Ministries' turf battles hurting Nurses

Although a recent public dispute between the heads of Kenya’s two health ministries seems to have been resolved, it highlighted serious problems in the country’s troubled health care delivery system.

Those problems are most visible in the nursing sector, where a severe staff shortage has diminished care and support nationwide.

According to the National Nurses Association of Kenya, lack of coordination and the bad relationship between the ministry of Medical Services and that of Public Health and Sanitation adds to the shortage problem.

The World Health Organisation calculates the recommended nurse to population ratio in developing countries at two nurses for every one thousand people.

Bickering

The association says that Kenya has 26,000 nurses, thus one nurse serves more than 1,400 people, more than twice the number one should cater for.

Bickering between the two ministries has also affected movement of nurses between health facilities at different levels.

“Before the creation of the two ministries, nurses from clinics and dispensaries would sometimes serve in hospitals whenever the need arose. Now, even if there was an outbreak in a provincial hospital, it would be impossible for nurses at dispensaries to offer their help. Technically, they report to different ministries,” said Luke Kodambo, the association’s chairman.

The government needs to employ more nurses in the ministry of Medical Services, which Mr Kodambo says is too slow.

Medical Services ministry’s Permanent Secretary said; “We know there is a shortage, but the best we can do is employ 500 nurses each year,” he said.

Analysts argue that a lot more factors must be considered before any more nurses are employed.

A study commissioned by Action Aid International last September shows that Kenya’s health budget, which provides for the employment of new nurses and other public health officers, might be influenced by other policies of foreign lending institutions.

Lacks the will

“Most funding organisations are in favour of programmes which limit a government’s expenditure in social issues like employment,” said Ben Sihanya, a policy analyst and research consultant.

The split of the Health ministry has created a disease management nightmare for the nurses.

“It is impossible to draw a line between the functions of the two ministries when it comes to matters such as management of disease outbreaks,” said Mr Kodambo.

Prof Ole Kiyiapi said the two PSs have decided to have a joint approach when facing donors and tackling health issues. Both the nurses and him agree it was a mistake to divide the Health ministry.

“Health is a large sector, but the different sections in it are greatly linked. This is a political issue. We would be better of with a single ministry of Health,” said Prof Ole Kiyiapi. “It has been a recipe for chaos for us,” said Mr Kodambo.