Broken health system driving Kenyans into poverty

Every week Kenyans considered to be ‘of means’ get requests from friends and relatives for donations to help clear hospital bills or send someone to India for treatment.

Indian companies have taken the marketing several notches higher, pushing the argument that treatment in India is more advanced and cheaper than it is in Kenya.

Some time in the past, a colleague got an even more interesting request from a client.

The patient, who suffers from a mental illness called bipolar disorder, asked for a medical report to facilitate her transfer to a doctor in India for ‘more advanced treatment’.

According to the patient, doctors in India had discovered a new surgical treatment that completely cures bipolar disorder! Unfortunately my colleague had to burst her bubble and inform her that no such surgical procedure exists.

What is going on in our health system that has taken it out of the reach of our people?

MISPLACED FOCUS
Firstly, one should not be ashamed to state that the quality of care has significantly plummeted.

The fact is that since the health function was unceremoniously dumped on county governments, health workers have been distracted, spending inordinate amounts of time and energy arguing about their terms and conditions of service.

At any one time, health workers in several counties are on strike due to non-payment of salaries.

Their salaries have in many cases been arbitrarily slashed, while in many cases discrimination and intimidation have played a role in lowering staff morale and therefore quality of care.

Secondly, many counties have focused on spending money on appearances rather than on variables that would improve quality of care and reduce treatment costs.

Million-shilling gates, exorbitant wheelbarrows and flashy paint jobs have been undertaken at the expense of medications, better pay and training for workers, theatre equipment and similar provisions for improved care.

As a result, many county hospitals are unable to offer basic services, forcing citizens to seek these services in private facilities that are obviously more expensive.

Thirdly, the absence of a sustainable national health financing strategy ensures that most of our health expenditure remains out of pocket.

Even easy-to-manage chronic conditions like hypertension and diabetes mellitus become tickets to poverty in many homes.

WAY FORWARD

Cancer treatment is out of reach for most of those in need, and only charity helps them breach the gap.

One solution that can improve things is a national health financing strategy. We have previously suggested the creation of a health fund whose main input would be a form of health tax on income.

This fund would pay for preventive and promotive activities, as well as treatment of the most common causes of death and disability in the country.

For instance, if we determined that the biggest killer of Kenyans are respiratory diseases, the health fund would guarantee free treatment for these conditions by purchasing equipment and medications, training health workers, and educating the public on prevention and early recognition of these illnesses.

This would eliminate the pay issues for health workers, and remove the burden of determining health priorities from ill-equipped county governments, leaving them to implement national health policy for the benefit of their citizens.

But since we prefer to play politics with the lives of our people, ideas such as these are unlikely to see the light of day.