There’s a lot that can be said about Nairobi Metropolitan Services, but one thing that we can all agree on is that they made a bold move by embarking to set up public health facilities in the city’s densely populated areas.
The Nairobi Metropolitan Services built health centres in places like Majengo, Kayole, Soweto, Korogocho, Kawangware, Mukuru kwa Njenga, Kibra, Githurai, and other informal settlements in Nairobi.
It was not that the funds to build new hospitals were readily available, they had to be efficient and prudent in the use of public funds -- they looked at collaborative opportunities with existing facilities.
This was no easy task. The reason I say this is as far back as medical school, not just me, but all of us, were conscious that we represented the equivalent of a very small army being prepared to fight a very powerful enemy.
The disease burden in this country is massive, as is true in all countries that have large populations living in densely populated slum areas without access to healthcare.
Here was an initiative that was guaranteed to play a big part in strengthening the public health infrastructure in Nairobi and, dare I say, provide a model that could be replicated across the country.
To my mind, one of the key areas the government needs to address is health systems strengthening.
Why do I say this? Although we focus on education as the key to a better life and rightfully so, what we do not hear much about, largely because it mostly affects the poor, is that you need to be in good health to go to school or to go to work.
There is a unique perspective brought on by the poor, who do not have much of a voice. This is because, if I have to borrow money from a friend or neighbour each time, I need a simple blood test or even basic medication, it is unlikely I will escape the cycle of poverty.
Public health infrastructure that guarantees every Kenyan reasonably good health services is fundamental, and this is something that we are very far from achieving. It is only until that infrastructure and accompanying policy are in place that we can speak of universal healthcare.
We have been very good at coming up with vision and priorities, from Vision2030 to the Big Four, where critics would say that it is a slogan, but it will be intended to achieve multiple goals in the health sector.
Some might argue, the biggest takeaway from the Nairobi Metropolitan Services should have been that as a lower middle-income country we need to have healthcare interventions at the only phase that can have maximum impact – at the prevention level.
Dr Rono is a medical Doctor practicing in Eldoret and KMPDU official, Uasin Gishu County