President Uhuru Kenyatta (centre) claps as Health Cabinet Secretary James Macharia (left) exchange documents with Mr John Flannery, President and CEO of General Electric Healthcare after the signing of contracts for Medical equipment at State House in Nairobii recently. Photo/HUDSON WAINAINA

Khalwale right, cynics must give Sh38b healthcare project chance

With Chris Odwesso
As we marked World Cancer Day last week, focus inevitably turned to indicators which point to debilitating inadequacies and challenges dogging the health sector. The symptoms are reflected in statistics which are grim—particularly the cancer mortality and morbidity toll (39,000 new cases annually and 27,000 deaths).
Decrepit or non-available facilities, persistent and chronic drugs shortages, poor service delivery and discontented personnel. A World Bank report last week added to the list, the gap between skills and knowledge and capacity to diagnose and successfully treat afflictions.
All these combine to cast a perilous shadow on service delivery. There are, of course, well documented shortfalls in policy framework, capacity realities and equity issues. Bridging the gap between what is available and what is required is massive, given other competing needs.
Funding remains the key plank to meeting challenges posed to healthcare. National expenditure on health remains low despite concerted efforts to boost the sector, for example with Sh47.4 billion for the 2014/15 allocation, up from Sh36.6 billion the previous year.
With a ratio of one doctor for 17,000 patients and per capita investment of about Sh2,000 per year, we are in deep trouble. And when it comes to cancer, the number of experts (oncologists) and those who can provide clinical services and the facilities, the situation is woeful.
And with just two public hospitals—Kenyatta and Moi referral hospitals—catering for cancer patients, it is no surprise that patients who cannot afford the alternative are condemned to wait for up to a year for chemotherapy and radiotherapy. Thousands die waiting.
This in part provides the backdrop to last Friday’s unveiling of Sh38 billion healthcare project for 98 facilities by President Uhuru. Long-suffering Kenyans rightly think this is a revolutionary step in healthcare provision and are unable to understand the cynicism and apprehension expressed by governors who have made the project an issue.
Their contention? That since health provision is a devolved function, they ought to have been more involved in the massive project. Details notwithstanding, with Sh21.8 billion earmarked for cancer, Sh2.2 billion for renal, Sh3.3 billion for ICUs, Sh12 billion for theatre and laboratory equipment, there has never been more upbeat news for a sector on its knees.
As Kakamega Senator Boni Khalwale put it, governors should be happy the National government has intervened and stop misleading the public that they will carry the burden of loan repayment for the equipment and maintenance. To attain Millennium Development Goals, on which the curtains come down this year, the proportion of expenditure on health was expected to be scaled up six times!
The Sh38 billion project provides a credible takeoff platform besides making a significant step towards setting Kenya on the course towards fulfilling the Abuja Declaration of 2001 which had recommended allocation of 15 per cent of national budget to health.
Kenya may not be there yet, but it is the capacity and funding issues which find expression in ill-equipment and discontent among others as the gap between dwindling resources and burgeoning demands prove impossible to bridge. Medical experts did blame the hiccups on devolution which they say was hurried.
This may be true, however, governors would be doing injustice to the sector by appearing to throw spanners into the works. Healthcare deserves more attention and resources otherwise the numerous persistent symptoms of weak system will not subside.
Kenyans deserve improved clinical care, nursing services with general administrative capacities enhanced, realisation of which is also a function of better accountability and governance of health institutions. chris.odwesso@mediamax.co.ke