BY VICTOR BWIRE
The recent media expose on the plight of cancer patients in Kenya, the confusion the recently purchased equipment by the national government to be distributed to county hospitals and mishandling of the health sector by especially the county governments is a clear indication of how we are still averse to the Constitution’s recognition of economic, social and cultural rights by enshrining them in chapter 4 under the Bill of Rights.
It was expected that the government will move fast and establish the National Health Authority, which will have coordinated the provision of health to Kenyans, both at the National and County levels without hitches. The delay is actualising this body is a major contributor in the current confusion the health sector and suffering by Kenyans.
Indeed, with such having happened, Kenyans can now sue both the national and county governments in case of refusal to provide these rights. With the incorporation of the ESCR into the Constitution of Kenya 2010 (Article 43), and through ratification and domestication, international human rights laws and standards become part and parcel of domestic law. This means that judicial interpretation on ECOSOC rights is required, and this can only happen by people going to court over the failure of the governments to provide adequate health care. The lack of clarity in handling the sector, as seen in the inability to place health services either under the county governments of the national government, how to process the salary and administrative services in the sector and related is least desirable. Both governments have a role in the provision of health to Kenyans: it’s not either national government or county government- we need to move past this petty rivalry and serve Kenyans through proper coordination and support to each other: after all, the funds are taxpayers’ money.
In the Social pillar of the Vision 2030, the government commits to improve the overall livelihoods of Kenyans; the country aims to provide an efficient and high quality health care system with the best standards. This will be done through a two-pronged approach: (i) devolution of funds and management of health care to the communities and district medical officers. This is not happening smoothly as would be expected.
Flagship projects singled out include; revitalise community health centres to promote preventive health care (as opposed to curative intervention), de-link the Ministry of Health from service delivery in order to improve management of the country’s health institutions primarily by devolution of health management to communities and healthcare experts at district, provincial and national hospitals. Additionally is to create a National Health Insurance Scheme in order to promote equity in Kenya’s healthcare financing; and scaling up the output-based approach system to enable disadvantaged groups to access health care from preferred health facilities.
This cannot be achieved within the current argument that health is already a devolved function thus the national government has no role. The actualisation of the Vision 2030 cannot be achieved without the involvement of the national government.
The national government through the anticipated National Health Authority is expected to oversee the deployment of health workers to those districts in Kenya where they are needed most in order to improve health care coverage for the poorest mothers and children, ensure that health workers are adequately trained, equipped and supported to deal successfully with the principal threats to every maternal or child survival particularly through the first five years of life and the critical period after birth for the child and pre and post natal for the mother.
(Bwire is the Deputy CEO & Programmes Manager at the Media Council of Kenya)