Fix the core challenges first, side projects a duplication of efforts

On March 10, thousands of Kenyans participated in the annual Beyond Zero Half-Marathon in Nairobi.

The initiative of First Lady Margaret Kenyatta aims at raising funds, mobilising resources and creating awareness on maternal and child mortality.

And, as before, corporate bodies donated millions of shillings towards the fourth edition of the race, for which their employees signed up.

The initiative’s website states that the marathon has raised Sh600 million ($6 million), in cash and kind, over its first three editions, funds that are said to have provided every county with at least a mobile clinic that runs integrated services.

That sounds great, doesn’t it? However, it falls into a problematic pattern. Across the country, there are many private initiatives started every so often to address the same issues the government does.

PLANNING

In child and maternal health alone, for instance, there is the free maternity healthcare, rolled out by the government in 2013, and Linda Jamii, which registers expectant mothers with the National Hospital Insurance Fund (NHIF). And then there is the Beyond Zero initiative.

All these rely on the existing health system, which has challenges ranging from strikes by medical staff over issues ranging from their pay and welfare to shortage of drugs or expired medicines in hospitals.

This is the picture we saw when the free primary education programme was introduced. Classroom doors were thrown open for all but the number of teachers and size of classrooms remained the same, affecting the quality of education.

In his 2017 Jamhuri Day address, President Uhuru Kenyatta announced key plans for his second term: Food security, affordable housing, manufacturing and universal healthcare. This ‘Big Four Agenda’ is to be achieved before he retires in 2022.

DUPLICATION

Under the healthcare pillar, the Big Four aims to ensure universal health coverage (UHC) by actualising a 100 percent cost subsidy on essential health services and reducing medical out-of-pocket expenses.

Pilot schemes were recently rolled out in four counties, whose residents got UHC cards.

According to the Ministry of Health website, the card will give the holder access to services ranging from emergency, child and maternal health to mental health, inpatient and outpatient services in all public health facilities.

However, while the First Lady’s initiative has covered ground in mobilisation and publicity on child and maternal health, earning her global recognition, there seems to be a duplication of efforts between the office of the President and hers.

RESOURCES

The President recently established the National Development Implementation and Communication Committee.

Its role includes supervising government projects, including the Big Four, and monitoring and evaluating resources allocated to national government priority programmes.

Among the things this committee should look into is this duplication, which stretches the already thin resources in healthcare provision.

Although Beyond Zero boasts of having delivered 47 mobile clinics, reports show that most of them are non-operational for reasons such as understaffing, lack of fuel and inadequate medication and salaries. These are the same issues healthcare faces in Kenya.

ROOT CAUSES

Ironically, those who run in the marathon or donate to it contribute to the very services that Kenyans pay taxes for.

Instead of coming up with new initiatives under different offices and brand names, the government should address the core issues in healthcare and work on providing this vital service in its highest possible quality, as spelt out in the Constitution, without exposing Kenyans to financial hardships when seeking these services.

Once that is established, initiatives such as the First Lady’s Half-Marathon would then play a complementary role.

Ms Wafula is a mental health social entrepreneur, TED Speaker and Aspen New Voices fellow. [email protected], @Sitawa_Wafula