A nurse tending to a patient. FILE PHOTO | NMG
President Uhuru Kenyatta has set affordable healthcare for all as one of his four main action plans for the next five years.
This
wouldn’t have come at a better time since the world is heading towards
Universal Health Care that focuses on access to quality services for
citizens.
Achieving this noble idea requires bold
discussions around the key pillars of an effective health system as
defined by World Health Organization.
A
well-functioning health system responds in a balanced way to a
population’s needs and expectations by improving the health status of
individuals, families and communities; defending the population against
threats; protecting people against the financial consequences of
ill-health; providing equitable access to people-centred care; and
making it possible for people to participate in decisions affecting
their health.
The WHO has identified six key components of a well-functioning
health system as: Leadership and governance, health financing, human
resources for health, health information systems, essential medical
products and technologies, service delivery.
Kenya
ranks position 140 out of 190 in the WHO Ranking of the Worlds Health
Systems in 2000 where countries like France and Singapore ranked in the
top 10.
The difference between Kenya and these leading
countries is the component of health financing where huge investments
are made in the countries budget as opposed to ours which has never
reached 50 per cent of the expected as per Abuja Declaration that
resolved countries dedicate 15 per cent of their budgets to health.
This
has greatly affected other components like human resources for health,
essential medical products and technologies and ultimately service
delivery to public health consumers who add up to 90 per cent of
Kenyans.
The WHO provides for the minimum staffing
norms and standards for health. These guidelines were further customised
in the ‘August 2014 Human Resources for Health Staffing Norms and
Standards’ by the Ministry of Health.
The guidelines
indicated the minimum number of health care professionals needed to
achieve the minimum ratio of health worker to population as provided for
by WHO by end of the year 2018.
According
to the guidelines we were supposed to have 16,278 clinical officers,
13,141 doctors and 38,315 nurses in public health sector employment
against the current numbers of approximately 6,000 clinical officers,
5,000d doctors and 25,000 nurses.
The ideal minimum
health worker to population ratio should be 23 health workers to 10,000
Kenyans or better broken down to 40 clinical officers per 100,000
Kenyans, 32 doctors per 100,000 Kenyans or 95 nurses per 100,000
Kenyans.
The apparent acute shortage will be a serious determinant of the success of universal health coverage.
Access
to highest attainable standards of health is a constitutional right
under Article 43(1)(a) and, therefore, Kenyans have a right to ask their
elected leaders to account on facilitation they have provided for its
enjoyment.
It’s the role of the Executive and MPs to
allocate budget to different sectors. The Ministry of Health should
advice the Treasury and Parliament on the adequate financing.
Peterson Wachira is Kenyatta chairman, Kenya Union of Clinical Officers.
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