Introduction: One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different systems of health financing suggest that a strong public role in health financing is essential for health systems to protect the poor. Health systems with the strongest state role are likely to be more equitable and achieve better aggregate health outcomes. Using Kenya as a case study, this paper seeks to evaluate the progress and capacity of a middle income country in terms of health financing for universal coverage, and also to highlight some of the key underlying health systems challenges. Methodology: The World Health Report 2010: Health Systems Financing:The Path to Universal Coverage was used as the framework to evaluate the Kenyan healthcare financing system in terms of the provision of universal coverage for the population, and the Kenyan National Health Sector Services Fund Accounts (2011) provided the latest Kenyan data on health spending. Measuring against the four target indicators outlined, Kenya fared modestly with total health expenditure close to 4.5% of its GDP (3.75%), out-of-pocket payment below 40% of total health expenditure (30.7%), comprehensive social safety nets for vulnerable populations, and a tax-based financing system that fundamentally poses as a national risk-pooled scheme for the population. Results: Nonetheless, within a holistic systems framework, the financing component interacts synergistically with other health system spheres. In Kenya, out-migration from public to private of public health workers particularly specialist doctors remains an issue and financing strategies needs to incorporate a comprehensive workforce compensation strategy to improve the health workforce skill mix. Health expenditure information is systematically collated, but feedback from the private sector remains a challenge. Conclusion: As far as Service delivery is concerned, there is a need to enhance financing capacity to expand preventive care, in better managing escalating healthcare costs associated with the increasing trend of noncommunicable diseases. Additionally, health financing policies need to instill the element of cost-effectiveness to better manage the purchasing of new medical supplies and equipment. Good governance and leadership are needed to ensure adequate public spending on health and maintain the focus on the attainment of universal coverage, as well as making healthcare financing more accountable to the public, particularly in regards to inefficiencies and better utilization of public funds and resources.

An educational environment (EE) is made up of three major compo nents: the physical environment, the emotional climate and the intellectual climate. [1] The EE of professional health training is mainly determined by the interactions between different stakeholder groups and the organisational structures of the environment. [2] Ideally, the EE should foster intellectual activities and academic progression, while simultaneously encouraging friendliness, cooperation and support. It is important to get students' feedback on how they experience their EE. [3] Different studies aiming to assess medical or health sciences students' perceptions of their learning environment have been conducted in many developed and developing countries, such as the UK,

Background: Hand washing with soap and water is one of the most effective and inexpensive means of preventing infections. Rates of hand washing are low worldwide even amongst health care workers who should know about its importance. The aim of the study was to evaluate the knowledge, attitudes and hand washing practices both in and outside the hospital amongst medical students in Moi University. Method: This was a descriptive cross sectional survey carried out amongst randomly selected fourth to sixth year medical students of the of Moi University. A simple questionnaire exploring perceptions, attitudes and self reported behavior was used. Information obtained included biodata, awareness information and practice. Data were analyzed using descriptive statistics. Results: Two hundred and sixty one students participated in the study with an M: F of 1.5:1. Diarrhea diseases were most commonly recognized as being associated with contaminated hands. 37.6% washed their hands regularly after interacting with their patients while 33.9% did so only after the days work. 58.3% and 58.9% washed hands before meals and after defecating respectively. Use of soap was generally low. The greatest motivation for hand washing was fear of contracting disease, whilst constraints included lack of soap, forgetfulness and inconveniently located sinks. Conclusion: Hand washing rates are low amongst medical students in Moi University. Recommendation: There is need for regular education and re-education of students on hand washing practices.

Background: The current wave of Hemorrhagic fevers currently being witnessed require increased bio-risk assessment exercises and vigilance at all levels of the healthcare continuum. This article review will outline key subjects from an agenda-setting, multi-disciplinary panel convened to examine implications for health systems in Kenya. Discussion: Researchers" personal stories and media debates to define fundamental issues and opportunities for preparedness focused on three inter-linked subjects. First, the risks of the fear response itself were underlined as a danger to the reliability and stability of quality care. Second, healthcare workers" reservations were complicated by a demonstrable lack of societal and personal protections for infection prevention and control in communities and healthcare facilities, as evidenced by an ongoing cholera epidemic affecting over 5,000 patients across Kenya in 2015 alone. Third, a lack of clear messaging and course from leadership have limited organization and strengthened a level of suspicion in the government"s ability and obligation to mobilize an adequate response. Initial recommendations include urgent investment in the needed supplies and infrastructure for basic, routine infection control in communities and healthcare facilities, provision of assurances with securities for frontline healthcare workers, establishment of a multi-sector, "all-hazards" outbreak surveillance system, and engaging directly with key community groups to co-produce contextually relevant educational messages that will help decrease stigma, fear, and the demoralizing perception that the diseases defy remedy or control. Summary: The occurrence of hemorrhagic fevers especially the Ebola outbreak in West Africa provides an unprecedented opportunity for other countries like Kenya to make progress on tackling long-standing health systems weaknesses. These discussions emphasized the urgent need to strengthen capacity for infection control, occupational health and safety, and leadership coordination. Substantial commitment is needed to raise standards of hygiene in communities and health facilities, build mechanisms for co-operation across sectors, and engage community stakeholders in creating the needed solutions. It would be both distressing and irresponsible to waste the opportunity.

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