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Efforts to improve health facilities across the country are finally paying off, with several counties reporting improved service delivery in local public hospitals.

Similarly, Universal Health Coverage (UHC), a government initiative that seeks to promote equity in accessing healthcare, being piloted in five counties, has made it easier for mwananchi to access health services.

A spot-check by People Daily in Nyeri, Machakos, Kisumu, and Trans Nzoia counties paints a picture of a healthcare system fast evolving to meet health needs of communities. 

In Othaya, Nyeri, the construction of a brand new Level Six hospital, Othaya National Referral Hospital, has significantly reduced need for patients to visit Kenyatta National Hospital (KNH) or Moi Teaching and Referral Hospital (MTRH), the two main referral health facilities in the country.

Benson Ndegwa, 70, from Othaya considers the new hospital a huge relief, both financially and emotionally.  He suffers from arthritis, a condition that has seen him hop from one major hospital to another including the Karen Hospital and Nyeri Provincial General Hospital, spending a lot of time and money in the process.

Purely referral 

“We no longer need to make long trips in search of treatment now that specialists are here. We now have the laboratories and the drugs we need,” says Ndegwa. 

Sicilia Nyoka Muriithi from Karima, Othaya was referred to the facility from the adjacent Othaya Level 4 Hospital where she had gone to give birth. 

“I am happy they have a theatre next to the maternity ward to deal with any complications that may occur during child birth. It’s nearer to my home and their services are fast. The hygiene, both personal and general, is very high,” she said.

The yet-to-be commissioned hospital has been operational since August this year and will serve the entire Mount Kenya region.

The Level 6A hospital, however, does not allow walk-in patients, except during medical outpatient clinics. “We did not want to make the same mistake made by other referral hospitals of allowing people in need of primary healthcare to use the facilities. This is purely a referral hospital,” said Michael Thuita, Head of Clinical Services. 

The hospital has already reduced pressures on other referral hospitals in the country, according to Thuita. “The same services they sought at Nyeri Provincial General Hospital, KNH and MTRH are now available here,” said Walter Nyareru, Head of Outpatient Services.

In October alone, the hospital attended to 109 outpatients referred from other hospitals up from 35 the previous month, according to Nyareru. 

The 350-bed capacity hospital, funded by the National government, has 254 medical staff, including 14 specialists, and has attended to more than 1,000 patients since it began operations in August. Once fully operational, it will have 1,300 medical staff. 

From scratch

It has a 35-bed maternity, four surgical theatres and handles a wide range of medical conditions requiring specialised treatment.

The only other Level Six public hospitals in the country are KNH, MTRH, and the newly opened Kenyatta University (KU) Hospital, according to Thuita. However, only KU Hospital will be a purely referral facility such as Othaya.

In Trans Nzoia, the county government is seeking to replicate Othaya’s success by constructing a 400-bed Level Six Kitale Referral Hospital from scratch. 

The construction, which began in 2015, is projected to cost Sh1.4 billion (excluding the cost of medical equipment) and should be ready for occupation by February 2020.

“When we took over in 2013, we realised the health sector in this county had a challenge. All the hospitals in Kitale had a combined capacity of 320 beds only. The new hospital will anchor health in the county and reduce congestion at the MTRH,” said Trans Nzoia Governor Patrick Khaemba.

The facility will have 10 surgical wards, 40 intensive care unit beds, a cancer centre, eight specialised clinics, and a 50-bed children’s ward, with the largest ward accommodating only 12 beds, according to the governor.

Residents are eagerly awaiting the commissioning of the hospital. “This time around, God has remembered us. Sometimes patients die on the way to the MTRH, Eldoret. Travelling to Eldoret is expensive as many of us don’t have the money,” said Alfred Tosha, a Kitale newspaper vendor.

In Machakos county, the UHC programme has significantly increased access to healthcare for the locals. Under it, all medical services are free, including laboratory tests, consultation, maternity charges and drugs.

Tabitha Nthenya, an expectant mother and a diabetic from Matuu, Yatta, says she was impressed by the service she received at Machakos Level 5 Hospital under UHC. 

“It’s my first time here and I am happy with the service so far. You don’t pay for drugs or food and we don’t share beds. I was referred here from Matuu level 4 Hospital. Were it not for M-Tiba, I don’t know where I would have gotten the money,” she said. M-Tiba is a platform through which patients register for UHC.

Countrywide rollout

Julia Muthoni, a first time mother, considers UHC a godsend. She was referred from Mavoko Hospital, Athi River, with a complicated pregnancy. “I have been here for a week and I haven’t paid a cent. Left on my own, I couldn’t afford to pay the bills as I am currently jobless after my business collapsed,” she said.

According to Hansen Kituku, the County Executive Committee (CEC) in-charge of Health, the county has witnessed a 40 per cent increase in number of patients visiting the hospital since UHC launch in December 2018.

 “The programme is really helping. This 40 per cent, where were they seeking medical services before the programme was launched?” posed Kituku.

In the last nine months, about 2.8 million people have visited various health facilities in the county, including 51,000 inpatient cases, Kituku says.

To handle the increased number of patients thanks to the UHC programme, the county has put up level four hospitals in each of its nine sub-counties and a further 26 health centres and 128 level two health facilities.

At Kisumu’s Jaramogi Oginga Odinga Teaching and Referal Hospital (JOOTRH), commonly called Russia, the management expected only 40 per cent increase in the number of outpatient service seekers when UHC was launched in the county. 

However, the numbers rose by over 100 per cent to about 1,800 patients a day, according to the hospital Chief Executive Officer, Peter Okoth.  

“To handle the increased numbers we had to redesign our emergency care services so that doctors now go to the patients, not the other way around,” he said.

The hospital has also invested in new technology such as a state-of-the-art medical waste steriliser, endoscopy technology, and a new oxygen supply system among others.

Elizabeth Akoth, a mother to a two-week old baby from Seme, Kisumu, admitted in the paediatric ward, was happy that her county was one of the five chosen to pilot UHC.

“Had I taken my sick baby to a hospital that does not support this programme, I would have been charged heavily. I am happy I came here,” she said of JOOTRH.

The 600-bed capacity hospital handles 600 to 700 births a month and serves the entire wider western region including Kisii and Kakamega counties.

The UHC was launched in December 2018 and piloted in Kisumu, Machakos, Nyeri, Isiolo and Machakos counties for one year, after which it will be rolled out in the rest of the country.