10 years of devolution; the hits and misses for coastal healthcare sector

Immediate former County Public Health Chief Officer Pauline Oginga says the upgrading and equipping of Coast General Hospital saw it transformed into a major referral and teaching facility sought by patients from East and Central Africa.

For instance, she noted, the hospital is the only facility in the country with a catheterisation laboratory. A cath lab, the common name, is an examination room with diagnostic imaging equipment used to visualise the arteries and treat any stenosis or abnormality found.

The county government has also rehabilitated rundown health centres and dispensaries that looked like museums under the defunct Mombasa Municipal Council.

But doctors questioned the issue of delayed pay, promotion and lack of professional progression under the counties.

They demanded that their salaries be paid directly from the national government to ensure uniformity.

"We want to be taken back to the national government to secure our pensions and ensure prompt payment of salaries and allowances," said a doctor who sought anonymity.

In Taita Taveta, Devolution County Chief Officer Habib Mruttu said drug shortage was no longer an issue after the county paid its pending bills to Kenya Medical Supplies Authority (Kemsa), Lancet Kenya and Mission for Essential Drugs and Supplies (MEDs).

"We now receive drugs without any delays after we cleared all medical supplies pending bills. Despite resistance after the health sector was devolved, things are now working better," said the CCO.

Mruttu said there had been delays in the disbursement of share of allocation and salaries in the past, which led to a series of strikes, crippling operations in health facilities.

"We have improved the health budget and ensured that all county workers get their salaries on time and their working conditions improved," he stated.

In Kilifi County, acting Director for Health Hassan Khamis says over 150 health facilities have been put up in Kilifi, which is more than double those built before devolution.

"Before, community health units were being run by the national government and growth was very slow," said Dr Khamis.

He said the percentage of women giving birth assisted by a skilled birth attendant had almost doubled, from 16 per cent in 2013 to 69.5 per cent in 2022. "We have also put up Kilifi medical complex with over 11 beds, an emergency and accident wing and five operating rooms.''

In Tana River, the authorities say they have made major strides in the health sector; by building additional health facilities, employing health workers and acquiring equipment.

Governor Dhadho Godhana said for the first time the county has two morgues in Hola and Minjila Garsen that can hold up to 34 bodies.

Before that residents used to rely on Kilifi for morgue services.

Godhana said Hola hospital has been upgraded to level four facility and equipped with CT scan and dialysis machines.

The county is planning to build a level five hospital.

[Reporting by Patrick Beja, Renson Mnyamwezi, Marion Kithi and Joackim Bwana]