Eating and sharing: Universal Health Coverage, citizenship and narratives of 'free' public healthcare in Kenya
Jacinta Victoria Syombua Muinde (University of Oslo)
Paper short abstract:
This paper explores the everyday realities of the recent implementation of Kenya's UHC pilot project to show how claims of corruption have shaped contradicting and competing narratives of 'free' public health provisioning and experiences of citizenship in the country.
Paper long abstract:
In the recent years, social protection projects such as cash transfers and 'universal' healthcare schemes have become a popular 'development' strategy in Africa. In Kenya, for instance, the government is piloting Universal Health Coverage (UHC) in several of its counties, after what has been perceived as successful implementation of cash transfers. Central to Kenya's UHC is not only the promotion of the country's national health insurance, the National Health Insurance Fund (NHIF), but also insistence on free access to health services and goods including medicines in public hospitals in the pilot counties. However, implementation of Kenya's UHC is faced with various challenges including corruption claims associated with NHIF and shortage, lack of and poor distribution of medicines. Indeed, studies on welfare provision in African countries have noted such factors as inadequate infrastructure and mismanagement of resources, mainly associated with corruption, as key to unequal or unfair redistribution of services and infrastructure. Yet with critical suggestions of an emerging new politics of distribution and redistribution in Africa, few studies have focused on the realities of how such challenges as corruption may inform the experiences and narratives of the state and citizenship in their specific local contexts such as of public health provision in Kenya. Based on ethnographic fieldwork in Kenya, this paper explores the everyday realities of the recent Kenya's UHC pilot project to show how claims of corruption have shaped contradicting and competing narratives of 'free' public health provisioning and experiences of citizenship in the country.
Welfare, redistribution and new forms of the "public good" [Sponsored by AFRICA: Journal of the International African Institute]