Health is Political

By Patricia Nudi

The Universal Health Coverage course was a big eye-opener in my health advocacy career. I have always known that Universal Health has many facets to it but never fully understood how the different pieces of the puzzle that make UHC come together and why one facet cannot function optimally without the other. Through the course, I learned that health is a political issue. As health advocates, our work ought to begin from the point of interrogating political manifestos, advocating for change in line with those manifestos and legislative frameworks and, holding leaders accountable. The training also solidified my knowledge of strategic purchasing and the pros and cons of the various health insurance schemes.


Health and social accountability


Before the training, I concentrated more on advocacy at the executive level but after the training, I realised the importance of community influence on budget-making processes. As a result, I interacted with the political manifesto of the Kisumu County Governor and adjusted my asks in line with it. I also embraced social accountability as a tool for influencing political will: I did this by championing the setting up of a team that will ensure that social accountability on UHC is realised in Kisumu County. Together with a team of grassroots organisations, we identified community champions who will work closely with the county health committees to present action plans, mobilise communities to participate in public participation forums and other budget-making processes and, demand accountability from the political class. Through this structure, we have managed to interact with the budget process at the Annual Development Plan stage.


Health cannot operate in a vacuum


I remember the words of Dr. Gitahi Githinji, AMREF Global CEO, during the course:  “Tax efficiency and high population affect per capita public allocation.” Health cannot operate in a vacuum and to effectively advocate for an efficient health system, we must also address taxation, corruption, procurement, human resource, poor health seeking behaviour, bad governance, poverty and leadership. Corruption, waste, inefficiency and lack of transparency undermine the progress of UHC; in order to effectively sort out the health issues, we must ensure that all other issues affecting accessibility, availability, acceptability and quality of health care are sorted out. Health advocates must remain vigilant and ensure they are always at the table when decisions are being discussed. We must ensure that the leaders who ascend to power, care about health and all its determinants and we must hold them accountable to the promises they make.

The training solidified my resolve to advocate for and ensure the following: that political manifesto promises are followed; that policies and laws are made and implemented; that budgetary allocations for health are made, released and properly accounted for; that strategic plans are implemented and that service charters are promulgated and honoured. I am grateful for the opportunity that the Advocacy Accelerator scholarship gave me to attend this training. It has truly revolutionised the way I carry out advocacy.

Meet the author

Patricia Nudi Orawo is an advocacy and policy specialist with over 10 years’ experience managing health advocacy projects specifically in the following fields:

  • Universal Health Coverage
  • Sexual Gender Based Violence
  • Sexual Reproductive Health & Rights
  • Social Accountability and Mobilisation
  • Gathering and Dissemination of Research Findings on Human Rights Based Approach to Health (Accessibility, Availability, Acceptability and Quality of health services).

She is the founder of numerous Reproductive Health grassroots initiatives and has additionally worked at KMET Kenya. She has conducted consultancies for Global Health Strategies, Women Deliver young leader’s project in Kenya, AMREF, and Access to medicines among others.

She is a 120 under 40 nominee and an International Women Health Coalition (IWHC) young leader. She sits in a number of boards. She has spoken at the World Health Assembly, ICPD 25+, Commission on the Status of Women, UN High Level Meeting on UHC and ICFP’s Not Without FP Conferences.

Patricia is currently pursuing a master in Public Policy degree and holds a Bachelor of Laws degree (LLB) (Hons). Her purpose is to interpret laws and declarations with a view of creating impact at grassroots levels. Her work centres on engagement of duty bearers and rights holders to strike a cohesive balance between law and health, policy and practice.