Kenya’s blood supply has been supported by the US government through the US President’s Emergency Plan for Aids Relief (Pepfar) since 2004 (U.S Embassy in Kenya, n.d.).Pepfar has been funding blood collection, testing and policy issues but since 2017, Pepfar has been cutting its funding to Kenya and the supply shock is already felt in the country. The reason for the cut in funding has been attributed to Kenya largely achieving most of its PEPFAR goals and Kenya’s plan towards universal health coverage which is hoped to ensure Kenyans receive the quality health services they need without suffering financial hardship. Universal Health Coverage was launched in December 2018 (The Council of Governors, 2018) with four pilot counties but there is no indication that blood safety is part of the package. Despite Pepfar giving the Kenyan government year on notices to plan for the transition to sustain results, the government seems surprised with the Cabinet Secretary Ministry of Health, Sicily Kariuki requesting for a six-month extension for funding but was denied.
In 2016, Pepfar spent on HIV and Blood safety services nearly 40% of what the government spent on its entire health sector and as the Ministry of Health transitions to fully funding its programs, it is critical that it is supported by dynamic budgetary changes and proper coordination between the Kenyan government and Pepfar. As Pepfar reduced its spending, the Ministry of Health was expected to absorb its own costs. On September 12th 2019, the CS Health in a press brief assured Kenyans that blood transfusion services will not be affected by the withdrawal of funding from Pepfar (Health, 2019). But with the National centers running out of blood and National testing laboratories running out of automated screening reagent, are the services really unaffected?
Kenya National Blood Transfusion Service (KNBTS) was established in 2000 within the Ministry of Health to collect, test, process and distribute blood and blood products (KNBTS, n.d.). KNBTS manages six regional blood transfusion centers: Nairobi, Nakuru, Kisumu, Eldoret, Mombasa, Embu and the satellite centers at the Counties. According to KNBS, students in secondary schools and colleges are the biggest blood donors (80%) in Kenya. When schools and colleges are in recess, hospitals face shortages of blood supply forcing patients to buy blood from private hospitals and surgeries that require a lot of blood suspended. According to the World Health Organization (WHO) the minimum amount of blood a country needs is 1% of its population. With Kenya’s population of 47,564,296, a minimum of 470,000 units of blood is needed.
Chart 1: Pints of Blood Collected in Kenya in 2019 versus the target.
Source: (Prevention, 2016)
KNBTS has tried a few campaigns to mobilize blood donation in the country (KNBTS, n.d.). The Show Your Love blood donation campaign and Pledge 25 campaign in 2019 was aimed at reaching the annual target set by the World Health Organization of 470,000 units of blood but only 164,275 units was collected. Even when there is supply, there is no system in place to support donations due to lack of blood bags and testing reagents at hospitals forcing them to send blood to Nairobi for testing. This increases the chances of error and unsafe blood transfusion will place recipients at the risk of contracting HIV, hepatitis B, hepatitis C and syphilis.
Cabinet Secretary Ministry of Health, Sicily Kariuki said the ministry had drafted the Blood Bill to make blood donations sustainable in Kenya. The bill will provide a robust legislative and regulatory framework that aims to strengthen the current blood transfusion governance structures that will facilitate steady supply of the country’s blood needs. Countries like Ethiopia, Rwanda and Tanzania have managed to completely absorb the cost involved in blood collection and testing. Kenya too can achieve this through policy implementation and proper budget allocation.
Table 1: Percentage share of funding to national blood transfusion services from the Ministry of Health.
Source: (Prevention, 2016)
Countries that have successfully transitioned to covering their costs attribute it to the use of incentives and technology in blood donation. Kenya’s blood supply is procured through donations with no structure for incentives. The table shows that from the year 2014-2016, government spending on blood transfusion services in Rwanda increased by about 800% while in Tanzania and Ethiopia government spending increased by 245% and 85% respectively. Kenya however is an outlier as it shows a decline in government spending on blood safety services. In 2014, Kenya contributed 67% of funding towards blood transfusion services but significantly dropped to 25% by the year 2016. The Ministry of Health had enough time to prepare for this transition but did not put a plan in place to make it successful.
With our blood supply falling, this maybe the time Kenya experiments with new incentives for blood supply. In Rwanda, the NBTS instituted a cross-cutting incentive system to attract and retain voluntary blood donors with repeat donors qualifying for items such as insecticide-treated bed nets to combat malaria. In Nigeria, a mobile application that reminds donors on the next round of donation has been used to encourage repeat donors. Equipping the public with information on the benefits of blood donation and incentives such as the free medical checkup, will go a long way in encouraging potential donors and increasing the country’s blood supply.
With Kenya’s budget deficit and increasing public debt, there is concern that the government will not do much to avert the blood crisis soon and Kenyans might continue pleading for blood on social media when disaster strikes. This moment is the most appropriate for Kenya to introduce an incentive either in cash form or non-cash form to meet the country’s blood demands.
