Health data should be at core of campaign promises

The campaign period is one of the best times to study social psychology: how language is used to influence masses and why people are attracted to the politicians they vote in.

In Kenya, it is also a time to gauge whether politicians are in touch with the plight of the people whose interests they claim to serve, and if they are, whether they are committed to solving the electorate’s needs.

On the campaign trail, you will hear things like “I will build more hospitals.” Sounds credible because healthcare concerns us all, but will building more hospitals solve the myriad existing healthcare problems?

In the financial year 2012/2013, Kenyans spent Sh234 billion on health-related costs. Medical expenses drive most households to poverty because most of them pay out of pocket. According to the 2016 Economic Survey, only 5.3 million Kenyans are covered by the National Health Insurance Fund (NHIF) out of a population of over 40 million. It is therefore important for politicians to commit to addressing healthcare concerns. However, declaring that one will build more hospitals will not make the cut.

During the 100-day doctors’ strike earlier this year, the numerous flaws in our public health system were laid bare. We learnt that the human resources in our medical facilities are inadequate. While countries like Cuba have one doctor attending to 600 patients, in Kenya, a physician attends to more than 5, 000 patients. This doctor to patient ratio cannot allow doctors to work for just two hours a day as our leaders claim.

NUMBERS DON'T LIE

Surprisingly, it is not just politicians who don’t get the gist of our healthcare problems. Even voters whose taxes run hospitals, do not know what goes on in them. Why? There is hardly any data to measure the outcomes of all the investments that have been put into healthcare, especially in the last four years.

What impact has the money allocated to healthcare had on maternal health, for instance? Does the politician know whether the clinic he put up in his community brought any changes that can be measured? If a politician says he or she wants to focus on the maternal health, what is this decision based on? Only data can answer these questions.

Data would tell for sure, without exaggeration, whether doctors work for 48 hours or two hours in government hospitals. Building a hospital might actually be a good thing, but it would be better if we knew something about what already exists? Do you know how many health facilities are in that constituency or county?

How many of them have adequate drugs, medical equipment, adequate human resource and functional labs? What is the distance people walk to access healthcare and how would an extra facility reduce that gap? What is the greatest health concern of the people in that particular area?

Is it malaria, cholera, or non-communicable diseases such as diabetes? If that is the case, what equipment is needed? It would be sad to bring in huge unnecessary equipment in a small facility while bigger facilities that would utilise the equipment better lack it.

While some Kenyans detach themselves from politics, the nexus between it and health is too great to be ignored. Since politicians control resources — what gets allocated where and how much — the debate about access to quality healthcare cannot be held without including them.

After they have been included, we need to think about the data. That is the only way we will track progress of every investment we have made in this space. We need to hold people accountable starting with Ministry of Health officials and healthcare workers.

We have heard of scandals where drugs disappear in huge volumes from government hospitals. Good information systems would be a simple solution to these kind of problems.

Let us not be a nation that applauds “launching” of things. Unlike the wooden bridges that we have seen press conferences held for, a health facility needs forethought  –such as the number of people it would serve — and the afterthought of what drugs need to be put on the shelves and what kinds of health professionals to employ and in what numbers.

Quality data and sincere commitment is what will change health from being just a word politicians throw around to something that actually gets improved in a useful manner. We cannot continue to be a country that spends colossal amounts of money on health and still feels content with mediocre services.

Mr Nguta is a health systems management expert and the acting Managing Director of Electronic Health Solution for Healthcare Providers in Kenya