Much more must be done to improve healthcare provision in Kenya
9 December 2015
Author: Emmanuel Toili
Participants at the 4th Annual Health Research-to-Policy Conference that was held in Naivasha, Kenya from November 27 - 29, 2015. Photo: Felix Okaka

Recent research by the World Bank has shown that less than 20 per cent of health facilities in Kenya meet the minimum standard for the provision of internationally recognised services to patients. This finding compounds the already known fact that Kenya has inadequate health facilities. And now, less than 1 out of 10 of the few existing health facilities meets internationally recognised standards for healthcare provision.

This means that if Kenya is to meet the recently launched Sustainable Development Goals relating to health by 2030, it has to shift from the “˜business-as-usual’ model and make deliberate and radical efforts to improve its health sector. This was the resounding message from the recently concluded conference on the health sector held on November 27-29, 2015 in Naivasha.

There are some promising efforts, but much more must be done

The devolution of health care in the country since 2010 and the 2013 free maternity services initiative are some encouraging efforts that have potential to steer Kenya in the right direction if implemented effectively.

This fiscal year, parliament approved over Sh50 billion for the health sector, but most of these monies will be spent on recurrent expenditures, leaving very little for the improvement of actual service delivery. As this is not enough, part of these monies will fall through the now common wasteful spending by county governments.

The Naivasha conference noted that research evidence, which is a critical component of effective decision-making and programme implementation, plays a limited role in health sector decision-making processes in the country. The government makes very minimal investments in health research, which often means that there is no evidence to inform health sector decisions or the available evidence does not speak to the urgent needs of the health sector as it’s externally funded.

At the conference, counties executives committee (CECs) for health accused the national government of not financing health research. They further accused key research institutions of not partnering with county governments in conducting research so that the resulting research findings can be owned and taken up at county level.

The CECs further argued that members of the county assemblies (MCAs) did not prioritise health and health research, and so deprived the health sector of critical resources needed to effectively respond to the many health challenges in counties. The CECs at the conference believed that if the MCAs had access to health research and other data at county level, they would make such decisions from a more informed perspective and consequently health budgets wouldn’t suffer so much.

Integrate stakeholders, innovate in resource mobilisation

Both the national and county governments need to mobilise resources hugely from the private sector, which injects 60 per cent of their financial resources in the health sector. However, concerns still remain over the under-regulated health facilities by the private sector, which continue providing poor quality of services. Other research and health funding options include a partnership with elites that are interested in improving the quality of life for the human race.

Development partners such as the USAID Kenya have played significant roles in the health sector. For instance, the United States Government funds USAID Kenya close to US$ 500 billion annually to improve multi-sectoral programmes in Kenya. This funding is available especially for consortiums, and counties stand a good chance if they partner with other institutions.

Unfortunately, patients have been ignored in the streamlining of the health sector. Patient safety in Kenya still remains an area for critical improvement in quality of care for both public and private sectors. Cases such as that of Alex Madaga who spent 18 hours in an ambulance and eventually died (October 2015) and a pregnant woman who gave birth on the floor at the Bungoma District Hospital (September 2013) are grim reminders of unresponsive health care systems in the country.

The conference concluded that increased investments in health research and routine data, and increased focus on using the research and data to inform decisions at policy, programme and service provision levels will greatly contribute to tackling the key challenges facing the health sector in Kenya.

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