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A health worker adjusts a mask on a colleague in Kenya.

Corona Virus

COVID-19 pandemic: Kenya not out of the woods yet

While it is good to acknowledge that measures taken to mitigate the effects of the COVID-19 pandemic are well and expertly intentioned, they have been sabotaged by majority Kenyans.

And we need to either take action against those flouting them or lift them altogether. The only people who continue to obey them at a very high cost are the marginalized and vulnerable people.

It is a waste of human resources and a rethink is urgently required, given the reality of how the majority are disobeying measures such as cessation of movement from and to some regions, operation of social and religious places, curfew hours and general basic hygiene. Along the roads, most of the screening is not done well, police roadblocks remain ineffective as people either bribe their way, use riders to dodge or walk past the points with impunity, making a mockery of the stops, people wearing masks below their noses while a number of washing/sanitization points are ignored.

We are yet to own the pandemic consequences and a number still think the government is using the pandemic to secure donor funding, while discussions around the status of the health sector, funding, policies and infrastructure still remain muted. With over 100 days counted since the first case of COVID-19 was announced, and government on expert advise put in measures in place to contain the pandemic, the rich and the middle class have tried all means to scuttle the effort to cushion the vulnerable against the adverse effects of the outbreak.

The complacency on the part of the authorities especially officers managing cessation checkpoints, the behaviour by riders to sneak in or out persons from these areas, and Kenyans who seem determined to showcase impunity by breaking the government directives are indeed frustrating public health interventions to contain the pandemic. It’s true that the military approach to handling the pandemic is problematic, and has alienated members of the public from fully feeling part of the solution, we have no reason to flout these measures simply because we are yet to lose a family member or close friend.

While data on the fatalities and infections from other communicable diseases such as cholera, malaria, TB, HIV and AIDS during the COVID-19 pandemic are currently not easily available, the modest behavior change so far exhibited by Kenyans including physical distancing, washing of hands, avoiding crowded places, homecare, physical fitness and improved diet, it is evident that the state of Kenyans health has improved. But these gains might be eroded by the challenges faced by those with chronic diseases who have been advised to avoid hospitals or those previously importing life-saving drugs, or hard to reach populations, this lessons learned must include urgent establishment of the health commission, to streamline services in the sector.

Chapter 4 of the Bill of Rights provides for the right to adequate health which cannot be actualised in the current state where we lack clear policies and a legal regime to guide the sector. The government, through Vision 2030, commits to improving the overall livelihoods of Kenyans; provide an efficient and high-quality healthcare system through devolution of funds and management of healthcare.

In addition to the devolution of the health services, which has rarely worked so far while the establishment the commission to manage the health work force is still in abeyance, government promise to delink the Health ministry from service delivery in order to improve management of health institutions primarily by devolution of health management to communities and healthcare experts to counties and national hospitals. By failing to establish a national health commission as provided for in the Constitution, we have contributed to escalating challenges in the health sector.  We have for a long time waited to see reforms at the Kenya Medical Supplies Agency and streamlining buying of medical equipment and drugs by country governments without any progress.

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Health provision including dealing with emergencies is a key agenda both in the Big Four agenda, Constitution and Vision 2030. This obviously follows the Constitutional requirement, Kenya Health Act 2014 and Kenya Health Policy 2014-30. In addition, Kenya has ascribed to the Sustainable Development Goals (SDGs), including SDG No3, that commits governments to provide quality healthcare for all.

The responsibility of providing quality and accessible healthcare for all Kenyans lies on both the national and county governments. The national government is responsible for policy formulation and managing referral hospitals while county governments are charged with managing health facilities within their jurisdiction.  Interventions on improving the health situations of Kenyans including dealing with outbreaks like Coronavirus is the responsibility of both governments, and a national narrative through the media auditing the country’s response and preparedness.

Providing quality health care for all has serious implications and the responsibilities go beyond national and county government to include private establishments, the political class, faith-based organisations, civil society and households. It requires effective and well-structured partnerships. Kenyans must rethink and use this pandemic to expand the debate on access to universal health, through adopting behavior change to support healthy lifestyles, pushing for reforms in the  health sector including the establishment of the health commission, budget enhancement to improve the infrastructure in the sector and issue of resolving the national and county government tussle over management of the sector.

The writer works at the Media Council of Kenya.

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