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Kenya’s Health Sector Hangs in the Balance: An Opinion on the Impasse between the National and County Governments

February 27, 2023 By

By: Mark Mwenda

The relationship between the national and county governments in Kenya has been characterized by numerous disagreements, with the health sector being one of the most affected. These disagreements have caused significant delays in service delivery, resulting in a negative impact on the health of the Kenyan population. In an effort to address these issues, the President, Dr. William Ruto, recently convened a summit in Naivasha with the council of governors and other government officials. The summit aimed to promote consultation and cooperation between the two levels of government and resulted in 23 resolutions, with five of them being related to the health sector. These resolutions included improving insurance coverage, aligning medical equipment services at the county level, supporting community health workers, assessing health worker conditions, and extending Universal Health Coverage (UHC) staff contracts. In this opinion piece, we will explore the implications of these resolutions for the health sector, while also highlighting the shortcomings of prior agreements the summit sought to address.

Kiambu County Community Members queue for registration in the National Health Insurance Fund, Supported by the Kiambu County Government towards attainment of Universal Health Coverage

The recent breakthrough in the impasse between the national and county governments in Kenya is a welcome development, especially for the health sector. The Naivasha Summit’s resolutions on the health sector are a step towards improving the quality and accessibility of health services for Kenyans. However, the delays and inefficiencies that have characterized the process leading to this agreement are a cause for concern.

One of the major issues is the delay in convening this meeting. It is unfortunate that it took so long for the national and county governments to come together to discuss and resolve the issues affecting service delivery. The wait has caused a lot of suffering for Kenyans, especially in the health sector, where critical services have been postponed due to lack of funds or disagreements on administrative issues. The government must ensure that such delays do not happen again in the future and take proactive measures to prevent similar situations from arising.

Another issue is the slow progress in aligning medical equipment services at the county level. The delay in this process is a significant setback for the health sector, as it hinders the provision of quality and timely health services. The government must ensure that the necessary measures are taken to fast-track the alignment of medical equipment services in the counties, and that all the necessary resources are made available to ensure a successful process.

In relation to  the money promised to support 100,000 community health volunteers, it is essential to ensure that the funds are used appropriately by county governments once disbursed. There have been cases in the past where funds meant for healthcare have been diverted to other areas, and this must not happen again. The government must ensure that there is proper accountability for these funds to prevent misuse.

The extension of contracts for UHC staff for three more years under the same terms and conditions could reduce staff motivation, which may also influence the effective implementation of the program in the country. It is essential to recognize the crucial role played by these health workers in the implementation of UHC and other health programs. The government must improve the contract terms to motivate them and ensure the success of these programs.

Kenya’s President Dr. William Ruto chairing the Governors meeting in Naivasha, Nakuru County

On a positive note, the steps taken by the president to meet the governors while including the health sector in the agenda of the summit are commendable. The involvement of the health sector in the discussions, along with the five resolutions made, are a step towards improving the country’s health systems. The resolutions will improve access to quality health services, ensure accountability, and strengthen the health workforce.

Each of the summit’s five health-related agreements is crucial to improving the health sector in the country. The restructuring of the National Health Insurance, standardization of community health workers/volunteers’ services and training, assessment of health workers to facilitate the Collective Bargaining Agreement (CBA) negotiations, extension of contracts for UHC staff, and the involvement of counties in the negotiations for medical equipment services are all steps in the right direction.

Community Health Assistants in Kiambu County (Part of UHC Staff) and Volunteers undergo a training on Epidemic Preparedness and Response in Communities

In conclusion, the resolution of the impasse between the national and county governments is a positive development for the health sector in Kenya. However, the government must ensure that similar delays and inefficiencies do not happen in the future. The five resolutions made at the Naivasha Summit concerning the health sector are commendable, and the government must ensure their successful implementation to improve the health sector’s quality and accessibility.

 

Disclaimer: The views expressed in this opinion piece are solely those of the author and do not reflect the official position of any organization or individual. The information provided is for general informational purposes only and should not be taken as professional or legal advice. The author is not responsible for any errors or omissions in the content of this opinion piece, nor for any losses, injuries, or damages that may arise from the use of the information provided.

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Filed Under: CHWs, Community Health Worker, News, Voices Blogs

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