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The provision of healthcare in Kenya has been a central area of policy debate only that the various actors have failed to reach consensus on how to implement it for the good of all citizens.
In spite of its significant place in harnessing the economic prosperity of our country, both county and the national governments have failed to identify areas of synergy in healthcare, leading some analysts to argue that health services were prematurely devolved.
In 2013, the 47 devolved units were given autonomy to make decisions on human resource management, emergency, and primary healthcare.
Notably, more than 44,000 of the 66,000 workers that joined the counties were in the medical sector. This was a big challenge for most county governments that were unprepared for the additional staff. A year after devolution, the World Bank in a study titled, 'Delivering primary health services in devolved health system in Kenya', declared that a tenth of the existing healthcare facilities in Kenya had become non-functional.
The report judged Kenyan hospitals on the availability of networked, motivated and competent staff, supply of essential medicines, and funds for operation and maintenance.
While it is true that the national government has failed in some areas, including disbursement of funds, some county governments appear incompetent and structurally handicapped in the management of the crucial public health sector.
Unlike in developed countries, Kenya has not treated affordable healthcare as a right. Our Constitution makes it clear on this matter; every Kenyan has the right to the highest attainable standard of health, and the right to healthcare services, including emergency medical treatment.
Section 43(1)(a) of the Constitution, however, explicitly provides for the right to healthcare services and reproductive care, as well as the highest attainable standard of health.
Although Kenya has made significant improvements in the health delivery systems, accessibility remains a big challenge for many due to high cost. Available statistics show that in 2018, over one million Kenyans were impoverished by high health expenditures for themselves or their loved ones.
The government should now focus more on prioritising universal health care (UHC) and develop a comprehensive plan to progressively roll it out countrywide. In 2018, the government launched UHC Pilot Programme dubbed Afya Care – Wema Wa Mkenya.
The UHC should also prioritise scaling up prevention of waterborne and vector-borne diseases, tuberculosis, HIV and sexually transmitted diseases. Screening and treatment for non-communicable diseases should also be prioritised.
Delivering UHC requires close collaboration and synergy with the private sector, development partners, the active participation of the religious sector, civil society, and healthcare practitioners, and the support of all Kenyans.
Mr Obonyo is Public Policy Analyst.
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