Need to expand dialogue beyond health workers

This last week, the Kenya Medical Association held its 45th Annual Scientific Conference whose theme was “Health indicators for sustainable development”.

While several matters were presented and deliberated upon, the role of doctors in advocating improved health systems was a particular concern.

Strategies were discussed on how to ensure that the voice of the Association’s members is heard as law and policies are made both at the national and county levels.

During the conference, it became quite clear that a certain misconception exists in the minds of the public as well as in the minds of many doctors and health workers concerning who bears the greatest responsibility for protecting and promoting the health of the population.

Many of us have for a long time been labouring under the delusion that it is the sole responsibility of doctors and health workers in general to advocate health and deal with health problems in our communities.

DANGEROUS ATTITUDE

To my mind, it is time we changed this dangerous attitude if we are to make further strides in addressing the country’s health problems.

We must not only put our finger on the problems, but also place the responsibility for solving these problems squarely where it belongs.

There can be no doubt at all that the health of the population is every citizen’s responsibility.

Wringing our collective hands and asking health professionals to shoulder this burden on their own will only result in continued suffering for our people.

One can begin by arguing that health workers are a relatively privileged lot in our society, and may be quite far removed from the realities of determinants of health on the ground.

UNSAFE ENVIRONMENTS

Poverty, unsafe environments, unhealthy cultural practices, poor investment in health, and a disorganised governance structure are just some of the problems with a direct bearing on the health of our people.

These issues elevate the risk of disease and disability in the population, and disproportionately affect those that inhabit the lowest rungs of our socio-economic ladder.

Being among the more educated, at least in health matters, and relatively better remunerated workers in the economy, health workers are less likely to be affected by these risks than the majority of the population.

Most health workers are already aware of measures that need to be taken at personal level to improve their health, prevent disease, and get care early when they are unwell.

EDUCATE PUBLIC

A majority of people in the population do not. Health workers are, therefore, able to educate the public and provide the services necessary to keep themselves and their communities healthy.

However, the biggest problem in the health sector, as discussed by the keynote speaker at the conference, Dr Githinji Gitahi of AMREF, is health financing.

As long as we do not allocate sufficient resources for health promotion, prevention of disease, curative services, and rehabilitation, all the knowledge in the world cannot save us from debilitating health problems in this country.

This is where the citizens come in. While for years health workers have sung themselves hoarse about under-investment in health, it would appear that nobody with the ability to do anything about it has been listening.

ACCESS TO HEALTHCARE

We have bombarded policy makers with statistics on inequities in access to healthcare, on international declarations and policies touching on what percentages of budgets should be dedicated to health, and even on the importance of maintaining a healthy population, to little avail. Our relative budgetary allocation to the health sector has been declining over time.

In my view, the reason implementation fails to gain traction is that we have continued to assume that all health related advocacy and policy implementation must be conducted by health workers themselves. We have not sufficiently engaged partners in civil society in advocating increased health financing.

Lukoye Atwoli is Associate Professor and Dean, Moi University School of Medicine [email protected]