Experts: Kenya lacks access to key medical care
By George.Kebaso, June 26, 2023President William Ruto will this morning open a three-day national health financing dialogue in Nairobi in the backdrop of an assessment by Kenyan Section of International Commission of Jurists (ICJ Kenya) which pokes holes in the overall healthcare ecosystem.
In the face of this meeting hosted by the Ministry of Health, a myriad of challenges face the healthcare environment including the recent budget slash from Sh146.8 billion in the 2022-23 Financial Year to Sh141.2 billion in the 2023-24 period.
For eight months, a team of technical experts and support staff at ICJ Kenya combed through the legal and policy frameworks on the right to health, and pointed out huge inconsistencies.
The team, led by Executive Director at International Development Institute-Africa Dr Charles Oyaya assisted by Bryan Tumwa and Mercy Achieng’, concluded that despite the significant efforts towards achieving the right to health, many challenges and structural barriers – that inhibit access to healthcare services and full enjoyment of the right – remain.
“Consequently, the right to health, as currently enacted under national and international laws and policies, is insufficient to protect every person’s right to the highest attainable health standards and address the systemic and structural issues inhibiting the right to health,” the team concluded.
Dr Oyaya’s team was supported by ICJ Kenya Secretariat comprising of Julie Matheka, Geoffrey Odhiambo, Christine Akinyi and Paul Agina in the eight-month study funded by the Danish International Development Agency (Danida) through Uraia Trust.
Kenya has a robust legal framework to facilitate accomplishment of Article 43 (1)(a) and (2) that guarantees the right of every person to the highest attainable standard of health, which includes the right to healthcare services, reproductive healthcare and emergency medical treatment.
ICJ Kenya Executive Director Elsy Sainna explained that the right to health is not promoted; or even protected in view of the findings. Despite the fact that Kenya is signatory to various regional, global and local laws on health, Sainna listed a number of institutional, infrastructural and structural impediments.
“We generally have weak regulation and monitoring of private healthcare services in the sense that it has undermined the right to health as it has brought about inequalities in the availability, accessibility, affordability, acceptability and quality of healthcare facilities and providers, making dependants on healthcare services consumers rather than rights holders,” she said during a recent interview at the ICJ offices in Nairobi.
Sainna highlighted that, for instance, low-income households have had to rely on underfunded public healthcare facilities or low-cost private ones that offer substandard medical services.
This, she noted, has hampered their enjoyment of the right to healthcare.
“There is therefore a need to sufficiently implement legal framework for the regulation and monitoring of private healthcare service providers,” she said.
She further pointed out the lack of a clear strategy for scaling up and sustainability of the Universal Health Coverage (UHC) pilot programme.
She also pointed out that there’s generally inadequate healthcare workforce contrary to norms and standards.
This, she argues, is compounded by inefficient utilisation of available human resources within the national and devolved health system; weak supply-chain management systems for medical commodities, consumables, equipment and technologies, and also a lack of formal recognition and integration of the community health system as a critical part of the health structure.
“An enabling legal and policy framework for health is therefore vital to realising the right to health as enshrined in the Constitution,” she noted.
Despite the existing efforts to promote exclusive breastfeeding and proper child nutrition, the study finds that there has been slow progress in reducing wasting and stunting in children under five years.
The study further points out that there is presence of acute nutrition deficiencies, including underweight indicators in children under five years, with the problem of the chronically undernourished minors more prevalent in urban areas.
Successive regimes since the country embarked on the implementation of devolution of health programmes from 2013 have made UHC one of its main development priorities.
However, while there is evidence of improvements in indicators for specific age groups, particularly those related to adult, infant, and child health, it was found that some indicators are off track, especially those related to neonatal and maternal health.
The study finds that there is a yawning gap in terms of inadequate healthcare workforce contrary to the norms and standards of staffing as captured in the Health Act.
Sainna says there is need for a Health Service Commission as an independent constitutional body for effective management of healthcare staff.
“This will help in the recruitment, posting, promotion and remuneration of all health workers within a standardised framework for the National government and all the 47 county government health systems,” she noted.
She also suggests that there should be a strengthened health emergencies response and preparedness.
Further, the ICJ Kenya Executive Director suggested the need to establish a national policy guideline on a rights-based approach to managing public health emergencies and protecting human rights and the right to health during emergencies such as pandemics, epidemics, disasters and other humanitarian situations.
Establish a national healthcare system capacity-strengthening strategy and programme on health emergency preparedness and management, Sainna advised.