President William Ruto has placed Community Health Promoters at the centre of his defence of Kenya’s healthcare reforms, promising to equip all 107,800 workers with new smartphones and modern health kits in the next 90 days.
The announcement, made on Tuesday at the Kenya Health Summit at the Kenyatta International Convention Centre in Nairobi, comes as the President faces sustained criticism over the rollout of the Social Health Authority and the state of public healthcare.
Ruto met about 5,000 CHPs on the sidelines of the summit and used the occasion to praise their work at the grassroots, where they provide basic health information, conduct screenings and refer patients to health facilities.
“Our Community Health Promoters are the pillar of our primary healthcare at the grassroots and we must therefore support and empower them to serve our people effectively,” the President said.
He said the new equipment would replace kits and smartphones that have been in use for the past three years, following complaints from CHPs that some of their tools had become outdated.
The move is the latest in a series of measures through which the administration is seeking to strengthen the CHP programme and make primary healthcare the first line of defence against disease.
Ruto had in July ordered that every CHP receive a new screening kit and smartphone within 90 days. He also announced that all CHPs would be enrolled under SHA, with Sh390 million set aside for the programme and counties expected to contribute half of the amount.
The President has described the workers as a critical part of his universal healthcare strategy, arguing that the battle for affordable healthcare cannot be won in hospitals alone.
“UHC will not be won in hospitals. It will be won in households through our Community Health Promoters,” Ruto said during an earlier meeting with Nairobi CHPs.
That strategy, however, has run into a broader political argument over whether the government's health reforms are delivering the promised relief to Kenyans.
Opposition leaders have seized on problems surrounding SHA to challenge Ruto's record, with Nairobi Senator Edwin Sifuna among the most vocal critics.
Sifuna recently accused the government of presiding over a healthcare system in which hospitals lack essential drugs and patients continue to struggle to access services.
“Our hospitals have no drugs, and people are not getting health services as required because of his dubious health insurance, the Social Health Authority,” Sifuna said in August, while promising to overhaul the system if elected President.
In another attack, Sifuna said the problem went beyond the insurance scheme.
“We have no personal beef or hatred against President Ruto, but we have a big problem with how he has messed up this country. We have a collapsed healthcare system where SHA is not working,” he said.
Former Deputy President Rigathi Gachagua has also made SHA part of his broader criticism of the Ruto administration.
In his recent assessment of the President's four years in office, Gachagua faulted the government over healthcare costs and policy decisions, while earlier accusing the administration of rushing the transition from NHIF to SHA.
The criticism comes against a backdrop of continuing financial difficulties in the health sector. In May, SHA owed health facilities more than Sh77 billion, citing Rural and Urban Private Hospitals Association chairman Brian Lishenga, who said the debt had continued accumulating.
The government, however, insists the reforms are beginning to change how healthcare is delivered.
Ruto has repeatedly defended SHA, arguing that Kenyans should judge the system by the number of people accessing treatment rather than by the political criticism surrounding its rollout.
“Those asking us to return to NHIF are threatening the health of our people,” Ruto said recently. “If they want to know whether SHA is working, they should ask the Community Health Promoters.”
His administration has also pointed to the expansion of grassroots healthcare as evidence that its reforms are moving beyond policy announcements.
The President says CHPs are registering households, identifying illnesses early, educating families and referring patients for treatment. In Nairobi alone, the government says CHPs have registered hundreds of thousands of households through the electronic Community Health Information System.
Ruto has received backing from some leaders in his broad-based administration. Nairobi Governor Johnson Sakaja said Tuesday that the President's health reforms could become one of his most enduring legacies, arguing that they are giving effect to the constitutional right to healthcare.
But the political question remains whether the government's investment in primary healthcare can translate into an improvement that Kenyans can actually feel.
