CHAPTER SEVEN

DELIVERING UNIVERSAL HEALTH CARE

The Challenges:

Good health is a basic need for the survival of human beings and the maintenance of a life of dignity. The right to access basic health services is a must. It is enshrined in most of the international human rights instruments that Kenya has signed and ratified.

The health status of Kenyans remains below acceptable levels. Childhood and maternal morbidity and mortality remain too high, and Kenya is unlikely to achieve the Millennium Development Goal (MDG) 4 (reduce child mortality) and MDG 5 (improve maternal health).

Human resources in the health sector remain scarce, and hospital resources are continually overstretched. The entire health provision is grossly under-funded and delivering universal health care remains a priority. These problems are juxtaposed with the irresponsible wastage of the savings deposited by Kenyans in the National Health Insurance Fund. From Kshs 3 billion that the fund receives annually, a significant amount goes into salaries and administration costs.

It is disheartening that despite the professed national goal of eradicating disease, few ordinary people have access to good healthcare services. Our hospitals are poorly equipped and staffed and some are in a deplorable state. They rarely have essential drugs and basic medical equipment. Healthcare professionals are de-motivated often due to overwork and unfavourable working conditions.

The state of our public health is worsened by the inefficiency and corruption in drug and medical equipment supplies. In the rural area the healthcare facilities are few and far between. Kenya has one of the poorest pre-natal and post-natal care services in Sub-Saharan Africa. We are among the leading nations in infant morbidity and mortality from preventable diseases such as malaria.

Our Commitments:

We will emphasise preventive and promotive healthcare through targeted heath education.

We will ensure equitable allocation of government resources to reduce disparities in health status.

We will increase the cost effectiveness and cost efficiency of resource allocation and use.

We will create an enabling environment for increased private sector and community involvement in health service provision and finance.

We will continue to manage population growth.

We will introduce better management structures to ensure efficiency in the management of the healthcare institutions and systems.

We will review the health financing policies and invest in the National Health Security Services as a key national health financing mechanism that will progressively ensure equal access by the poor to the basic health services.

We will increase the efforts in the fight against HIV/AIDS to improve and increase the lives of those infected and reduce the number of those getting infected every year.

We will increase the health service infrastructure to ensure better access to health, particularly in the historically disadvantaged areas.

We will devolve healthcare system management, procurement and financing.

We value our healthcare human resources, and we aim to train more professionals and paramedical workers and enhance their terms and conditions of service and remuneration.

We will reduce corruption in the health sector and increase access to medicines.

We will ensure the development of effective regulatory and inspection mechanisms to protect the public from health injuries and loss of lives related to substandard health services.

Your ODM Government will:

• Enhance government spending in the health sector.

• Improve hospital infrastructure substantially by upgrading rural hospitals, building new health centres in under-served areas by using public/ private partnerships, and working progressively to realise the target of having a 30 bed-hospital in each location/ward.

• Provide free health care to all children under the age of 5 years. This will be the first step in our goal to provide free universal health care for all.

• Strengthen our fight against HIV/AIDS through education and counselling to promote behavioural change, mitigating the socio-economic impact of the disease which remains a priority.

• Continue to encourage population control strategies.

• Expand safe motherhood programmes in all districts by ensuring that these centres are adequately equipped and have improved referral systems, communication systems, and transportation facilities.

• Provide free ante-natal, maternity and post-natal care for expectant mothers.

• Achieve full immunization against TB, polio andmeasles.

• Promote simple practices that will prevent diseases like malaria and diahorrea in communities.

• Specifically work with cultural and community structures to eliminate beliefs and myths that undermine the promotion of primary health.

• Introduce gender indicators in the health monitoring systems at all levels to ensure equitable benefit of health interventions by gender.

• Build health centers in rural areas with an aim of progressively having a health facility accessible within a radius of 5 km.

• Improve the partnership with communities and religious and non-governmental organizations in an effort to increase access to good healthcare facilities.

• Use the government manufacturing rights under the Industrial Property Act to increase access to HIV/AIDS drugs and essential drugs to reduce the alarming death rate resulting from HIV/AIDS related diseases.

• Urgently invest in the research on TB to curb the spread of the emerging dangerous strains of the disease.

• Introduce a bottom up planning system in the health sector where the policy is driven by the needs on the ground rather than the perceived need by the Health Ministry headquarters.

• Overhaul the administrative and reporting mechanism to reduce bureaucracy, increase efficiency and ensure accountability.

• Train health economists to assist in the effective planning and monitoring for better services in the health sector.

• Overhaul the procurement procedures in the health sector to ensure accountability in the implementation of programmes and efficient use of the much needed resources in the sector including drugs and other medical supplies.

• Introduce hefty penalties for any commissions and omissions leading to the loss of resources in the health sector.

• Overhaul and strengthen the health inspection system to eliminate dangerous drug use and distribution practices that are undermining the efforts in controlling diseases like malaria and TB.

• Establish a ministerial monitoring and evaluation unit to ensure accountability in the implementation of the health sector policies.

• Empower devolved units to manage healthcare services.

• Introduce a national policy on nutrition as a component of health provision and a complement to key programmes like the management of HIV/ AIDS and infant and maternal mortality.

• Increase research in and regulation of the use of cultural/indigenous and herbal medicines for health provision in Kenya.

• Progressively build up more referral hospitals to ensure greater access to specialized services, especially in mental health.

• Invest more in biomedical research and introduce a sound legal framework to facilitate such research while protecting our vulnerable populations from unethical experimentation from the international drug companies.