Lessons from Marwa

Lessons from Marwa

By Lorraine Anyango

The setting up and operalization of the Marwa Kisumu Solidarity Health Cover has generated great lessons for the National roll-out of the Universal Health Cover (UHC).

The same lessons are what the Katsina State Contributory Health Care Management Agency  (KTSCHMA) leaders flew miles from Nigeria to learn.

Portability of patient records was one of the greatest lessons from Marwa, as a digital platform was established making it easy to get a patient’s history upon referral as the 49 Marwa facilities were linked.     

Initially, facilities worked in Silos, and hence whenever a referral was done doctors put aside preliminary investigations, begging afresh and this ended up costing more money. 

“Networking facilities have increased access to medical care, cutting down on cost saving time and money,” Mr. Gilbert Osoro of NHIF said.

Marwa also realized joint monitoring of government facilities in a bid to enhance quality to meet international standards.

Marwa’s footprints are those of robust and resilient primary care, as level one and two facilities have realized capitations and resources plowed back directly to them to facilitate their development.

Since it started operating, Marwa has also facilitated the harvest of data hence data-driven decisions are being undertaken in Kisumu County.   

These were some of the lessons that a delegation comprising the Honorable Commissioner of the Ministry of  Health, Katsina Nigeria, Engr Yakubu Nuhu Danja, Mr. Isah Ismaila Kaita who is the chair of KTSCHMA, and Mr. Muhammed Tukur Ibrahim Safana the Director General KTSCHMA among other leaders from Katsina were shared with.

The team was accompanied by PharmAccess, County Director Dr. Wasunna Owino, and received by Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) Chief Executive Officer Dr. George Rae together with the hospital’s Executive Committee Members.                    

 “As regards the provision of insurance for the informal sector, enforcement of the same remains an elephant, we need to find a way to navigate this.” Mr. Osoro added as he shared lessons from Marwa that they were implemented under the National UHC.

He proposed a policy to ensure that one’s business entity is registered, the proprietors must also pay for an insurance-compliant certificate.

Mr. Osoro added that there should be a provision for retired public servants to be part of the insurance scheme.

The KTSCHMA is a partner of pharmAccess.The team’s purpose for visiting Kenya was to understand the guiding principles and process in the development of a National Health Insurance scheme while working together with NHIF.

The team also sought to get insights into NHIF’s universal health coverage policy, the Kenya financing strategy, and the benefits package.

 Their specific area of interest at the national level included financing modalities, the coverage process, and gaps in the guaranteed basic package.

They also sought to understand revenue generation, government budgets for UHC, and the contribution of the informal sector.

The team also wanted to learn how people were accessing care at the county level and financing of UHC at the county level and Marwa’s sustainability.

The team toured JOOTRH as it’s the main referral facility for Marwa.

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