Saturday, May 3, 2014

It’s not too late to redeem health services

By Lukoye Atwoli
Sunday Nation 27 April 2014

The Kenya Medical Association held its 42nd Annual Scientific Conference this past week where it came to light that health services are in dire straits. The Medical Board gave alarming statistics that showed a huge discrepancy between the number of doctors trained in Kenya, and those currently working in the country. Obviously there is an exodus of doctors and other health workers in search of the proverbial “greener pastures”. 

Why is this happening?

Until a few years ago, the terms and conditions of service for doctors were unbelievably pathetic. Following the registration of the doctors’ union and a series of strikes, the government improved the pay packages for health workers and developed a retention policy. For the first time in many years, health workers started seeking change of employer from the private sector to the public sector. Many people in far-flung areas were for the first time in their lives able to see a doctor when unwell.

Then came the new Constitution that devolved a portion of health services to the counties. In a monumental misreading of the Constitution, the national government purported to have devolved the health sector “100 per cent”. As a result, many health workers found themselves in the employ of county governments that had other priorities.

In their first budgets, many county governments did not provide funding for health workers’ pay. As a result, there are still problems with remuneration of health workers. Many health policy decisions are being taken as afterthoughts, without regard to the fact that their impact often means that people could die.

A perception has been created that health workers are against devolution of health to the counties. This is an erroneous assertion aimed at painting health workers as spoilt brats who do not want to be supervised in their work. Many governors are pushing this argument, going as far as to claim that many of those asking for pay are “ghost workers”. Some have embarked on an ethnic audit of their health staff, and others have been encouraging doctors to emigrate to their “home counties”.

Finally, many doctors expect that when employed, their employer would eventually pay for them to undergo further studies in pursuit of specialisation. The national government has, to a large extent, facilitated this through a scholarship programme in the Ministry of Health. Unfortunately, this assurance is lacking in most county governments.

These are some of the issues that are driving doctors and other health workers away from public sector employment to the private sector and, more worryingly, to other countries. Right from the beginning, health workers have proposed solutions to deal with these and other emerging issues. These suggestions have been largely ignored by the powers that be.

Happily, political leaders at the national level are coming to the realisation that unless urgent steps are taken, people will continue to die and suffer from preventable causes. A parliamentary committee has been reported arguing for the formation of a national agency to deal with human resources for health in order to eliminate inequities and address the welfare of health workers and the public.

One hopes that those responsible for the health of Kenyans will take this initiative seriously, unless they are happy with the continued deterioration in the sector. 

Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine.

1 comment:

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