New law to make four key Taita Taveta County hospitals semi-autonomous

Health CS Mutahi Kagwe distributing PPEs to Moi County Referral Hospital in Voi town, Taita-Taveta County during a past event. [Renson Mnyamwezi]

The four main public hospitals in Taita Taveta County will now be allowed to retain a huge portion of the money they generate if new regulations MCAs have passed are approved by Governor Granton Samboja.

The monies will be used to improve service delivery across the county.

The regulations target Voi town-based Moi County Referral which, according to records from the health department, collects between Sh70 million to Sh80 million annually from patients.

The hospital serves thousands of patients including accident victims from the busy Nairobi highway, as well as patients from neighbouring regions.

Other facilities to benefit from the laws that require them to keep 75 per cent of their quarterly collections and use it to procure drugs and equipment are Mwatate, Taveta, and Wesu sub-county hospitals.

Taita Taveta has over 60 public health facilities. The money is managed by the county government.

When patients make any payment, the money goes to the county's accounts, indicating the hospital the patient has visited.

The county puts collections in one basket together with what other sectors generate.

The money is then shared with all county government departments as is necessary.

A portion is set aside for procuring drugs and equipment that are distributed to health facilities.

Currently, health care in Kenya is financed from three main sources: out-of-pocket expenditure (where households pay directly for services received), government expenditure, and donors.

The passing of the County Health Services Regulations, 2021 has now operationalised the Health Services Bill, 2020, which set standards for health care services delivery in the county.

The regulations will also make the four hospitals semi-autonomous even as the county administration strives to provide quality healthcare services.

County Assembly Health Services Committee chairman Ahmed Omar told the house, during a session chaired by Speaker Meshack Maganga on Thursday, that Moi County Referral Hospital lacks X-ray films among other essential equipment due to budget constraints.

The committee's vice chairman Frank Mcharo and Mgange-Mwanda MCA Anselim Mwadime told the House that what has been ailing the health system is the cash flow and bureaucracy.

"The new regulations will give public hospitals some fresh air by making them more effective in their operations as they will no longer struggle to access funds. Medical services have been strained due to cash flow and especially government bureaucracy,” Mwadime said.

Under the new laws, Community Health Volunteers (CHVs), whom Mcharo accused the county administration of neglecting despite the important role they play in the provision of health services, will also be given a stipend to motivate them.

“For the first time since the inception of devolution, there will be a stipend for the CHVs. The health workers record births at village levels and give real-time data,” said the Wundanyi-Mbale MCA.

He said they will zone the county into community health units with each having at least 15 CHVs.

"The regulation provides for payment of stipend to the volunteers as is sufficient to defray expenses reasonably incurred in the discharge of the functions," said Macharo.

Under the regulations, Omar said, the county administration will be expected to embrace and fund routine rapid result initiative programmes aimed at reducing the burden of communicable and non-communicable, including the neglected tropical diseases.

The regulations also provide that the county shall have certified incinerators in every sub-county.

The incinerators will be licensed by regulatory agencies, including National Environment Management Authority.

The county shall also establish a warehouse, that shall be managed centrally, to ensure safe storage of the health products.

The warehouse will also enhance the distribution and redistribution of health commodities, according to the regulations currently before Samboja.

"Health services shall be available, accessible, acceptable, affordable, and of good quality and standards. The laws will also ensure equitable distribution of resources to the health facilities in the region," Omar said.

The Kaloleni MCA added: “The new laws will also make the hospitals financially autonomous to promote access to reproductive and health care services while facilitating, in a progressive and equitable manner, the highest attainable standards of health services."

"It seeks to have revenues from health services invested in drugs and equipment for public hospitals.”

County health executive John Mwakima Mwangeka said enactment of the new law will not only improve service delivery but also promote access, including reproductive healthcare services and the right to emergency medical treatment.

The law requires that the county executive shall develop supplementary sources of income for the provision of services in so far as these are compatible with the applicable law.

“It also seeks to provide for medical audits of deaths in health units and communities with a special emphasis on maternal and perinatal deaths as a tool for the further development of obstetric and perinatal care,” stated part of the law seen by The Standard.