In December 2018, President Uhuru Kenyatta launched Universal Health Coverage (UHC) in the country, as part of his Big Four Agenda. With the launch, it was expected that every Kenyan will have access to good healthcare services they require, as part of the sustainable development goals before 2022.
According to the World Health Organization (WHO), UHC means that all individuals and communities are able to receive the health services they need without suffering financial hardship. This is inclusive of essential, quality health services, from health promotion to prevention, treatment, rehabilitation and palliative care. WHO further explains that, with UHC, everyone is able to access the services that address the most significant causes of disease and death, and ensures that the quality of those services is good enough to improve the health of the people who receive them.
Yet, in many ways, the healthcare system in the country continues to suffer with the numerous healthcare workers’ strikes, un-honored MoUs with the government and unsolved issues and complaints by different cadres in healthcare. Even Medicine students in Universities have been affected every once in a while when their lecturers go on strike.
For Wanjiku, who probably only has access to the local government health centre where drugs and services are given free of charge, any news of a Doctors’, Nurses’ or Clinicians’ strike is a sharp pain to her already desolate pockets. She is the infamous grass that gets hurt when two oxen fight.
But that is a story for another day.
So, are we headed in the right direction or is UHC just but a far-fetched dream?
I sought a bit of clear explanation to the state of affairs in the health sector, from Dr. Flavio Mugendi, a practicing Doctor at Kenyatta National Hospital, and lead practitioner at webdoctorke.
In his words, Daktari explains, “Our Kenyan healthcare system needs to first adhere to local and international standards at the input and processes level before we look elsewhere. The fact that Kenyans can come up and run Private Hospitals that offer quality healthcare and that are leaders in the industry across the region, is a testimony enough that the public health system can work too. It is the same personnel that work in private that also work in public hospitals. The difference is just the system. The private healthcare systems have institutional standard operating procedures that are adhered to by professors and sweepers alike. On the other hand few are bothered by the existence or lack of standard operating procedures in the public system.”
On issues infrastructure and resources, he adds, “We cannot function with infrastructure that was set up in the colonial and post colonial period. As the population expands so should the public facilities. Well trained healthcare workers no matter how passionate are perennially let down by infrastructural inadequacies. The placement and development of infrastructure should match the capability and availability of staff that man them. That is, the personnel and the infrastructure should be in tandem. Yes you can send a doctor to a sub county hospital, but if the theatre has no water the doctor has little options in the event a case that requires surgical intervention presents, no matter the doctor’s passion or qualifications.”
Clearly, this is a topic that needs multiple intentional and multipronged approaches for it to work. Unless we recognize health care as a public good, one that benefits individuals and whole communities, the frailty of our system will continue to be exposed. A lot of inputs and discussions have to be made if we are going to work towards a successful implementation of a basic human right – good health.