Health system requires immediate reforms


Meteitei Sub-County Hospital in Nandi County. FILE PHOTO | JARED NYATAYA | NMG

The health system of a nation dictates the pace of the economic growth of a country hence why William Ruto’s government, which pegged its manifesto on economic transformation, should not take it lightly as the doctors’ strike looms next month.

Although the country is reeling in a serious economic crisis and a ballooning wage bill against an overwhelming debt profile to accommodate any cash-related demands, the government must look into ways of dialoguing with the doctors before they strike considering the situation of the Kenyans and the dire consequences this would bring.

Both the county and national governments have scored very poorly on dealing with the doctors’ issues leading to long protracted wars that are finally never amicably resolved after punishing millions of Kenyans. This is the background on which the planned strike rests upon.

Since the devolution of health services in 2013, industrial strikes have frequently disrupted health services. In 2017, health workers recorded about 250 strike days, disrupting health services across the country. Overall, Kenya needs a comprehensive health reform plan to address the challenge of access, standards and cost of healthcare, which has remained the greatest impediment to the ongoing efforts to fully reform the sector and achieve quality healthcare as envisioned in the Constitution.

The World Health Report pointed out three fundamental objectives of health systems, namely improving the health of the population they serve, responding to people’s expectations and providing financial protection against costs due to illness. The idea of the National Health Insurance Fund (NHIF) has been a plausible one except that its implementation has been wanting and lacks clear clarity. Kenya should spend time and invest resources to address the causes and not symptoms of the health problems in the country – to avoid an even worse healthcare system.

Devolution of the health services was a clever idea to ensure that ordinary Kenyans get health services but unfortunately, the national government still retains a huge budgetary allocation denying the county governments an opportunity to nurture their health system.

The Constitution of Kenya (2010) devolved health services to 47 counties. However, the operations of public institutions such as the National Referral facilities and research institutions, which are key in laying the foundation for the health sector reforms, were left under the national government.

Immediate reforms the health system in Kenya requires include fast-tracking Universal Health Coverage, which has been piloted in a few counties, management of health equipment Services that were hired and became controversial from the onset, and Kemsa’s last mile’s delivery and associated reforms.

Mr Obonyo is Public Policy Analyst.