Report: Why hospitals, doctors struggle to get your diagnosis right
A State investigation has exposed a shortage of crucial medical equipment in health facilities that explains cases of patients being treated for wrong diseases.
The report, supported by World Bank and the United Nations Population Fund (UNFPA), found the diagnostic accuracy level of Kenyan health workers to be 67 per cent, meaning there is a chance you may be misdiagnosed when you walk to a hospital in the country.
Prepared by the National Council for Population and Development (NCPD), it notes over half of health facilities don’t have adequate basic equipment and chemicals such as reagents for diagnostic tests which further compounds the problem.
The report has detailed how majority of facilities in the country do not have the basic equipment and drugs, that play a role in diagnosing patients.
An equipment as simple as a thermometer for taking body temperature were missing in some of the facilities surveyed which begs the question how equipped hospitals are in giving the correct diagnosis and treatment.
Other basic equipment missing were stethoscopes used to listen to a patient’s heart beat, weighing scales and fridges crucial for storing drugs and reagents used for carrying out diagnostic tests.
According to the report launched last Thursday, only 46 per cent of the 3,094 health facilities had all the basic equipment.
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The most affected were Level Two hospitals where health centres and dispensaries fall.
The survey covered level two, three and four hospitals.
But even so, the report still found that just 54 per cent of the facilities had the priority drugs like painkillers (morphine, paracetamol) and antibiotics (amoxicillin).
Of the 47 counties, Kirinyaga, Tharaka Nithi and Bomet counties were poorly- rated in terms of availability of the drugs with 41, 43 and 43 per cent respectively.
Rated highly was Marsabit County with 71 per cent.
The modality used to gauge this accuracy was based on tracer diseases: severe dehydration, pneumonia, pulmonary tuberculosis and type one diabetes.
Director General of NCPD Josephine Kibaru said the choice of using the above ailments was based on their commonality in health facilities.
Doctors were the leading cadre of health workers who would get right a patient’s diagnosis at 75 per cent, followed by clinical officers 74 per cent and nurses 60 per cent.
When the numbers were broken down to counties, a patient is likely to be misdiagnosed or have a case of missed diagnosis in Vihiga County whose diagnosis accuracy level are lowest at 49 per cent.
Wajir had the highest diagnosis accuracy level at 87 per cent.
“An accurate diagnosis, however, is unfortunately not a guarantee for providing the correct treatment. There were substantially large discrepancies between diagnosis and treatment across the board revealing a critical disconnect in provider knowledge and follow-up,” the report reads in part.
The report noted that among severe dehydration and diabetes conditions, more providers offered correct treatment actions even though they had lower diagnostic accuracy.
The failure to provide correct treatment could be blamed on non-adherence to the set clinical guidelines.
The report showed that health providers adhered to 43 per cent of the clinical guidelines in management of tracer conditions. Doctors adhered to more of the clinical guidelines.
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