Shortage of specialists hampers provision of quality health care

Corporate News

Women queue for mobile clinic services in Baragoi, Samburu North. Lack of human resource in most hospitals has been cited as one of the factors hindering delivery of services to citizens. PHOTO | JOHNSTONE KETI  

By ANGELA OKETCH

In Summary

• Patients in rural Kenya suffering from chronic illnesses often find they have to make trips to Nairobi to see specialists or access certain treatments like dialysis or CT scans.

For years Rosalia Akwiri, who succumbed to diabetes last month, has been travelling every two months from her rural home to see her endocrinologist in Nairobi. She had to travel because there was no specialist doctor dealing with hormonal disorders in her village home in Aboke, Siaya County.

Her children say transporting their mother to Nairobi for check-ups and referrals drained their resources.

“Travelling to Nairobi on road was very tiring because the roads were in bad state. But even if we were incurring the expenses, it was better than to lose her,” says Brian Akwiri, the oldest son. Mr Akwiri believes that had there been a specialist doctor in his county or at nearby hospitals, his mother would not have died.

“On the fateful night when she developed complications, she was home alone. On being rushed to the nearby hospital for first aid before being flown to Nairobi for treatment, my mother was no more; she surrendered,” said Mr Akwiri.

Ms Akwiri represents many Kenyans living in rural areas who are facing challenges seeking specialist care when they develop illnesses like cancer, heart problems and diabetes. Lack of human resource in most hospitals has been cited as one of the factors hindering delivery of services to citizens and causing rapid deaths.

A survey released by the ministry of Health last month revealed that majority of hospitals in the country lack specialist doctors. Patients in rural Kenya suffering from chronic illnesses often find they have to make trips to Nairobi to see specialists or access certain treatments like dialysis or CT scans.

The report titled, The Government of Kenya 2014: The Kenya Service Availability and Readiness Assessment Mapping (SARAM) Report 2013, stated that most hospitals lacked skin specialists, specialists in the diagnosis, prevention and treatment of dental and facial irregularities (othordonitists), pathologists, oncologists, endocrinologists, psychiatrists and many others.

The study, which was carried out between April-May 2013, identified that the most common specialists across the counties were general physicians, pharmacists, public health specialists and midwives.

The report noted that health human resource management (HRM) is still manual and thus several HRM domains – such as staff appraisal and promotion, tracking of training and placement­ – suffered inefficiencies. It gave three key areas invest of focus for the sector: Strategic recruitment of human resource, training and skill upgrade of existing staff and adoption of a robust human resource management information system.

From the report, the specialist health workforce in Kenya comprises 56 per cent females, with the highest concentration in the nursing, clerks, medical social workers and supportive staff cadres. Major gender disparities were found among economists, occupational therapists, medical engineering, environmental health specialists and drivers, with more than two thirds from one gender.

The report found that the doctor population ratio was less than one to 10,000 people while there were three nurses for every 10,000 people. The ratio for registered clinical officers was one to 10,000 while all other health professionals were in a ratio less than one per 10,000 people.

From the statistics, Kenya has a total of 67,075 health specialists. Nairobi County has the highest number with 5,807 specialists followed by Mombasa with 4,694, Uasin Gishu (4,123), Kiambu (4,022), Nakuru (3,873), Embu (2,956), Meru (2,605), Machakos (2,442), Kakamega (2,159) and Kitui has 1,492 practitioners.

The counties with the least specialists according to the report are Lamu with 142, Tana River (254), Turkana (451), Mandera (473), Kajiado (512), Samburu (524), Isiolo (550), Elgeyo Marakwet (582), Kisii (676), Nyamira (670) and Narok (702).

The Saram report says there is only one ophthalmologist in the country based in Garissa County and only eight oromaxillofacial surgeons (one in Kakamega, one in Machakos, two in Meru and three in Nairobi).

The report, which was released last month, also revealed that there are only 12 anaesthesiologists in the country and all are based in Garissa.