Posted by on Jun 8, 2017 in Recent News | 1 comment

Every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care A person shall not be denied emergency medical treatment… The State shall provide appropriate social security to persons who are unable to support themselves and their dependents.– Article 43 of the Kenyan Constitution [1]

Do Kenyans have a right to healthcare? Yes, the people of Kenya maintain a statement of solidarity to their fellow citizen in providing high benchmarks in quality and access to care. A new constitution has put Kenya on a path to improving the equity of medical attention provided to its citizens. While the foundations of Kenya’s government recognize the inherent right of each citizen, many institutional and societal challenges face the growing nation on its mission to empower all Kenyans with healthcare.

In a historic 2010 vote, 67 percent of the Kenyan people ratified a new constitution that enhanced their individual rights and autonomy [1]The constitution states that both rural and urban inhabitants of Kenya have a right to the highest attainable standard of health, including the right to reproductive care [1]. In articles 53-57, the constitution enumerates the rights of specific peoples including children, individuals with disabilities, and other marginalized citizens [1]. Another key element of the Kenyan Constitution is devolution of power to 47 counties, each overseen by a governor. Under the belief that a more accountable and personal decision-making process will improve healthcare, the Kenyan government has empowered these county governments to service their communities with medical services, pharmacies, ambulances, and the promotion of primary health care [2].

The majority of Kenyan’s derive their right to healthcare by financing care via the National Hospital Insurance Fund (NHIF). Formed in the 1960s, the NHIF is the oldest government medical scheme in Africa [3]. The NHIF is a mandatory tax for those in formal employment, and is an optional fee of 500 Shilling per month for those in informal employment; in 2016, 25 million Kenyans are benefitting from the program [4],[5]. The government has also undertaken initiatives to specifically focus on child and maternal care by guaranteeing a child’s right to hospital admission and the new Linda Mama platform. For all children under the age of five, the government has ensured their right to free healthcare through all public hospitals; consequently, the mortality rate for children has drastically improved [6]. Launched in 2016, Linda Mama will provide expecting mothers with postnatal and antenatal clinics, as well as yearlong child health services in public and private hospitals; the program aims to serve 400,000 women [7].

In Siaya County, Sagam Community Hospital (SCH) is evidence of success at the local level. By undergoing infrastructure and community investment SCH is able to provide its patients with their right to efficient and quality care. SCH upholds an expert staff of trained clinical officers, an efficient acute response service, and frequently host’s trainings and foreign doctors dedicated to providing care in a rural setting. Recently, from June 1-3, doctors from Nairobi traveled to SCH in an effort to conduct Laparoscopic surgery training. Furthermore, SCH is partnered with Massachusetts General Hospital in the United States to conduct research and exercise best practices to improve the public health of Siaya.

In concert with the excellent care provided at SCH, the hospital frequently ventures into neighboring communities as a part of an initiative known as Community Outreach. The program often sees over 200 patients in one outing, offering services that include cervical cancer screenings, HIV testing, blood pressure assessments, and eye examinations. The Community Outreach enriches the knowledge and overall health of surrounding villages; subsequently, saving many lives.

While Kenya has taken significant strides to improve the lives of its citizens, significant barriers prevent the country from realizing basic healthcare standards. A key barrier to a successful system that plagues all of sub-Saharan Africa is endemic corruption. Corruption strangles the growth of Kenya as it prevents the distribution of healthcare services from reaching the target population. Currently, Kenya is ranked 145 of 176 nations in terms of corruption [8]. Without responsible politicians and institutions, Kenyans will continue to struggle to receive proper care afforded to them in their constitution.

Further barriers to healthcare success in Kenya include access to trained medical professionals and proper infrastructure. The stock of medical professionals in Kenya continues to limit the access citizens have to quality care. For example, Kenya has only two doctors for every 10,000 people, leaving their healthcare system compromised by significant delays; the World Health Organization recommends 23 per 10,000 [9]. Compounding the problem is weak infrastructure throughout Kenya. Often times medical professionals in Kenya are unable to provide high standards of care to their patients due to weak infrastructure. Currently, 17 million people lack access to clean water, 33 million people lack access to improved sanitation, and 40 percent of the population lack access to electricity [10],[11]. Without proper infrastructure, Kenya’s healthcare system will not be able to achieve the high benchmarks set by the constitution.

