Privatization of Health Care in Kenya Limits Access, Study Finds

Privatization of Kenya’s healthcare sector has had a negative impact leading to exclusion, draining public resources, and pushing people into poverty, according to a report from Kenyan human rights organization Hakijamii and New York University’s Center for Human Rights and Global Justice.

The report says this has left the public sector ill-equipped to meet the needs of the population pushing many into poverty.

“The privatization of healthcare in Kenya has led to high costs for care, failed to deliver on public health priorities, reduced access to care, and pushed people into poverty. As the role of private actors has grown, individuals have been forced to spend more money for less care and public resources have been squandered, diverted to private profits and suspect initiatives,” part of the report titled  “Wrong Prescription: The Impact of Privatizing Healthcare in Kenya”, reads.

According to the report, private-sector healthcare spending by patients is estimated to be 12 times more than the public sector, having risen by 53 per cent between 2013 and 2018.

“The haves and the have-nots experience entirely different private sectors. Private health care is often disastrous for poor and vulnerable community members who are left with low-quality, low-cost private providers that are too often unsafe and even illegal,” said Rebecca Riddell, lead author of the report, and co-director of the Human Rights and Privatization Project at NYU Law says.

The report is based on interviews with 55 community members; more than 130 private and public healthcare workers, community health volunteers, government officials, and experts and activists engaged on issues of health and human rights; and a review of public documents, surveys, and laws related to health in Kenya.

Interviews were conducted by trained human rights researchers between March and May 2021 in Isiolo, Mombasa, and Nairobi.

Private providers need to extract profits, face higher borrowing costs than the public sector, and often charge patients overwhelmingly more than public providers,” HakiJamii Executive Director Dr Nicholas Orago says.

The report further notes that “Private providers’ focus is on making a profit, not providing a strong healthcare system that meets national objectives. Because of these misaligned incentives, the private sector neglects important public health priorities.”

For instance, it discloses that the International Finance Corporation (IFC), the World Bank Group’s private sector-focused arm, has committed over USD $50 million to private healthcare companies in Kenya since 2010 and encouraged private sector-friendly reforms and amalgamated financing from development actors.

Similarly, the Bill and Melinda Gates Foundation has supported the growth of the private sector in Africa including through the development of technical expertise and investments.

“Despite these failures, the government and international actors continue to promote the privatization of care at the expense of improving the public health care system.

Policymakers have misdiagnosed the situation, and should undertake a thorough impact evaluation with a view to reconsidering the overall approach,” the authors of the report note.

“Ultimately, the privatization of healthcare in Kenya is undermining efforts to achieve universal health coverage.

The choice to prioritize a private-sector friendly social insurance program, the National Hospital Insurance Fund (NHIF), will not resolve, and may actually exacerbate these problems.” 

They emphasise that the public health system is far better positioned to deliver on public goals than the private sector. 

“Health policy and expenditure should prioritize the public system. National and county governments should work together to ensure the public healthcare system provides accessible, affordable,  quality care for all Kenyans, and that healthcare workers enjoy dignified working conditions.

Greater transparency and access to information relating to the private sector’s role in healthcare is also sorely needed,” they say.