Shortage of staff threatens universal health care goal

President Uhuru Kenyatta has set affordable healthcare for all as one of his four main action plans for the next five years.

This wouldn’t have come at a better time since the world is heading towards Universal Health Care that focuses on access to quality services for citizens.

Achieving this noble idea requires bold discussions around the key pillars of an effective health system as defined by World Health Organization.

A well-functioning health system responds in a balanced way to a population’s needs and expectations by improving the health status of individuals, families and communities; defending the population against threats; protecting people against the financial consequences of ill-health; providing equitable access to people-centred care; and making it possible for people to participate in decisions affecting their health.

The WHO has identified six key components of a well-functioning health system as: Leadership and governance, health financing, human resources for health, health information systems, essential medical products and technologies, service delivery.

Kenya ranks position 140 out of 190 in the WHO Ranking of the Worlds Health Systems in 2000 where countries like France and Singapore ranked in the top 10.

The difference between Kenya and these leading countries is the component of health financing where huge investments are made in the countries budget as opposed to ours which has never reached 50 per cent of the expected as per Abuja Declaration that resolved countries dedicate 15 per cent of their budgets to health.

This has greatly affected other components like human resources for health, essential medical products and technologies and ultimately service delivery to public health consumers who add up to 90 per cent of Kenyans.

The WHO provides for the minimum staffing norms and standards for health. These guidelines were further customised in the ‘August 2014 Human Resources for Health Staffing Norms and Standards’ by the Ministry of Health.

The guidelines indicated the minimum number of health care professionals needed to achieve the minimum ratio of health worker to population as provided for by WHO by end of the year 2018.

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According to the guidelines we were supposed to have 16,278 clinical officers, 13,141 doctors and 38,315 nurses in public health sector employment against the current numbers of approximately 6,000 clinical officers, 5,000d doctors and 25,000 nurses.

The ideal minimum health worker to population ratio should be 23 health workers to 10,000 Kenyans or better broken down to 40 clinical officers per 100,000 Kenyans, 32 doctors per 100,000 Kenyans or 95 nurses per 100,000 Kenyans.

The apparent acute shortage will be a serious determinant of the success of universal health coverage.

Access to highest attainable standards of health is a constitutional right under Article 43(1)(a) and, therefore, Kenyans have a right to ask their elected leaders to account on facilitation they have provided for its enjoyment.

It’s the role of the Executive and MPs to allocate budget to different sectors. The Ministry of Health should advice the Treasury and Parliament on the adequate financing.

Peterson Wachira is Kenyatta chairman, Kenya Union of Clinical Officers.