Healthcare in Kenya
Kenya’s health care system is structured in a step-wise manner so that complicated cases are referred to a higher level. Gaps in the system are filled by private and church run units. The structure thus consists:
- Dispensaries and private clinics
- Health centres
- Sub-district hospitals and nursing homes
- District hospital and private hospitals
- Provincial hospital
- National hospital
- 1 Health care units
- 2 Maternal and child healthcare
- 3 Ministry of Health
- 4 Important institutions (acts of parliament)
- 4.1 Medical practitioners and dentists board
- 4.2 Clinical officers council
- 4.3 Kenya Medical laboratory Technicians and Technologist Board (Act of Parliament)KENYA GAZETTE SUPPLEMENT ACTS, 2000, NAIROBI, 28TH JANUARY 2000
- 4.4 Nursing Council of Kenya (NCK)
- 4.5 Kenya Medical Supplies Agency (KEMSA)
- 4.6 Pharmacy and Poisons Board
- 4.7 National Hospital Insurance Fund (NHIF)
- 4.8 Kenya Medical Research Institute (KEMRI)
- 5 Private Health management organisations
- 6 Careers and training
- 7 See also
- 8 References
- 9 References
Health care units
The government runs dispensaries across the country and are the lowest point of contact with the public. These are run and managed by enrolled and registered nurses who are supervised by the nursing officer at the respective health centre. They provide outpatient services for simple ailments such as common cold and flu, uncomplicated malaria and skin conditions. Those patients who cannot be managed by the nurse are referred to the health centres there.
Most private clinics in the community are run by nurses. In 2011 there were 65,000 nurses on their council's register. A smaller number of private clinics, mostly in the urban areas, are run by clinical officers and doctors who numbered 8,600 and 7,100 respectively in 2011. These figures include those who have died or left the profession hence the actual number of workers is lower.
All government health centres have a clinical officer as the in-charge and provide comprehensive primary care. Because of their heavy focus on preventive care such as childhood vaccination, rather than curative services, local council (municipal) and most mission, as well as many private health centres, do not have clinical officers but instead have a nurse as the in-charge.
Health centres are medium sized units which cater for a population of about 80,000 people. A typical health centre is staffed by:
- At least one Clinical officer
- Health administration officer
- Medical technologist
- Pharmaceutical technologist
- Health information officer
- Public health officer
- Supporting staff
All the health centre staff report to the clinical officer in-charge except the public health officers and technicians who are deployed to a geographical area rather than to a health unit and report to the district public health officer even though they may have an office at the health centre.
The health centre has the following departments:
- Administration block where patients register and all correspondence and resources are managed.
- Out-patient consultation rooms where patients are seen and examined by clinical officers.
- In-patient (wards) where very sick patients can be admitted. The wards are divided into male, female and paediatric with newborn units.
- Laboratory where diagnostic tests are done. These laboratories can do the following tests: bloodslides for malaria parasites, sputum AFB, urinalysis, full haemogram, stool ova and cysts, blood sugar, Elisa and CD4 counts in comprehensive care centres for HIV/AIDS patients.
- Minor theatre where minor surgical procedures are done, e.g., circumcision, stitching wounds and manual vacuum aspiration
- Maternal and child health
- Kitchen and catering
- Student hostels for rural health training centres where students go to get rural experience.
These are similar to health centres with addition of a surgery unit for Caeserian section and other procedures. Many are managed by clinical officers. A good number have a medical officer and a wider range of surgical services.
These are owned privately by individuals or churches and offer services roughly similar to those available at a sub-district or district hospital. They are also believed to provide better medical services compared to public hospitals.
Each district in the country has a district hospital which is the co-ordinating and referral centre for the smaller units. They usually have the resources to provide comprehensive medical and surgical services. They are managed by medical superintendents.
Kenya has eight provinces, each with a provincial hospital which is the referral point for the district hospitals. These are regional centres which provide specialised care including intensive care and life support and specialist consultations.
