BERNARD MUTHAKA explores how delay in policy review has slowed down shifting tasks
Major indicators are showing that Kenya will miss out on the health-related millennium development goals.
Among the concerns is that the current approaches to health service provision need major re-thinking.
Figures from a recent demographic and health survey, indicate that about half of children under five years, do not go to hospital for major illnesses like malaria, diarrhoea and pneumonia. Yet they are the leading causes of death in that age group.
Medics contend that such children are getting services at home, which means, it is crucial to start empowering the community to render certain basic health services.
Presently, the health sector faces a crisis with many facets including a dissatisfied workforce. In such a context, the strategy now widely referred to as "task-shifting" â where some tasks are delegated to the lower categories â can make a big difference in access to basic health services.
While neighbouring countries like Uganda and Ethiopia have already begun implementing aspects of the strategy, Kenyaâs progress has been consigned to policy proposals.
"We have already designed a curriculum for training of community health workers (CHW) which would enable them to carry out curative duties such as giving of antibiotics for major childhood illnesses," confirms Dr Khadija Abdullah of the Division of Child Health, Public Health ministry.
It is not clear why the necessary steps towards making changes to the policy have been delayed. This is despite the presence of robust evidence that show CHW can implement interventions that can lead to improved health outcomes.
Such evidence includes an award-winning project called Sauri millennium village which is being implemented in Western Kenya. The project delivers a free minimum package of primary health care services at the village level.
It has involved the use of about 800 professional and paid CHW who deliver health care services to underserved communities.
The workers have clear performance indicators and regular supervision, in addition to financial and non-financial incentives.
