Empowering Local Health Structures In East Africa
Kenya continues to make great strides in improvement of her healthcare systems in regards to the UN Kenya Sustainable Development Goal Number 3 that states good health and wellbeing that ensures healthy lives and promotes wellbeing for all at all ages. Kenyan healthcare is broadly divided into three :Public, private and Non-Governmental Organizations.
In 2013, Kenyan Healthcare was devolved from the National Government to the county government. Under devolution, health service delivery was transferred to the smaller semi-autonomous county governments whilst the National Government retained policy making and regulation (Masaba, Moturi, Taiswa, & Mmusi-Phetoe, 2020, ).
Devolution was introduced to allow the autonomy of county governments to empower them to come up with their own innovative models and interventions that best suited their Health needs and to allow effective community engagement.
However, devolution of the Healthcare system is not without its fair share of challenges. There have been reports of inadequate staffing, poor capacity building, lack of funding, poor legal and institutional frameworks. The ripple effect of this is that there is stagnation of healthcare delivery, delayed salaries and rampant strikes.
Cross sector partnerships are important for effective, equitable health service delivery. Local health care systems if empowered can provide sustainable efficient and equitable health care services to all its citizens at all ages.
Sustainable Goal number three lays a lot of emphasis on Preventive Health care which emphasizes on proactive health screenings and prevention of diseases to reduce the burden of disease and associated risk factors.
Under devolution, a lot of gains have been made in healthcare with improvement of certain health indicators e.g. solid waste management, water supply and sanitation, reduction of maternal mortality rates, etc, this in turn has led to reduction of deaths from communicable and non-communicable diseases.
The National Hospital Insurance fund is a public institution that was founded to provide mandatory health insurance cover for both the formal and informal sector. It is now bound by law that every citizen at least have a NHIF card that can allow anyone seek treatment at any government hospital
With devolution of health services, Universal Health Care was introduced.
It is still in its early initial stages but its main aim is to ensure everyone can access quality healthcare in well-equipped Hospitals without financial burden. Access to affordable quality primary healthcare is the cornerstone of UHC, as it is critical to people’s ability to lead a productive life.
Policymakers worldwide promote collaboration between local and international Health organizations for health systems strengthening. Health systems strengthening is any initiative or strategy that improve one or more aspects of the health care system leading to better improved healthcare (Ejaz et al., 2011,)
Health systems are expected to serve the people effectively and in an equitable manner and non-Governmental organizations play a big role in improving local health care. They should however be in sync and complement the public services. These partnerships are important since they help in achievement both national and international health care goals.
It is without a doubt that the Public Healthcare service delivery is wanting. There is mis appropriation of resources, understaffing and underutilization of the few resources present thus PHC services are underutilized and people are forced to travel far and wide to access simple basic healthcare that they could have otherwise got at their devolved county Hospitals, this further worsens the economic burden to the people and reverses any gains that might have been made.
Through legal frameworks and laid out strategies, the International Health organizations can help in capacity building which shall empower the local health care workers. The national and county governments should in turn should facilitate the ease of getting a study leave on the same.
The NGOs can also advocate for policies that promote and support the public Health sector. In addition, they can help equip the public hospitals with the necessary equipment and have the local healthcare workers trained on use and maintenance of the machines.
NGOs can support the Ministry of Health as they engage the community and come up with self-sustainable programmes to improve healthcare delivery eg Community Health workers programmes.
They too can engage in hiring practices and advice on employee compensation packages so as to ease the burden on local ministries. Moreover, NGOs can guide in leadership and governance which shall allow a smooth transition once the programme is fit to run on its own.
Cross sector partnerships are important for effective, equitable health service delivery. Local health care systems if empowered can provide sustainable efficient and equitable health care services to all its citizens at all ages.
