The scorecard: Assessing Kenya’s health system

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On the 27th of October 2022, Susan Wafula Nakhumicha was sworn in as the Cabinet Secretary for Health, taking over from Mutahi Kagwe.

The Ministry of Health was at the time plagued by a number of challenges including lack of health commodities in public facilities and corruption allegations at the Kenya Medical Supplies Authority. In order to restore sanity, major changes were made at KEMSA, with the previous board disbanded and a new one chaired by Irungu Nyakera inaugurated on the 18th of May 2023.

During the inauguration, the health Cabinet Secretary issued a stern warning to those intending to taint the image of KEMSA.

“We have individual culprits who taint the image of this institution. I will not stop at anything. Even if it means sending home an entire department, I am ready to deal with it”. Declared Nakhumicha.

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Despite the changes, some public hospitals are still struggling as their stocks run dry. The cabinet while in Kakamega on the 29th of August 2023, considered and approved crucial Bills that promote healthcare, for transmission to Parliament. The bills include The Primary Health Care Bill, 2023;  The Digital Health Bill, 2023;  The Facility Improvement Financing Bill, 2023; and The Social Health Insurance Bill, 2023.

The bills are set to usher in a paradigm shift in the legal and institutional framework for healthcare in Kenya, by repealing the current National Health Insurance Fund. In its place, the Primary Healthcare Fund, Social Health Insurance Fund, and Emergency, Chronic, and Critical Illness Fund will be established if the proposals are endorsed by parliament.

On the other hand, the Digital Health Bill addresses the existing legal and regulatory gaps in the framework for the e-health ecosystem and its data lifecycle; enabling the development of standards for the provision of m-health, telemedicine, and e-learning in healthcare. According to George Gibore, the Secretary General of the Kenya Union of Clinical Officers, the bills are in order but more needs to be done to seal corruption loopholes

“One thing I’m not appreciating in that bill is that Kenyans have been complaining about corruption. There are no specific measures proposed in that bill to ensure we are not going to lose our money again,” observes Gibore.

This new architecture is expected to provide a framework for improved health outcomes and financial protection of families. As part of efforts to shift from over concentration to curative to a preventive mode of caring for patients, the government is set to unveil 100,000 community health promoters on the 20th of October 2023 during the Mashujaa Day celebrations. This will help in decongesting hospitals as minor ailments can be identified and managed at the community level.

Gibore however opines that the community health promoters need to be well motivated.

“They will help ease congestion in hospitals. However, the government needs to pay them well in order to perform as intended” says Gibore.

The Ministry of Health recently conducted a health facility census. The exercise was aimed at identifying the number of hospitals, and the number of staff and equipment available with a view to inform policy formulation to improve services. Despite the numerous reforms in the health Sector, Health workers’ unions want more to be done as far as their welfare is concerned.

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