The doctors’ strike is a late symptom of a gap in healthcare leadership that has existed for decades.
The country does not recognise healthcare managers as an essential cadre, away from the mainstream clinical cadres.
Healthcare workers who seek skills in healthcare management are frowned upon and face outright rejection by the establishment.
The result is policy leadership that ill-advised the country leadership to devolve healthcare workers and underpay doctors for decades.
Consequently, the common man receives poor medical services from low level cadre when the country is spending millions of dollars to train doctors, only for them to emigrate to Europe and South Africa.
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Misadvised, the country has also spent about Sh40 billion on equipment that hospitals have no idea how to use.
Nothing demonstrates the disconnect between reality and ignorance at Afya house than the Ministry of Health’s Ministerial Strategic and Investment plan July 2014 – June 2018 which was done when Mr Macharia and Dr Kasachon were at the helm of the Health ministry as Cabinet and Principal Secretary respectively.
The document is a copy-and-paste work from previous unhelpful strategic plans devoid of a solution to what the ailing system needs most - the retention of doctors in the public sector. How this is missed by a whole ministry is laughable.
There is one doctor for every 17,000 Kenyans. This looks bad until you look at it more keenly, then you will be shocked.
Kenya trains close to 1,000 medical doctors each year.
Despite this, there are less than 3,600 doctors working in the public sector.
About 60 per cent of whom serve the 26 per cent of Kenyans who live in urban areas, leaving about 30 million Kenyans to be served by 1,000 doctors in rural Kenya.
Thus, in rural Kenya, one doctor serves about 30,000 people, against the WHO’s standard of 1 doctor for 1,000 people. Statistics for specialties will shock you even more.
There are less than 1,500 dentists in the country. One pharmacist serves about 25,000 people, and any serious brain injury can only be treated in Nairobi, where all of Kenya’s 16 neurosurgeons are located.
Where do the nearly 1,000 doctors who are trained each year go to?
They emigrate to Europe, South Africa, Botswana, and Namibia to name a few, because there, the governments are sane enough to notice the socio-economic dynamics of the healthcare worker haemorrhage.
Doctors in these countries earn an average seven times more than a Kenyan doctor, despite comparable or even lower GDP.
Economists have estimated that the cost of educating a single medical doctor from primary school to university is about Sh6.6 million.
For every doctor who emigrates, Kenya loses about Sh5.2 million worth of returns on investment.
The total cost of educating one nurse from primary school to college of health sciences is about Sh4.3 million. Kenya loses about Sh3.4 million on return on investment when a nurse emigrates.
But for a country that loses a third of its budget to corruption, brain drain may go unnoticed.
As much as 50 per cent of deaths occurring in the public sector facilities may be prevented if the Government invested in the correctly trained, facilitated and well remunerated workforce.
Simple bacterial infections, preventable outbreaks like cholera, minor injuries from motorbikes and minor accidents and child birth are a major causes of death in Kenya, taking the country deeper into shame, and millions of citizens in grief not to mention countless orphans and widows that are created, to the indifference of the government and the middle class that makes the country’s policies.
The Government must retain doctors by compensating them commensurate with their skills and in a way that encourages them to work in rural and hard to reach counties.
The management of doctors must be devoid of tribalism like it is today, especially in counties.
It is almost impossible for most doctors to get training opportunities, promotions and even hiring if they do not fit in the tribe in the leadership.
The requests for doctors to work in their home counties have flooded all county human resource offices.
Without the ability to move back to their home counties and diminishing prospects of fair treatment, doctors feel trapped.
The Government must get it right and address the real grievances that prevent the common man from getting the highest attainable level of health care.
Fair treatment of doctors and commensurate payment will retain doctors.
Policy leadership in Healthcare must be taken away from the clueless officers and streamlined to reflect the need of the current Kenya.
