Doctors to down tools in push for medical cover, posting of interns

Doctors led by Kenya Medical Practitioners Pharmacists and Dentists Union Secretary General Davji Atela demonstrate outside Afya house in Nairobi on April 9, 2024. [Collins Oduor, Standard]

Today, doctors, backed by Gen Z protesters, intend to storm Afya House to demand action in what is dubbed as ‘#Occupy MoH’.

The medics want the Ministry of Health to post intern doctors, and provide comprehensive medical cover to civil servants under Social Health Authority (SHA).

The medics consisting of mostly young doctors who fall within the Generation Z age bracket, plan to join Kenya Medical Practitioners Pharmacists and Dental Union (KMPDU) to camp at the ministry’s offices.

KMPDU Secretary-General Dr Davji Atellah told The Standard in an interview that according to return to work formula, the ministry was to post intern doctors by July 6, 2024.

However, by yesterday, posting was yet to be actualised.

“We want the ministry to comply with the return to work formula signed on May 8, 2024 which agreed that they will post intern doctors within 60 days,” said Atellah.

 There are at least 1,500 intern doctors awaiting posting. Some have been on stand-by for two years, one year and six months now.

Dr Cheyenne Oyando, a medical officer intern observed that doctors and health workers at large remain one of the most disrespected professionals in our country.

She said most of the interns have been out of school for more than a year.

Oyando regretted that the court has further pushed the posting orders further 90 days when we had been told we would get the verdict by early July,” she added.

“According to the 2017 CBA agreement, one is supposed to be posted for the mandatory internship programme within 30 days of finishing medical school, which we need to complete in order to get our medical licenses,” said the doctor.

Point of contact

Oyando observed that intern doctors are the backbone of healthcare, as these are the first point of contact for a patient.

Failing to post them, she said, leaves a huge gap in hospitals, crippling their functionality.

Additionally, she took issue with the government’s plan to slash pay of intern doctors.

Initially, according to the 2017 Collective Bargaining Agreement (CBA) signed between doctors and the Ministry of Health, an intern doctor should earn Sh206,000 a month.

But Salaries and Remuneration Commission (SRC) slashed the pay to between Sh47,000 and Sh70,000, earning the wrath of the health workers.

“The government wants to slash the salaries by 91 per cent, which is very unfair once you look at not only the economy, but the amount of work that interns do,” added Oyando.

She added that the #OccupyMOH initiative will not only benefit medics, but also Kenyans.
Atellah criticised the Social Health Authority’s failure to have comprehensive medical cover, saying it will force civil servants to acquire other medical insurance to access healthcare. “With SHA, doctors and civil servants will be forced to have private insurance while seeking care,” said Atellah.

Doctors filed a case in court demanding that SHA provide comprehensive cover to all civil servants. The matter is still active in court.

However, amid push, the Social Health Insurance (General) Regulations, 2024 do not have compressive cover. It also doesn’t have premiums for beneficiaries. 

In a recent media engagement, SHA chairperson, Dr Timothy Olweny, maintained that the new scheme has no schemes as witnessed in the repealed National Health Insurance Fund (NHIF).

“This kind of arrangement (NHIF) was complicated. It had over 90 schemes, and perception was it was discriminatory. Social Health Insurance Fund (SHIF) will be explicit,” adds Olweny.

Additionally, doctors want Linda Mama to be reinstated.

“Linda Mama has helped many people. In whatever the situation, it should be protected at all costs,” said Atellah.

The SG added, “If we assumed free deliveries, we shall end up having more women suffer. We cannot just wish free deliveries away”.

In the 2024/25 budget, Free Maternity Healthcare, which is offered under the Linda Mama programme was allocated Sh2 billion down from Sh4 billion.

During the deliberation of health budget estimates, the Director of Health Financing at the Ministry of Health, Elizabeth Wangia, told the National Assembly Health Committee that only indigent women will be considered for free delivery under SHA. She explained that all schemes under SHA will be collapsed.

“As much as Linda Mama will be a stand-alone fund, we will identify pregnant women as provided in the Act. If indigent, they should be assisted to get service,” said Wangia.

“Just like any other indigent, means testing is done, and a pregnant woman is considered an indigent, so she will be covered,” she added.