Healthcare in Kenya

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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:

Contents

[edit] Health units

[edit] Dispensaries

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.

[edit] Private clinics

These may be registered by the clinical officers council, nursing council or the medical practitioners and dentists board depending on the proprietor’s qualifications. Clinical officers require ten years experience in order to open their own clinics. They are usually small units, often with a medical laboratory, which offer a wide range of services depending on the training of the proprietors.

[edit] Health centres

These are medium sized units which cater for a population of about 80,000 people. A few are owned by mission hospitals. They are managed and run by Clinical officers who are the team leaders. A typical health centre is staffed by:

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: 1. Administration block; where patients register and all correspondence and resources are managed from. 2. Out-patient consultation rooms where patients are seen and examined by clinical officers. 3. In-patient (wards) where very sick patients can be admitted. The wards are divided into male, female and paediatric with newborn units. 4. 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. 5. Pharmacy 6. Minor theater where minor surgical procedures are done e.g. Circumcision, stitching wounds and manual vacuum aspiration 7. Maternity 8. Maternal and child health 9. Kitchen and catering 10. Student hostels for rural health training centres where students go to get rural experience.

[edit] Sub-district hospitals

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.

[edit] Nursing home

These are owned privately by individuals or churches and offer services roughly similar to those available at a sub-district or district hospital.

[edit] District 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.

[edit] Provincial hospitals

Kenya has eight provinces, each with a provincial hospital which is the referral point for the district hospitals. These are regional centres which provide specialized care including intensive care and life support and specialist consultations.

[edit] National Hospitals

There are two national hospitals in Kenya, namely:

  • Moi Teaching and Referral Hospital (MTRH); and
  • Kenyatta National Hospital (KNH).

[edit] Major causes of morbidity and mortality

[edit] Maternal and Child Health Care

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 1 in 38 shows us the lifetime risk of death for pregnant women. [1]

[edit] The ministry of health

Has its headquarters at Afya house in Nairobi. There are two ministers:

  • The minister for medical services
  • Minister for public health

Each minister has two assistant ministers and a permanent secretary

[edit] 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)

[edit] Sub-district hospital management board (SD-HMB)

[edit] 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)

[edit] Health centre management committee (HCMC)

  • Health centre management board (HCMB)
  • Health centre management team (HCMT)

[edit] Important institutions (acts of parliament)

[edit] Medical practitioners and dentists board

[edit] Clinical officers council

[edit] 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.

[edit] Kenya medical supplies agency (KEMSA)

[edit] 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.

[edit] National hospital insurance fund (NHIF)

Membership 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.

[edit] Kenya Medical Research Institute (KEMRI)

A state corporation that carries out medical research in Kenya. It collaborates with foreign research organisations such as CDC, Wellcome trust, Walter Reed Army Institute of Research etc.

[edit] Private Health management organisations

Private companies which offer additional health cover usually including outpatient cover which is not covered by the NHIF. They include:

[edit] Careers and training

[edit] See also

[edit] References

[edit] References

  1. ^ "The State Of The World's Midwifery". United Nations Population Fund. Accessed August 2011. http://www.unfpa.org/sowmy/report/home.html. 
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