The Building Bridges Initiative (BBI) task-force report highlighted the frustration that Kenyans have faced in accessing health care services due to the non-implementation of the constitutional guarantee of health, the absence of a patients’ bill of rights and provision of emergency services across facilities in the country.
Indeed, the sector has been marred by frequent industrial unrest. The turmoil is attributed to the mismanagement of health human resources across the counties, lack of medical supplies and inadequate financing of the sector.
The mismanagement of health human resources has majorly contributed to the industrial unrest. Health workers have been victims of ethnic antagonism, nepotism in recruitment of qualified personnel, political interference by local elected leaders accompanied with threats, constant salary delays despite timely disbursement of monies to counties, non-remittance of statutory deductions including PAYE, NHIF and NSSF, deductions to financial institutions including loans and insurance premiums with resultant penalties on the health workers and non-implementation of return to work agreements.
Across the country, hospitals are grappling with severe shortages of health workers across all cadres, county governments are unable to hire more staff due to budget ceilings. Equipment procured through the managed equipment service (MES) has been lying idle in several counties due to lack of personnel.
The health workforce is unevenly distributed with a majority of Kenyans unable to access the highest attainable standard of health services as envisaged in the constitution. This is despite the availability of thousands of qualified health professionals i.e. doctors, nurses, clinical officers and other health personnel who are unemployed.
The back and forth between the sector unions and county governments over the years can no longer be termed as teething problems of devolution. Indeed several counties continue to mismanage health workers, violate agreements and the rights of workers under their trust.
Administrative, legislative and policy attempts at resolving the turmoil in the sector through different intergovernmental mechanisms have not yielded the desired results largely due to the non-standard way of implementation by the county governments.
The reality is that the health workforce is disgruntled and demotivated, the resultant effect is a negative impact on quality of services provided to the common mwananchi who cannot afford private healthcare.
A more pragmatic approach is centralised and standard management of human resources for health through a Health Services Commission.
The commission should be tasked with recruitment of health professionals across all cadres, deployment of personnel across the country to ensure equitable distribution of the scarce human resources for health, maintain an inventory of all public health facilities to ensure optimum staffing needs; and transfer of personnel as per the service needs in the country.
It will also be charged with capacity building of health personnel and in service training of personnel for specialised health services, establishment of strong hospital boards for accountability of health funds at facility level; and set up a complaints tribunal against misconduct and negotiate collective agreements with the sector unions in order to provide a harmonious labour environment for continuous and optimum service delivery for achievement of universal health coverage.
DR. CHIBANZI MWACHONDA
The writer is deputy secretary general KMPDU.