References
Governors, C. o. (2018, 12 18). The Council of Governors. Retrieved from Universal Health Coverage: https://cog.go.ke/component/k2/item/122-launch-of-the-universal-health-coverage-pilot
Health, M. o. (2019, 09 12). Ministry of Health. Retrieved from Ministry of Health: http://www.health.go.ke/government-to-ensure-sustainability-and-availability-of-blood/
Kenya, U. E. (n.d.). U.S Embassy in Kenya. Retrieved from U.S Embassy: https://ke.usembassy.gov/our-relationship/pepfar/
KNBTS. (n.d.). KNBTS. Retrieved from Kenya National Blood Transfusion Services: https://nbtskenya.or.ke/
Prevention, C. f. (2016, 02 12). Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/mmwr/volumes/65/wr/mm6505a4.htm#T1_down
While Kenya has long implemented the NHIF (National Hospital Insurance Fund) whose core mandate is to provide medical insurance coverage to all its members and their declared dependants and also to make medical care affordable, enrolment rates, particularly in the voluntary and informal sectors, remain low. Yet, NHIF is the most common type of health […]
Introduction According to the United Nations, Double Taxation Agreements (DTAs) are “bilateral agreements between two countries which allocate taxing rights over income between those two countries thereby preventing double taxation of income. The main objective of DTAs therefore, is to prevent and or eliminate avoidance and evasion of taxes on income and capital by both […]
Courts as Monopolies Access to justice is fundamental in any democratic society, ensuring individuals can pursue their legal rights and seek redress for grievances. However, when courts operate as monopolies, it can have implications for access to justice. Monopolies have exclusive control or dominance over a particular market or industry. Courts are monopolies because they […]
Introduction Public policies are formulated to achieve specific societal outcomes, and when their implementation is delayed or falls short, it can lead to significant adverse consequences on the overall functioning of the system they are designed to govern. Implementation delays in government policies can occur for various reasons. These include intricate and protracted bureaucratic implementation […]
Introduction Every year since 2007, various countries around the world come together to celebrate Data Privacy Day, observed on the 28th of January. For Kenya, this day commemoration, spearheaded by the Office of the Data Protection Commissioner, brings together Data controllers, industry players, consumers and businesses. The theme for the 2024 celebration is: ‘Fostering a […]
Post date: Fri, Feb 14, 2020 |
Category: Budget |
By: Darmi Jattani, |
Kenya’s blood supply has been supported by the US government through the US President’s Emergency Plan for Aids Relief (Pepfar) since 2004 (U.S Embassy in Kenya, n.d.).Pepfar has been funding blood collection, testing and policy issues but since 2017, Pepfar has been cutting its funding to Kenya and the supply shock is already felt in the country. The reason for the cut in funding has been attributed to Kenya largely achieving most of its PEPFAR goals and Kenya’s plan towards universal health coverage which is hoped to ensure Kenyans receive the quality health services they need without suffering financial hardship. Universal Health Coverage was launched in December 2018 (The Council of Governors, 2018) with four pilot counties but there is no indication that blood safety is part of the package. Despite Pepfar giving the Kenyan government year on notices to plan for the transition to sustain results, the government seems surprised with the Cabinet Secretary Ministry of Health, Sicily Kariuki requesting for a six-month extension for funding but was denied.
In 2016, Pepfar spent on HIV and Blood safety services nearly 40% of what the government spent on its entire health sector and as the Ministry of Health transitions to fully funding its programs, it is critical that it is supported by dynamic budgetary changes and proper coordination between the Kenyan government and Pepfar. As Pepfar reduced its spending, the Ministry of Health was expected to absorb its own costs. On September 12th 2019, the CS Health in a press brief assured Kenyans that blood transfusion services will not be affected by the withdrawal of funding from Pepfar (Health, 2019). But with the National centers running out of blood and National testing laboratories running out of automated screening reagent, are the services really unaffected?
Kenya National Blood Transfusion Service (KNBTS) was established in 2000 within the Ministry of Health to collect, test, process and distribute blood and blood products (KNBTS, n.d.). KNBTS manages six regional blood transfusion centers: Nairobi, Nakuru, Kisumu, Eldoret, Mombasa, Embu and the satellite centers at the Counties. According to KNBS, students in secondary schools and colleges are the biggest blood donors (80%) in Kenya. When schools and colleges are in recess, hospitals face shortages of blood supply forcing patients to buy blood from private hospitals and surgeries that require a lot of blood suspended. According to the World Health Organization (WHO) the minimum amount of blood a country needs is 1% of its population. With Kenya’s population of 47,564,296, a minimum of 470,000 units of blood is needed.
Chart 1: Pints of Blood Collected in Kenya in 2019 versus the target.
