Wednesday, April 4, 2012

Government approach to healthcare baffling

Sunday Nation, 01 April 2012

On paper, the Kenya government acknowledges that Kenya is struggling with a very high burden of both communicable and non-communicable diseases. Many policy documents and statements of intent lie on shelves in various government departments, promising that the government will throw all the necessary resources at these health problems in order to achieve a healthy working nation in the shortest time possible.

This is why it is baffling that government health expenditure has been dwindling over the years, and has recently dipped to less than five per cent of total government expenditure. Despite government commitment to the Abuja Declaration binding it to allocate at least 15 per cent of the budget to the health sector, there is little tangible evidence that this is being actively pursued.

This past week the doctors’ union revealed that the government has been dilly-dallying in the matter of hiring doctors who graduated from medical school in December last year, citing lack of funds. Sources at the ministry of Medical Services had indicated that the government intended to hire these doctors in July, over eight months after they sat and passed their last exams in medical school.

In a meeting with the doctors’ union, officials at the Treasury pointed out that the ministry of Medical Services had delayed in requesting for the necessary resources for the hiring of these doctors, and authorisation was given in record time. Hopefully, these doctors should report for duty tomorrow.

Key problem

This incident demonstrates the key problem in our health sector. There are officials in the twin ministries of Health who are fossilised in the status quo, and no significant improvements will be seen in these ministries unless these officials are shown the door.

These officials are the main cause of unrest in the sector, and this country is set to see an exponential rise in the number of strikes and demonstrations by health workers unless the administrative structures in these ministries are reorganised.

I have had the opportunity to interact with these Afya House functionaries at different levels, both as a civil servant and as a member of organisations that deal with the ministries of Health. Unfailingly, in every interaction, there is always a cabal whose main role is to delay progress, plant roadblocks, and foment unrest.

It is unclear whether their actions are sanctioned by their seniors, or whether they are just the product of many years of “service” whose main goal is obfuscation and procrastination.

Another example of this fatal malaise is the ongoing attempt to develop a Health Bill to govern all aspects of healthcare in this country. After endorsing the Taskforce recommendation for a Health Service Commission anchored in the Constitution, the Afya House mandarins are now proposing to create a Health Service Authority to carry out the same tasks this commission is meant to address.

The development of the Bill itself has been shrouded in mystery, and the current draft is top-heavy with bureaucracy that duplicates almost every function envisaged by the drafters. Unless this Bill is closely scrutinised, the rot at Afya House will be transferred intact to the new administration under the new Constitution.

It is therefore time the government cleaned out this veritable Augean stable that sits at the helm of our Health infrastructure in order to forestall any further problems in the health sector.

Dr Lukoye Atwoli is sSecretary, Kenya Psychiatric Association and lecturer, Moi University’s school of medicine

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