Why Kenya’s hospitals won’t cope with spike in virus cases

A new report by the World Bank has painted a grim picture of Kenya’s preparedness against the coronavirus pandemic.

According to Africa’s Pulse report, Kenya is one of the countries punching below its weight in terms of availability and allocation of financing for the healthcare sector, investing much less than it should on personnel and medical facilities.

Kenya’s spending on healthcare per capita, or for each person, according to the World Health Organisation (WHO) is $66 (Sh7,000) against a recommended level of $86 (Sh9,110) for low-income countries.

The report comes at a time when Kenya has switched gears in its fight against the new coronavirus, which causes the disease Covid-19, throwing nearly everything in its arsenal at containing the pandemic.

And with the World Bank report noting that there is generally low coverage of health services in Africa, it is becoming increasingly inescapable that surviving the virus in the region will boil down to personal responsibility.

The low coverage is driven by a number of factors, including low population density in many parts of African countries, which makes service delivery relatively expensive; limited funding; supply bottlenecks; and low productivity of health professionals.

“Widespread, sustained community transmission could prove difficult to manage in sub-Saharan Africa, given the region’s weak health systems, including understaffed medical personnel (doctors, nurses, and midwives) and the lack of hospital beds and equipment, which could lead to a high level of deaths,” the bank said.

Universal health coverage (UHC) means that all people in a country receive the quality health services they need, while at the same time ensuring that the use of these services is affordable.

The availability and allocation of financing for the health sector is a major concern in sub-Saharan Africa, particularly the relatively high out-of-pocket expenses.

However, financing of healthcare has been deplorable, with total health expenditure per capita for most sub-Saharan African countries, in the most recent year with data, being $32 (Sh3,400).

This is less than half the levels recommended by WHO for low-income countries. It costs a lot of money to train and pay health personnel.

As at the end of 2018, Kenya had 11,667 registered doctors, which translates to one doctor for every 4,028 people.

This is against a recommended ratio of one doctor for every 1,000 people.

Standard ICU room

Further, there are 110 registered nurses for every 100,000 Kenyans against WHO recommendations of 250 health workers for a population of 100,000.

Reports indicate that it would cost between Sh7 million and Sh8 million to set up a standard ICU room.

Health Cabinet Secretary Mutahi Kagwe said Kenya plans to set up 1,000 new ICU beds, translating to a total cost of around Sh8 billion.

The country currently has 259 functional ventilators, necessary for those infected with Covid-19 who have difficulty in breathing. However, more than half of these are being used to manage other critical patients.

Most countries in Africa, noted Africa’s Pulse, have an influenza pandemic preparedness plan, with 35 of 47 countries in the continent putting the plan in place.

“However, most of these plans are outdated – they were set up prior to the 2009 influenza A H1N1 pandemic – and are considered inadequate to deal with a global pandemic,” reads the report.

All eyes are now on Treasury Cabinet Secretary Ukur Yatani. He needs to get money for these critical healthcare resources if Kenya is to avoid a full-blown crisis, such as the one that is unfolding in the United States and some European countries.

Mr Yatani has already received Sh7.4 billion from the Central Bank of Kenya and another Sh5 billion from the World Bank to boost the country’s healthcare system.

He is also expected to present a mini-Budget in which Sh1 billion will be appropriated for hiring of new health personnel, mostly nurses and clinical officers.

But raising enough funds will be a tall order for an economy that was already struggling before the pandemic hit export and tourism earnings.

This has necessitated the drafting of the masses into the war on coronavirus, with President Uhuru Kenyatta instituting a dusk-to-dawn curfew, and barring the entry of people into and out of Nairobi, Mombasa, Kwale and Kilifi counties.

Wearing of face masks in public spaces has also been made mandatory, while social gatherings have been stopped, with pubs, hotels, and churches being shut down.

There are also increased personal hygiene campaigns, with the public asked to wash their hands frequently, as well as practise cough and sneeze protocols to avoid spraying the deadly virus into the air.

President Kenyatta has been keen on implementing UHC, which would mean all citizens would receive the quality health services they need at an affordable rate.

Over the next five years, the government had set a target of 100 per cent coverage.

But the need for strong health systems has been accelerated by the coronavirus. Now, the Treasury has said the government will consolidate most of its resources for healthcare spending, as well as to cushion vulnerable populations from the crisis.