Source: (Prevention, 2016)
KNBTS has tried a few campaigns to mobilize blood donation in the country (KNBTS, n.d.). The Show Your Love blood donation campaign and Pledge 25 campaign in 2019 was aimed at reaching the annual target set by the World Health Organization of 470,000 units of blood but only 164,275 units was collected. Even when there is supply, there is no system in place to support donations due to lack of blood bags and testing reagents at hospitals forcing them to send blood to Nairobi for testing. This increases the chances of error and unsafe blood transfusion will place recipients at the risk of contracting HIV, hepatitis B, hepatitis C and syphilis.
Cabinet Secretary Ministry of Health, Sicily Kariuki said the ministry had drafted the Blood Bill to make blood donations sustainable in Kenya. The bill will provide a robust legislative and regulatory framework that aims to strengthen the current blood transfusion governance structures that will facilitate steady supply of the country’s blood needs. Countries like Ethiopia, Rwanda and Tanzania have managed to completely absorb the cost involved in blood collection and testing. Kenya too can achieve this through policy implementation and proper budget allocation.
Table 1: Percentage share of funding to national blood transfusion services from the Ministry of Health.
Source: (Prevention, 2016)
Countries that have successfully transitioned to covering their costs attribute it to the use of incentives and technology in blood donation. Kenya’s blood supply is procured through donations with no structure for incentives. The table shows that from the year 2014-2016, government spending on blood transfusion services in Rwanda increased by about 800% while in Tanzania and Ethiopia government spending increased by 245% and 85% respectively. Kenya however is an outlier as it shows a decline in government spending on blood safety services. In 2014, Kenya contributed 67% of funding towards blood transfusion services but significantly dropped to 25% by the year 2016. The Ministry of Health had enough time to prepare for this transition but did not put a plan in place to make it successful.
With our blood supply falling, this maybe the time Kenya experiments with new incentives for blood supply. In Rwanda, the NBTS instituted a cross-cutting incentive system to attract and retain voluntary blood donors with repeat donors qualifying for items such as insecticide-treated bed nets to combat malaria. In Nigeria, a mobile application that reminds donors on the next round of donation has been used to encourage repeat donors. Equipping the public with information on the benefits of blood donation and incentives such as the free medical checkup, will go a long way in encouraging potential donors and increasing the country’s blood supply.
With Kenya’s budget deficit and increasing public debt, there is concern that the government will not do much to avert the blood crisis soon and Kenyans might continue pleading for blood on social media when disaster strikes. This moment is the most appropriate for Kenya to introduce an incentive either in cash form or non-cash form to meet the country’s blood demands.
References
Governors, C. o. (2018, 12 18). The Council of Governors. Retrieved from Universal Health Coverage: https://cog.go.ke/component/k2/item/122-launch-of-the-universal-health-coverage-pilot
Health, M. o. (2019, 09 12). Ministry of Health. Retrieved from Ministry of Health: http://www.health.go.ke/government-to-ensure-sustainability-and-availability-of-blood/
Kenya, U. E. (n.d.). U.S Embassy in Kenya. Retrieved from U.S Embassy: https://ke.usembassy.gov/our-relationship/pepfar/
KNBTS. (n.d.). KNBTS. Retrieved from Kenya National Blood Transfusion Services: https://nbtskenya.or.ke/
Prevention, C. f. (2016, 02 12). Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/mmwr/volumes/65/wr/mm6505a4.htm#T1_down
While Kenya has long implemented the NHIF (National Hospital Insurance Fund) whose core mandate is to provide medical insurance coverage to all its members and their declared dependants and also to make medical care affordable, enrolment rates, particularly in the voluntary and informal sectors, remain low. Yet, NHIF is the most common type of health […]
Introduction According to the United Nations, Double Taxation Agreements (DTAs) are “bilateral agreements between two countries which allocate taxing rights over income between those two countries thereby preventing double taxation of income. The main objective of DTAs therefore, is to prevent and or eliminate avoidance and evasion of taxes on income and capital by both […]
Courts as Monopolies Access to justice is fundamental in any democratic society, ensuring individuals can pursue their legal rights and seek redress for grievances. However, when courts operate as monopolies, it can have implications for access to justice. Monopolies have exclusive control or dominance over a particular market or industry. Courts are monopolies because they […]
Introduction Public policies are formulated to achieve specific societal outcomes, and when their implementation is delayed or falls short, it can lead to significant adverse consequences on the overall functioning of the system they are designed to govern. Implementation delays in government policies can occur for various reasons. These include intricate and protracted bureaucratic implementation […]
Introduction Every year since 2007, various countries around the world come together to celebrate Data Privacy Day, observed on the 28th of January. For Kenya, this day commemoration, spearheaded by the Office of the Data Protection Commissioner, brings together Data controllers, industry players, consumers and businesses. The theme for the 2024 celebration is: ‘Fostering a […]