The sadness, emptiness and weakened will of Kenyans to fight for themselves must be addressed. Kenyans must demand for proper services from the government. The tragedy that we see daily cannot be ignored. The dream of every Kenyan is to prosper, to see a day when everyone will have enough food, proper education, shelter and medical treatment.
To achieve all this we need proper health. We have to hold the view, that the health of Kenyans depends on the skill in the hands of health workers. That is why first and foremost health-workers should be the best paid in the country. They hold the key to life and death only second to God. They need to be empowered and to have adequate skills to stop our children, mothers, fathers, friends and spouses from dying. Our happiness depends on those who are close to us. We all have to advocate and fight for our health.
We fight and cry that we are not well attended to in hospitals. When the people who provide this services are looked down upon and paid peanuts. They are not even provided with the basic requirements to do their work. They have to run up and down, looking for other revenues to be able to take care of their loved ones.Its that bad, they are not paid enough even to be able to manage their basic needs. That's why everyone has to take a role in fighting for improvement of healthcare in Kenya. Today it is me, but tomorrow it will either be you, your best friend or relative in this circumstances with poor amenities and demotivated service providers. They will die before you eyes, with a helpless doctor/nurse consoling you.
We have to call upon all health workers to rise up against this challenge. They have to set the pace for Kenyans to join them in the clamor for improvement. They have to stop the downward spiral in healthcare provision. People should not die in hospitals in the name of no facilities, no drugs or the absence of service providers. Health workers must rise up and give direction to healthcare. They must say rightly, and insist on correction of everything that has gone wrong. The state has to address health issues directly and stop hiding behind the face of devolution. As a matter of urgency, the state and parliament should set up a Health Service Commission to streamline service delivery. In addition to that, should re-allocate enough funds to set up proper infrastructure in all counties.
The pretense at providing free maternity healthcare must be condemned and rejected. Its not a worthy project but a populist political carrot/idea to delude Kenyans into more trouble. Free maternal healthcare require enough well motivated and remunerated staff in addition to proper infrastructure to make it successful. We lack all this and our leaders lost it by projecting and ratifying a measly budgetary allocation to healthcare. Not one member of parliament had a brain to think straight and ask about this. Our leaders must come back to their senses, in both legislature and government. It will require a hard knock to wake them up from this slumber. A major protest and a bold statement from stake holders will do that. Even in the form of an industrial action.They are surely out of this world and only an accident and a fatal one will bring them to reality.
The structures in our management cannot bring out this deficiency and advocate for enough funds. Therefore it remains a prerogative of the providers to give direction and to say that this profession is being choked. Yes, medical profession is being choked and is dying. Its only in Kenya where a Councillor( county representative, a section of a constituency) is tipped to earn more than kshs 440000, when a Professor is earning kshs 100 000 and a doctor is earning only kshs 40 000! Our members of parliament are earning more than Kshs 1 000 000.Its not a soap opera. And believe me, with all these, there is a mother in Jomvu slums, Mombasa who cannot afford insulin. I hope she is still alive. I really hope so.
Today I was talking with three of my doctor friends who told me categorically that they are now days away from relocating to other countries, there are no prospects in this here.Not as a threat, but a real plan. It does not make sense to study for seven years to work for your country, only to be treated in a manner that does not inspire respect and to be paid like someone who dropped out of primary school. Its better to go where one is respected. Kenya is losing professionals especially in Medicine at alarming rates due to this mediocre tendencies in government. Health workers must be paid well, salaries commensurate with the work they do to stop this.
The time is ripe for health workers to assert their authority and insist on taking their rightful role in the countries growth, plans and future. This position can only be taken by force, the current dispensation does not recognize professionalism. This is not an incitement, but a true reflection of the redemption in healthcare that this country needs. It is the system that denies healthcare the ability to grow as the other sectors. Because of that, the war of redemption has to be waged. There is no fear in demanding for recognition. A rightful recognition and rewards that come with the roles, obligations and services extended.
Health care workers have to create a niche, a niche for themselves just like workers in other sectors. They have to begin demanding for what is right in this sector. Things must change. Yes, things must change. This is a distinct sector that requires seriousness and decorum.
DO NOT BE AFRAID, IT IS A FIGHT FOR A GOOD COURSE.
Wednesday, 26 June 2013
Sunday, 9 June 2013
DEVOLUTION OF HEALTH CARE IN KENYA SHOULD BE HANDLED RIGHT
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...
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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