Here’s My Prescription for Kenya’s Ailing Public Health Sector

Most of our hos­pi­tals in rur­al Kenya are in the ICU. This real­i­ty hit home last week when my wife Susan and I drove my moth­er to the ameni­ty facil­i­ty of Kitui Coun­ty Refer­ral Hos­pi­tal for urgent med­ical attention.
To our shock, the doc­tor gave us a tiny, reused piece of paper with four hand­writ­ten words “3 Copies lab request’. In short, the hos­pi­tal was direct­ing us to a near­by bureau to pur­chase treat­ment appli­ca­tion forms before they could attend to us. They explained rather dis­mis­sive­ly that they had run out of the forms. Unfor­tu­nate­ly, the bureau was closed since it was a week­end. Inevitably, we sought a pri­vate hos­pi­tal in the area as I deeply thought about the patients we had left at the coun­ty hos­pi­tal, who sad­ly did not seem to have any alternative.

A while ago, Dorothy Loko­mu­tu­to the moth­er of a dear friend Moses Ban­da had sought treat­ment at the same hos­pi­tal after expe­ri­enc­ing some pain in her chest. The hos­pi­tal couldn’t attend to her because their diag­nos­tic equip­ment had bro­ken down. Instead, they referred her to Machakos where she was ‘diag­nosed’ with can­cer. Lat­er, sev­er­al X‑rays in Nairo­bi revealed that she had no trace can­cer in her body and was suc­cess­ful­ly treat­ed. Can you imag­ine the trau­ma of this family?
Dread­ful­ly, these two hon­or­able moth­ers’ expe­ri­ences are not isolated.

In 2020, the Kenya Nation­al Union of Med­ical Lab­o­ra­to­ry Offi­cers (KNUMLO) revealed that three out of every 10 patients in Kenya, received the wrong diag­no­sis or treat­ment. Con­se­quent­ly, the health of mil­lions has been severe­ly com­pro­mised and many have pre­ma­ture­ly lost their lives.

Accord­ing to the recent­ly released 2022 Kenya Demo­graph­ic and Health Sur­vey, 75% of Kenyans don’t have any health insur­ance. When they fall sick, they have to dig deep into their own pock­ets and seek treat­ment from pri­vate hos­pi­tals owing to the dys­func­tion in pub­lic hos­pi­tals. Accord­ing to the sur­vey, 80% of Kenyans in rur­al areas don’t have health insur­ance, com­pared to 60% in urban areas. In addi­tion, 25% of preg­nant women in rur­al areas give birth on their own, in the absence of a mid­wife or skilled health prac­ti­tion­er. The num­ber is much low­er in urban areas, at 3%. This bleak sce­nario con­tin­ues after babies are born. In rur­al areas, one in five chil­dren under­goes stunt­ed growth, dou­ble the num­ber in urban areas. Accord­ing to the World Health Orga­ni­za­tion, stunt­ed chil­dren fall sick more often and are more like­ly to suf­fer from chron­ic diseases.

There is there­fore an urgent need for deci­sive action to boost rur­al health­care. Of course, the short­age in pub­lic hos­pi­tal must be addressed, but we must focus on soft­er issues too.
First­ly, our health prac­ti­tion­ers need to own the prob­lem and be empa­thet­ic to the insti­tu­tion and those they serve. Cur­rent­ly, most of our prac­ti­tion­ers are detached from their insti­tu­tions and there­fore treat patients as irri­tants. As such, we should con­sid­er a nation­wide cam­paign and refresh­er cours­es to steer health work­ers back to their pro­fes­sion­al call­ing. That alone will change pub­lic per­cep­tion of pub­lic hospitals.

Sec­ond­ly, just like schools, there should be a clear bound­ary between pub­lic and pri­vate hos­pi­tals in the engage­ment of health prac­ti­tion­ers. If a pub­lic doc­tor can con­cur­rent­ly oper­ate a pri­vate clin­ic what would pre­vent a nurse from start­ing a side ‘hus­tle’ of a pho­to­copy bureau next to a pub­lic hos­pi­tal? Isn’t this a rea­son why our insti­tu­tions are large­ly dys­func­tion­al despite the resources at their dis­pos­al. Isn’t this the begin­ning of the very cor­rup­tion that we must uproot? Isn’t this the rea­son why local com­mu­ni­ties have been exclud­ed from the gov­er­nance of health facil­i­ties which is against the Health Act of 2017? Isn’t this one of the rea­sons why Kitui Coun­ty with its 340 health facil­i­ties, for instance, has delayed the imple­men­ta­tion of a vibrant Health bill?
The future of pub­lic health is in our own hands! Think act green!

About Dr. Kalua Green

He is the Chief Stew­ard of Green Africa Group, a con­glom­er­ate that was envi­sioned in 1991 to con­nect, pro­duce and impact var­i­ous aspi­ra­tions of human­i­ty through Sus­tain­able Mobil­i­ty & Safe­ty Solu­tions, Eco­pre­neur­ship & Agribusi­ness, Ship­ping & Logis­tics, Envi­ron­men­tal Pro­tec­tion Ini­tia­tives, as well as Hos­pi­tal­i­ty & fur­nish­ings sectors

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1 Comment. Leave new

  • The health care ser­vice in pub­lic hos­pi­tals needs urgent atten­tion giv­en that it’s the only avail­able fall back for major­i­ty of the bot­tom up mass population.


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