Policy and governance are crucial talking points in 2017

A resident of Awasi fetch water for her domestic usage from a wetland . As at January 2016, the US Centres for Disease Control reports, cholera had claimed 178 lives out of the 11,033 cases reported in just two years in the country. PHOTO| TOM OTIENO

The year 2016 began and ended on charged notes, with disease outbreaks, corruption scandals, medical discoveries, great milestones in the malaria war, and financing difficulties in the wake of a rebased economy dominating discourse in the health sector. Kenya’s public health care system was paralysed by the doctors’ strike starting early December, and most Kenyans start 2017 with their eyes on the government to see how it manages the current crisis. Besides labour disputes in the sector, here are the other key areas of focus this year:

 

Disease surveillance: As at January 2016, the US Centres for Disease Control reports, cholera had claimed 178 lives out of the 11,033 cases reported in just two years in the country. Then there was mosquito-vectored Chikungunya in the northern frontier, and many other flare-ups in the country. In a previous interview with this publication, the Kisumu County director of health, Dr Dickens Onyango, said controlling diseases is a complex matter that needs partnerships. He advocated for coordinated efforts between counties, citing Kisumu and Vihiga, whose problem arose from a river the two counties shared. So, two counties, with different budgets and health strategies, uniting in the fight against disease. Incredible! Given the fluid nature of pathogens, will counties manage to control diseases this year?

 

Funding cuts: At a meeting in Dar es Salaam recently, the United Nations Population Fund deputy executive director, Dr Natalia Kanen, appealed to governments in East Africa to finance their own programmes because the current trend of relying on donors is “not sustainable”. The Global Financing Facility (GFF), a multi-stakeholder partnership that supports country-led efforts to improve the health of women and children, has, for example, developed stricter rules for countries. There are many programmes that are still supported by donors, such as HIV, Malaria and Tuberculosis initiatives, but will Kenya find better ways of funding its health issues in 2017?

 

Cross-border diseases: Ebola ravaged West Africa because of the culture of greetings, hugs and related contact during socialisation, as well as interaction with the environment. This awakened Kenya and Africa at large to the call of “one health” — the idea that health is linked to animals and the environment — and therefore to the realisation that taking care of human health needs the collaboration of many science- and non-science-based disciplines. In Kenya, the Zoonotic Diseases Unit (ZDU) fosters these partnerships, but will they receive the support from the government in 2017 and not rely on donors?

 

Administration and policy: It is a month and a half since doctors went on strike, and throughout 2016 there  were sporadic health care workers’ strikes across the country. While HealthyNation has not been able to link the deaths in hospitals directly to the current strike, patients have spoken of the anguish they have gone through as medics miss from hospitals. The medics are not buying the government explanation that their Collective Bargaining Agreement is too expensive to implement because, just a few days before they went on strike, the Ministry of Health was reported as having misappropriated Sh5 billion. The sector looks forward to better running of public health institutions, as well as formulation of policy geared at improving efficiency of health care services.