Independent State agencies have a crucial role in public health reforms
A half-empty ward at the Coast Provincial General Hospital as the doctors' strike continues. PHOTO | WACHIRA MWANGI
What you need to know:
Part of the stemming inaction from the government arises perhaps because of the comfort decision makers have since they seek and obtain health services from private facilities.
Yet failure to see how the two sides — public health and private sector — are interlinked means one arm has been growing strong while the other is weakening leading to a net deficit.
The day regulators start applying the same yardstick to both private and public sectors is the day healthcare reforms in Kenya will begin.
Among healthcare entities focusing on the pro-poor segment, a regularly encountered phrase is “the total market approach”. The Global Health definition says “A total market approach is a lens or process that can be applied to develop strategies that increase access to priority health products in a sustainable manner.”
This also means taking cognisance of the ecosystem in which these are implemented.
The key words here being “increased access”, “priority health” and “sustainable manner” and the current doctors’ boycott seems to be geared towards that by hoping quality staffing returns to the public side.
The strike also offers us an opportunity to scrutinise the healthcare human resource through this total market approach. What are the implications for meeting the public doctors’ demands? Secondly does meeting them help serve the priority segment and is it sustainable?
From last Thursday, the doctors’ union had vowed to mobilise medical doctors from even the private sector to a 24-hour once a week work boycott.
If such a boycott actually takes place, the repercussions are obvious as there will be a total shutdown of major health management even in private medical facilities.
Part of the stemming inaction from the government arises perhaps because of the comfort decision makers have since they seek and obtain health services from private facilities.
Yet failure to see how the two sides — public health and private sector — are interlinked means one arm has been growing strong while the other is weakening leading to a net deficit.
For many of them, utilisation of public health services is an experience they have never endured. Long patient queues, missing equipment, shortage of drugs and low prognostic results contributed as a result of these are rumours.
Yet Kenyan doctors and patients on a daily basis are forced to live with the dysfunctional health system’s shortcomings.
We doctors in particular are blamed for the poor health outcomes from our interventions in this limited resources setup.
Lost in all this narrative though is the role independent medical regulatory bodies ought to play towards achievement of globally benchmarked best practice policies.
How many health staff should a facility, public or private have before it is allowed to continue serving patients? Are the basic equipment available for provision of these services there?
As far as human resource and staffing is concerned, the independent bodies charged with registration and overseeing quality, the Kenya Medical Practitioners and Dentists Board, the Pharmacy and Poisons Board and other affiliated bodies are letting Kenyans down.
The laws drafted under which they operate are meant to ensure cross-cutting oversight roles as far as human resources, equipment and quality of care is concerned both in the private and public sectors. Yet it appears that the public side is exempt from these regulations.
How the decades-old understaffing and under-equipping crisis even by the government’s own norms and standards guiding document has been allowed to go on is a mystery.
For instance, the pharmacy side in all private health facilities that stock and dispense medicines must have pharmacy staff by law.
An evaluation of the public health facilities reveals that more than 80 per cent are not staffed by pharmacy practitioners.
The medical practitioners’ board on the other hand is meant to oversee medical staffing, equipment and quality of service delivery across all health facilities.
The day regulators start applying the same yardstick to both private and public sectors is the day healthcare reforms in Kenya will begin.
