Kenya’s healthcare system in urgent need of radical reforms

Wednesday March 14 2018

Kenyatta National Hospital

Health workers protest over sexual harassment of female patients at the Kenyatta National Hospital, Nairobi, on January 23, 2018. One of the weakest links in the health system is poor and archaic management practices. PHOTO | KANYIRI WAHITO | NATION MEDIA GROUP 

By PETER WARUTERE
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The recent fiasco over baby theft, security of nursing mothers at night and surgical patient mix-up at Kenyatta National Hospital, Nairobi, should be a wake-up call to the government and other service providers to clean up the corrosion in the public and private healthcare system.

Investors in healthcare are more focused on providing physical infrastructure than improving the quality of service and care.

It’s not unusual to find a functional health facility without the personnel to man the equipment installed and interpret clinical results.

One of the weakest links in the system is poor and archaic management practices that have failed to respond to the needs of patients or care seekers.

MOTHERS

At the KNH, for instance, it shouldn’t have taken an ugly incident to have mothers and babies staying close to each other.

It is cruel to expect weak mothers recovering from delivery to be walking back and forth to feed their babies.

The other chronic problem is shortage of personnel.

The 2017 Economic Survey shows Kenya had only 172,706 registered health professionals for the 48 million population in 2016, an improvement from 153,802 the previous year.

HEALTH WORKERS

The distribution was 382 health professionals per 100,000 people in 2016, compared to 346 a year earlier.

But it was highly uneven among categories.

For instance, there were just 23 medical officers, three dentists and seven pharmacists per 100,000 people, compared to 126 registered nurses, 95 enrolled nurses and 38 clinical officers.

Radical reforms are needed to fix these problems and position the healthcare system to contribute to improving the people’s livelihoods.

DEVELOPMENT GOALS
Accelerating the training of health professionals is critical for Kenya to achieve universal healthcare, one of President Uhuru Kenyatta’s development priorities.

Good health and well-being is also one of the United Nations’ Sustainable Development Goals.

Kenya spends six per cent of gross domestic product — the average for low- and middle-income countries — on healthcare; hence the need to scale up investments with a focus on knowledge and innovation.

Rapid deployment of National Hospital Insurance Fund (NHIF) has doubled coverage from 3.3 million people in 2012 to 6.1 million in 2016.

While the public sector is the largest investor in healthcare, private commercial investors and faith-based organisations are important partners in health services.

PARTNERSHIPS

The future is in public-private partnerships (PPP), which have the potential to invest in large, quality healthcare services.

Incidentally, KNH is considered one of the potential PPP candidates.

A listing of investment opportunities by the Kenya Investment Authority includes a proposal to build a 300-bed private wing at KNH through a build, operate and transfer model estimated to cost $36 million (Sh3.6 billion).

The project, which is also posted on the Regional Investment Authority of the Common Market for Eastern and Southern Africa (Comesa), is described as the first health PPP in Kenya.

It is expected to provide specialty healthcare, cutting the cost of seeking specialised treatment abroad.

PREVENTION
Reforms in healthcare should also focus on preventive services — to effectively prevent people from getting ill and, hence, reduce the need for curative services.

A few low-cost interventions have the potential for transformative outcomes.

These include expanding access to clean water and sanitation, improving nutrition of mothers and children and living in a cleaner, safer environment.

Kenyans also need to embrace healthy foods and regular exercise to reduce the increasing burden of cancer and cardiovascular and mental health diseases, which are associated with poor lifestyles.

Mr Warutere is a director of Mashariki Communications Ltd. [email protected]