Here’s to a healthier nation beginning 2020
What you need to know:
Every health conversation today will inevitably veer towards a unified system of managing the health workforce.
The best outcome of this discussion will be the determination that health is a national security issue, and must be treated as such.
As we close the year, it is an undeniable fact that the health sector in this country is ailing. There are unacceptable variations in the quality of healthcare a person will receive based on where they live and how much money is at their disposal.
DETERMINATION
The variation is so extreme that it determines whether you will live or die. We do not at the moment have a minimum guaranteed standard of health care in this country for the simple reason that we have distributed the responsibility such that nobody can claim full responsibility for it.
In several counties today, the health sector is at a standstill because the health workers are on strike for one reason or another. In other counties where the workers are present, they do not have sufficient provisions to work effectively. Specialists are few and poorly distributed, and even counties that have money to recruit are having difficulties attracting them.
However, there is a glimmer of hope as we go into the new year. Kenyans seem to have arrived at the determination that this deplorable state of affairs must come to an end. Every health conversation today will inevitably veer towards a unified system of managing the health workforce, and more often than not the narrative will converge on the need for a Health Service Commission. The current discussion on the modalities of achieving this is healthy, and my expectation is that in the first half of 2020, we will finally fix this and agree on a way forward for our health sector.
STANDARDS
The best outcome of this discussion will be the determination that health is a national security issue, and must be treated as such. Certain aspects of health such as prioritising interventions based on local needs, and all primary health care focusing especially on health promotion and prevention of diseases must be managed by county governments. However, human resources for health and the referral chain for patients with severe illness must be managed nationally to stop exposing Kenyans to varying standards of care based mainly on the state of mind of those managing political affairs in counties.
Finally, as we all know, there is no health without mental health. In June this year, the president acknowledged that this country is facing a mental health crisis, with rising rates of suicide, depression, and substance related problems.
He directed the Health ministry to take immediate steps to address this important problem. As a result, last month the ministry of health organised the first national conference on mental health at which solutions to the mental health crisis were discussed. Further, the Cabinet resolved to give the Mathari national mental hospital autonomy to operate like other national referral facilities, and we expect the appointment of a new board and management team very soon.
INTERVENTIONS
Importantly, a taskforce has been established to prepare the roadmap towards better mental health for our country, and by the end of February, we should have a report clearly outlining the necessary interventions in this regard. If we sustain this momentum, 2020 will mark the beginning of a healthier epoch for the people of Kenya.
Lukoye Atwoli is Associate Professor of Psychiatry at Moi University School of Medicine; [email protected]
