While access to quality health care is a constitutional right, millions of Kenyans are denied access to quality health care due to various reasons such as, affordability, geographical barriers, shortage of health care providers among others. The structure of the Kenyan Health Care system can be divided into three sub-sectors namely; (a) the public sector which includes government health facilities, medical schools and the public pharmaceutical chain called KEMSA, (b) the non-commercial private sector; FBOs, NGOs which include mission health facilities, medical schools and MEDs and (c) the private commercial (“for-profit”) include health care facilities, medical distributors / supplies, ICT in health, health management advisory and training institutions.
A major concern in the health sector is the infant and under-five mortality rates. According to the World Health Organization, the infant mortality rate stands at 48%, a number that is very high considering the changes that have taken place in medicine’s history. The number is experienced due to several causes including; malaria, which is the main cause, respiratory infection, malnutrition due to high levels of poverty, diarrhea diseases, HIV/AIDS, and TB. To reduce the under-five mortality rates, sensitization programs have been done by private companies and other organisations such as the Kenya Red Cross to sensitize people on the importance of hand washing in the prevention of diseases, and also raising funds to help those that have a chance of recovering (Help a child reach five campaign). Additionally, there has been enhanced sensitization on the need to sleep under insecticides treated mosquito nets and improved treatment on malaria infected cases to help reduce cases of infant deaths.
Besides infant mortality, several cases of maternal mortality are also on the rise where women lose their lives during child birth. This is highly associated with the fact that most women especially in the rural areas still make use of traditional birth attendants mainly due to inaccessibility to medical services or preference on traditional birth attendants as compared to skilled birth attendants. Some myths and religious beliefs are no exception. Hospitals and clinics are located far as per the recommended 5 km radius within reach from their homes forcing most of them to skip clinic days as required, therefore, relying on midwives. Lack of skilled attendance at birth, delayed treatment, and high costs incurred at hospitals are also key contributors to maternity mortality.
The government of Kenya has however put in place measures that will greatly reduce the maternity mortality cases. Such measures include; the presidential directive on free maternity services to women giving birth in public hospitals since June 2013, mobile clinics specifically designed to reach women in areas where clinics are hard to access (beyond zero), campaigns that aim in educating women on the importance of prenatal care, improved infrastructure and equipment in hospitals and increased number of health care givers. The government abolished user fees in public sector at the dispensaries and health centers levels for specific groups i.e. children less than five years of age, pregnant women and orphans and vulnerable children. The government has also provided funding to compensate the facilities for the revenue loss from the limited user fee income.
Health care workers from various cadres have been expressing their grievances and demands in form of nationwide strikes, as witnessed in the recent past. Among these demands include; improved working conditions, poor working environment due to lack of equipment, inadequate health care workers with increased workload, poor remuneration, acute shortage of drugs and inadequate supplies which leads to poor service delivery. Recruitment and deployment of health care workers is another point of focus since the rural areas are lagging behind in terms of health care development and yet it is the goal of the government to change this since the Constitution of Kenya was promulgated paving way for devolution. It is evident therefore, that geographical disparities in health care access in Kenya are very high.
In conclusion, there has been tremendous improvement in the health sector where for instance, most people have taken up insurance covers after several campaigns and introduction of affordable rates across all classes of people, mostly convenient is the NHIF medical cover. The rate of HIV/AIDS infections has also gone down to 6.7% as compared to 10% in the 1990s. This was made possible due to awareness on how to prevent acquiring the virus, provision of free condoms and behavior change communication amongst the youth, availability of medical care to those who are prone to getting infected, and sensitization on the importance of living positively amongst PLWHIV. Besides, there has been an increase in numbers of dispensing clinics to prevent congestion in referral hospitals. The government has also increased its total expenditure on the health sector to up to 30%. More workers and medicine has been acquired. The government has also cut more deals with foreign countries like Japan, European countries, and USA on bringing the state of art