Shift focus from Covid-19 to ailing health care system
President William Ruto’s government has the uphill task of steering the strained healthcare system towards a more holistic focus after more than two years of resources being redirected to prioritising and managing the pandemic.
Whoever will be the new pick for the Health Ministry must redirect the nation’s energy and coffers to the promotion and protection of health as enshrined in Article 43 of the Constitution, which guarantees every citizen the right to the highest attainable standards of health, including the right to health care services, emergency health, and reproductive health care.
The bigger picture also includes safeguarding of citizens against mental health issues, which got a boost in the signing of the Mental Health (Amendment) Act, 2020, and the inclusion of a wide range of services pertaining to mental health in the National Hospital Insurance Fund (NHIF).
However, we still have a long way to go when it comes to access to reproductive health and mental health care especially for adolescents and young people, despite the efforts made by county governments with the help of civil society and other stakeholders in the pursuit of better outcomes.
Many times, these issues are often connected or counter-causal, and include sexual gender-based violence, teenage pregnancy, safe transition to motherhood, emergencies arising from childbirth, cushioning against mortality and morbidity, traumas and stigma.
According to UNESCO, the teenage pregnancy and motherhood rate in Kenya stands at about 18 per cent with variations in the counties, translating to about one in every five teenage girls between the ages of 15-19 years, who have either given birth or are pregnant with their first child.
The rate increases with age from three per cent among girls aged 15, to 40 per cent among girls aged 19, leading to a rise in mortality, morbidity and cases of depression leading to trauma and suicide.
This leaves a gap in the wholeness of “health” which, as defined by the World Health Organization (WHO), is not merely the absence of disease or infirmity but a state of complete physical, mental and social well-being.
The Ruto administration needs to put strict measures in place to prevent issues arising from graft that has in the past led to the disruption and denial of critical healthcare services and commodities.
The best way to strengthen the health sector is to build it progressively from the community health units as envisioned in the 1978 Alma-Ata conference which defined and granted international recognition to the concept of Primary Health Care as a strategy to reach the goal of Health for All.
Additionally, the government should strengthen the NHIF to reduce the health outcome inequalities and the increasing poverty gap caused by exorbitant out-of-pocket health expenditures.
The attainment of health as a human right will require the new government to be more deliberate, with transparent processes and stricter environments for the improvement of the health system in the country.
—The writer is a Kisumu-based youth advocate at the Network for Adolescent and Youth of Africa (NAYA Kenya)