The appointment of former Inspector General of Police David Kimaiyo to chair Kenyatta National Hospital (KNH) board has once more put the institution under spotlight, this time more on competence and suitability, and the larger government intention.
Again, board issues seem to overshadow the operational requirements and structural gaps at the hospital, which are more urgent than the board issues.
Away from national politics and the internal wrangles at KNH, the operational requirements are more urgent and a priority towards revamping the facility; a well-managed referral hospital especially in line with the Government’s Big Four agenda.
The country’s dream for universal access to health will require functional facilities, innovation, clinical research and centre of excellence supported by the Government and other players.
A closer look at the hospital reveals that operations require urgent attention and support.
While the hospital built in 1901 has a bed capacity of 2,063, 50 wards, 24 clinics and 26 operating theatres, it holds averagely 2,400 inpatients daily, and 2, 500 outpatients daily.
Annually, the hospital handles 70,000 admissions and sees 600,000 patients with 120 per cent bed occupancy.
Its physical facilities/infrastructure are dilapidated, a thing that can frustrate workers, especially at lower levels, leading to poor treatment of patients.
The broken down equipment and clinical tools added to the congestion in the wards and human traffic in the wards and corridors make the quality health care the hospital aspires for a mirage.
Against human resource capacity of nearly 10,000 officers, including specialists, KNH currently has 4,500 staff, mostly in the support and lower cadres.
The human resource gap, coupled with inability to meet staff labour requirement, including salary and related allowances, has fuelled strikes at the facility.
Statistics show that 78 per cent of the patients at KNH are unemployed Kenyans, 14 per cent in formal employment while eight per cent are from the informal sector or casuals.
Given the socio-economic class of majority patients, it means they cannot pay for the basic charges at the hospital, and conservative estimates indicate the referral facility spend more than Sh500 million on waivers for Kenyans.
With nearly 5,000 patients daily and 4,500 staff, and care givers who mainly are parents, guardians, friends, well-wishers, some of whom have stayed at the hospital for many days, the provision of security in the facility becomes a huge challenge.
Such a facility cannot as expected receive referred patients from within or outside Kenya for specialised health care, provide facilities for medical students and for research, provide training facilities in nursing and other health and allied professions and participate in national health planning as expected.
The institution needs improved budgetary allocation to assist in improving equipment, paying workers, procedures for doing things including staff placement, promotions, training, procurement and patient data management.
Structural and policy changes should help the facility to stop cartels that are known to push for ways that favour them.
Among other steps, these are some of the changes that will revamp KNH for its fair contribution to the Big Four agenda especially on universal access to health.
Victor Bwire Via Email.