Why we must prioritise quality healthcare provision

The provision of healthcare in Kenya has been a very central area of policy debate only that various actors have failed to generate consensus on how to implement it for the good of all citizens.

In spite of its significant place in harnessing the economic prosperity of a country, both the County and National governments have failed to identify areas of synergy in healthcare, leading some analysts to argue that health services were prematurely devolved. 

In 2013, the 47 devolved units were given autonomy to make decisions on human resource management, emergency and primary healthcare.

Although the idea looked plausible, bringing health services closer to the people, and having teams close to the people to manage health enterprise, health workers constituted the largest bulk of staff that left the National government to the counties. 

More than 44,000 of the 66,000 that joined the counties were in the medical sector.

However, this was a Herculean task for most County governments that were not prepared for the additional staff. 

A year after the inception of devolution, a World Bank study titled Delivering primary health services in devolved health system in Kenya, declared that a tenth of existing healthcare facilities in the country had become non-functional.

The report judged Kenyan hospitals on the availability of networked, motivated and competent staff; supply of essential medicines and funds for operation and maintenance.

While it is true the National government has failed in some areas, including disbursement of funds, some county administrations appear incompetent and structurally handicapped in the management of the crucial public health sector.

Unlike in developed countries; Kenya has not treated affordable healthcare as a right. Indeed, the Constitution makes it clear on this matter; that every Kenyan has the right to the highest attainable standard of health, and the right to healthcare services, including emergency medical treatment.

Section 43(1)(a) of the 2010 Constitution, however, explicitly provides for the right to healthcare services and reproductive health care, as well as the highest attainable standard of health.

Although Kenya has made significant improvements in the healthcare delivery systems, its accessibility remains a high challenge for many due to its high cost. 

Available statistics show in 2018, over a million citizens were impoverished due to high health expenditures for themselves or their loved ones.

Governments should now focus more on prioritising Universal Health Coverage (UHC) and develop a comprehensive plan to progressively roll it out countrywide. 

In 2018, the government launched UHC pilot programme dubbed Afya Care – Wema wa Mkenya which was meant to enable Kenyans to access affordable healthcare without financial hardship.

UHC should also prioritise scaling up the prevention of waterborne, vector-borne, tuberculosis, HIV and sexually transmitted diseases; improving the nutrition of women who conceive early screening and treatment for non-communicable diseases such as diabetes, hypertension, mental illnesses, and cancers to identify for early treatment initiation, rehabilitation and palliative care and treatment of the common outpatient and inpatient medical and surgical conditions in the public hospitals.

Delivering UHC requires close collaboration and synergy with the private sector, development partners, the active participation of the religious sector, civil society, and health care practitioners, and support from Kenyans at the individual, family, community and national levels.

— The writer is a Public Policy Analyst — [email protected]