Its is a reality that healthcare has been a challenge in this country. With a growing population and greater need for healthcare, the institutions that provide this services has been overstretched. This has been made worse by the slow progress in growth of relevant infrastructure, lack of adequate and well trained staff to work in the few centers available. To make it more clear, the markers of quality healthcare are at its lowest with a child mortality of 115/1000 before 5 years, maternal mortality 546/10000 annually and a lifespan of 46years. All are way below the expected standards. Its worse because the rural and hardship areas are not properly accounted for and go unreported by epidemiologists. Health therefore remains a vital element of the country, it needs a greater input and direct management from the central government.
Most workers in this sector are terribly demotivated and with good reasons. The working conditions have remained poor, both in terms of staff welfare and equipments. The services provided are essential and need to go on for 24 hours yet this employees are not given overtime allowance, proper rest rooms nor proper security arrangements. Vital equipments that would be needed in the diagnosis and management of patients are not available, the laboratories are poorly equipped and there are no drugs. Patients sometimes die before the eyes of this workers, most who can be treated. This is a song that has been sung a million times and all health workers have tried to drive the point home with no success. Its an issue of both underfunding and mismanagement of the few available funds by those charged with overseeing the work.
This workers are few and work for long hours. This brings a burnout, lack of time for trainings on new ways of managing patients. Most areas have retained time immemorial practices that should not be used in the current digital world. Its has been encouraged due to lack of inspection, no proper auditing and lack of alternatives. The government has stuck to its system and has no direct followup on its employees. As long as work goes on there is no problem. That's the saying within the ache-lions of management. Low pay has made most of the employees relocate out of the country in search of greener pastures.There are no incentives and opportunities that can stop this. The government has also acted truant by avoiding to directly absorb nurses and registered clinical officers who are out of colleges with claims of no funds. All this happening when Kenya registers more than 1 500 000 births every year.
The greatest mistake done by the Parliamentary legal committee on constitutional affairs during the fine turning of the new constitution was to scrap the article setting up a Health Service Commission. This would have greatly separated the role of the county and the central government. The county governments have no capacity to handle staffing, not now with this acute deficiency of staff. This role should still remain in central government. The same applies to infrastructure development, this should remain the role of the central government. Off course with assistance by the county governments. This would make it an abdication of duty by the state. It would be very disadvantageous to counties that are not economically endowed. It would end up very discriminative and cannot be fair in both the short and long-term.
The issue of training specialists is a major one, its not news to say that we lack health specialists and that is why this role has to be left in the central government. At the end of the day, proper allocation of the specialists is important, most will be attracted and remain in economically advantaged counties and leave the other counties to go to waste. With the central governments direct control, they will be equitably distributed in counties. Members of Parliament and Governors have to support the enactment of an amendment in the constitution to support the setting up of a Health Service Commission if they have the interest of this country at heart. This bill should be tabled in parliament soon.
Kenyans should support the same, with provision of free maternity services we expect a greater number of deliveries in hospitals and access to maternal healthcare. We should move towards proper and quality healthcare if this goes on well. The role of National Hospital Insurance Fund(NHIF) in all this should be to promote especially infrastructure development in public hospitals. This has the role of cushioning and assisting the poor access to proper services. It can take this opportunity to redeem itself from previous scandals. With time the parliament should also be coming up with amendments to NHIF act to review and redefine its role in providing Universal Healthcare. It needs to be more of a social security scheme.
It has always been, and its always true that when the public healthcare is removed from its slumber, properly equipped, human resource well developed and motivated, then we will have a healthy population. AND A HEALTHY POPULATION BECOMES A WEALTHY ONE.
Our journey...better HEALTH FOR ALL...
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