Solution to health crisis lies with government
What you need to know:
- Suffering: Confusion over who runs what has led to patients dying of preventable diseases.
Whenever there is a road traffic accident, or some other acute health emergency, the nearest hospital is inundated with casualties, some requiring specialised care to keep them alive.
On arrival at the nearest hospital, nobody asks for the victims’ identification in order to determine what their ‘home’ county is. They are all treated according to their condition without undue regard to other factors.
Whether it is a rich county or a poor one, its health facilities are available to serve any person taken there.
It is therefore interesting to hear that several county governments have come up with health packages meant to benefit their ‘citizens’ one way or the other.
A county has announced that soon every ‘citizen’ will have a special card that will ensure access to health services within the county, while another recently announced a comprehensive health plan for its ‘citizens’.
Should any of these initiatives be found to discriminate against Kenyans from other counties, they will run afoul of the constitutional guarantee of the right to health care for all.
Even as they made these announcements, many county administrations are at continuous loggerheads with health workers, and strike after strike is the order of the day. The bottom line is that many Kenyans are dying of preventable causes in hospitals.
Every time senior politicians opens their mouth to speak about health, it is a fair bet that they would assure wananchi of high quality health services while at the same time threatening to fire and replace ‘lazy’ health workers who are causing suffering to the people.
They will storm health facilities and insult the hapless worker on duty in front of cameras, and berate those in charge during local barazas.
OWNERS OF THE PROBLEM
Unfortunately those that suffer the most are poor Kenyans who have no access to alternative services. One would hesitate to blame county governments for this, because they found the crisis in place when they took office a couple of years ago.
The owners of this problem are to be found in the Ministry of Health headquarters at Afya House.
Experts had suggested that primary health care be devolved, so that county governments focus mainly on preventing disease and promoting health, while the national government deals with curative and rehabilitative services.
This was rejected out of hand, and instead a confused system of shared responsibility was introduced especially in curative and rehabilitative services.
The Ministry of Health interpreted this situation as 100 per cent devolution of health services, and the county governments were receptive of this idea.
Subsequently, experts have recommended a middle ground where health facilities continue being shared between the national and county governments while the scarce human resources for health are distributed nationally.
The idea has evolved towards a national mechanism, with national government input, that trains, registers, recruits, deploys and has general oversight over all human resources for health.
Such a mechanism will ensure equitable distribution of these scarce resources, and remove this unnecessary burden from county governments.
While discussions are ongoing, one truly hopes that the national government takes more than passing interest in this process, for the sake of the many Kenyans who continue to be assailed by conditions that are easily managed even with existing resources.
Prof Lukoye Atwoli is Associate Professor of Psychiatry and Dean, Moi University School of Medicine [email protected]