More systemic obstacles to a healthy Kenyan population are severe poverty and deeply rooted cultural norms. Extreme poverty is prevalent in all of sub-Saharan Africa as it debilitates the native population’s ability to access basic human needs, including food, safe drinking water, sanitation, shelter, and education. Poverty will impede a patient’s ability to pay the services associated with healthcare visits, and can even stop patients from traveling to hospitals due to high transportation costs. In addition, cultural challenges persist into the 21st century, as some traditional groups do not believe that new medical technology can be applied in a rural setting. Societal forces can also prevent individuals from seeking medical testing, mitigating the advancements made in HIV and other communicable diseases [3].

For Kenya to fulfill its promise of a right to healthcare, the national and county governments must end corruption, further invest in the density of medical professionals, and partake in cultural education of health literacy. The 2010 constitution is very clear in its healthcare objectives and outlining the rights of citizens, the next step is for the government to dispense its healthcare resources effectively. Kenya must continue to lead sub-Saharan Africa by overcoming the barriers to quality healthcare; doing so would mean capitalizing on its robust economy and wealth of natural resources to benefit the least well off. It is time for Kenya to follow-through on its constitutional commitments in providing high quality care to all its citizens, regardless of age, ethnicity, disability, or geography.

Resources

[1] Diallo, Mariama. “New Kenyan Constitution Ratified.” VOA. VOA, 05 Aug. 2010. Web. 02 June 2017. https://www.voanews.com/a/kenyas-new-constitution-ratified-100158209/123395.html

 

[2] International Journal Of Scientific Research And Innovative Technology, and Vol. 2 No. 1; January 2015. “HEALTH POLICIES IN KENYA AND THE NEW CONSTITUTION FOR VISION 2030.” 2.1 (2015): n. pag. International Journal of Scientific Research and Innovative Technology, Jan. 2015. Web. 2 June 2017. http://www.ijsrit.com/uploaded_all_files/2737275308_g12.pdf

 

[3] “Case Study: Kenya National Hospital Insurance Fund (NHIF).” USAID Health Finance & Governance, 9 June 2014. Web. 03 June 2017. http://healthmarketinnovations.org/sites/default/files/

Case%20Study%20Kenya%20National%20Hospital%20Insurance%20Fund%20%28NHIF%29.pdf

 

[4]Muema, Morris. “New NHIF Rates in Kenya Finally Take Effect.” Kenyan Business Review. N.p., 04 Nov. 2016. Web. 03 June 2017. http://www.kenyanbusinessreview.com/892/new-nhif-rates-kenya/  

 

[5] “NHIF Operations.” National Hospital Insurance Fund, n.d. Web.

http://www.nhif.or.ke/healthinsurance/Operations

 

[6]“Health Challenges Facing the Realization of Children’s Right to Health in Kenya.” United Nations Human Rights Office of the High Commisioner, n.d. Web. 6 June 2017. http://www.ohchr.org/Documents/Issues/Children/Study/RightHealth/

KenyaNationalCommissionHR_2.pdf

 

[7] Odhiambo, Rhoda. “State Launches ‘Linda Mama’ to Target 400,000 Women Delivering at Home.” The Star, 18 Oct. 2016. Web. 6 June 2017. http://www.the-star.co.ke/news/2016/10/18/state-launches-linda-mama-to-target-400000-women-delivering-at-home_c1440376

 

[8] “Corruption Percentage Index 2016.” Transparency International, 25 Jan. 2017. Web. 2 June 2017. https://www.transparency.org/news/feature/corruption_perceptions_index_2016#table

 

[9] Kushner, Jacob. “Kenya’s Doctors to End 100-day Strike.” USA Today, 14 Mar. 2017. Web. 6 June 2017. https://www.usatoday.com/story/news/world/2017/03/14/kenya-doctors-strike-over/99171746/

 

[10] “Kenya’s Water and Sanitation Crisis.” Water.Org, n.d. Web. 6 June 2017. https://water.org/our-impact/kenya/

 

[11] Chumo, Ben. “Kenya’s Electricity Access Rate Now at a Historic 60 per Cent.” Daily Nation, 23 July 2016. Web. 6 June 2017. http://www.nation.co.ke/oped/Opinion/kenya-electricity-access-rate-now-at-a-historic-sixty-per-cent-/440808-3307998-p0whfa/index.html