move by the Kenyan President to create affordable healthcare for all, human resources, finance, essential medical products, technologies and service delivery remain challenges.

The story of a woman under the alias of “Dorothy” exemplifies the financial challenge in assessing care at treatment sites. Dorothy was enrolled in a study looking at integrating HPV testing into community health campaigns, and was ultimately referred to a selected health facility in Kisumu where she was booked for treatment. After she received treatment, she further was referred for biopsy testing. But, months later, she had still not been able to receive this service and therefore gave up. Dorothy’s neighbor happened to have been enrolled in the same study. Her neighbor followed up and was scheduled for treatment, but asked Dorothy’s opinion. Dorothy narrated her story, and realized from her neighbor that there was treatment being offered at a different health facility. Hoping to get a second opinion, Dorothy decided to see a doctor at that different facility.

Dorothy was well received by a different staff, which advised her to buy a care card as the first step at the treatment site. But, Dorothy’s challenge began here; she didn’t have the 50k to purchase a medical care. Because of her dire need to seek care, she was lucky to find thrown away cash receipts in acknowledgement of payment. She presented these at the front desk of the facility along with her vitals written at the back of the receipt.

She presented this to me and, because the receipt looked untidy, I became curious and wanted to read the details more. To my surprise, the receipt contained a male name issued the first week of October, and this was the last day of October. I read on her face the panic she was already going through. I was careful not to confront her in front of other clients, so I called her aside. She narrated her story of having financial problems and even having to walk 5km to the facility. I was forced to part with 50k to assist her get a genuine health record card. This is just one of those many challenges both clients and health providers find themselves having at public facilities in seeking UHC.

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