There are two national hospitals in Kenya, namely:
- Moi Teaching and Referral Hospital (MTRH); and
- Kenyatta National Hospital (KNH).
Major causes of morbidity and mortality
- Respiratory tract infections
- Road accidents
- Factory accidents
- Diabetes mellitus
Maternal and child healthcare
In June 2011, the United Nations Population Fund released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Kenya is 530. This is compared with 413.4 in 2008 and 452.3 in 1990. The under 5 mortality rate, per 1,000 births is 86 and the neonatal mortality as a percentage of under 5's mortality is 33. The aim of this report is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Kenya the number of midwives per 1,000 live births is unavailable and the lifetime risk of death for pregnant women 1 in 38. 
Ministry of Health
The Ministry of Health has its headquarters at Afya house in Nairobi. There are two ministers:
- Minister for medical services
- Minister for public health
Each minister has two assistant ministers and a permanent secretary.
Director of medical services (DMS)
- Provincial director of medical services (PDMS)
- Provincial medical officer of health (PMOH)
- Provincial health management board (PHMB)
- Provincial health management team (PHMT)
- Provincial hospital managent team (P-HMT)
Sub-district hospital management board (SD-HMB)
District medical officer of health (DMOH)
- District health management board (DHMB)
- District health management team (DHMT)
- District hospital management board (D-HMB)
- District hospital management team (D-HMT)
Health centre management committee (HCMC)
- Health centre management board (HCMB)
- Health centre management team (HCMT)
Important institutions (acts of parliament)
Medical practitioners and dentists board
Clinical officers council
Kenya Medical laboratory Technicians and Technologist Board (Act of Parliament)KENYA GAZETTE SUPPLEMENT ACTS, 2000, NAIROBI, 28TH JANUARY 2000
Nursing Council of Kenya (NCK)
The Nursing Council of Kenya is a body corporate established under the Nurses Act Cap 257 of the Laws of Kenya to regulate standards of nursing education and practice in Kenya. It protects the public by promoting standards of clinical care through training, licensure and enforcement of codes of regulation.
Kenya Medical Supplies Agency (KEMSA)
Pharmacy and Poisons Board
The Pharmacy and Poisons Act, Cap 244 is an Act of parliament to make better provision for the Control of the Profession of Pharmacy and trade in drugs and poisons. The Pharmacy and Poisons Board (PPB) is established as a body corporate, under the Pharmacy and Poisons Act, Cap 244 Laws of Kenya. The PPB is regulatory body within the Ministry of Medical Services. It is a body corporate under Section 3(6), and the de-linking process is on-going.
National Hospital Insurance Fund (NHIF)
Membership to the National Hospital Insurance Fund is compulsory to all salaried employee with voluntary membership to those in self-employment. Contributions range from Ksh 160 to a maximum Ksh 320. However plans are underway to compute contributions as a percentage of ones salary. When members or their declared dependants fall ill and are admitted in accredited hospitals, they are only required to pay the balance of the bill after the rebate has been calculated. The rebate varies depending on the hospital status and ranges from ksh 400 to ksh 2,000 per day.
Kenya Medical Research Institute (KEMRI)
Private Health management organisations
Private companies which offer additional health cover usually including outpatient cover which is not covered by the NHIF. They include:
Careers and training
- Medical officers and clinical officers
- Pharmacists and Pharmaceutical technologist
- Nurses are holders of a 2½-year certificate (enrolled), 3½-year diploma (registered) or 4-year bachelor's degree (BSN)
- Dentists and Dental technologists
- Medical technologists are trained by the Kenya medical training college, national polytechnics, universities or private colleges.
- Public health officers and technicians degree (4 years), higher national diploma (1 year), diploma (3 years), and certificate (2 years)
- Health information officers
- Orthopedic technologists
- Medical engineers
- Hospital administrators
- "The State of the World's Midwifery". United Nations Population Fund. Retrieved August 2011.