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A five-point formula towards more efficient health system

By Isaac Kalua | September 26th 2021

My open letter to the Health Cabinet Secretary last week left me with a better appreciation of the challenges that his ministry faces as it seeks to entrench quality world-class healthcare into this country. As such, I choose to suggest five viewpoints that may energise our march towards better health.

First, we all appreciate that Kenya is in need of more medical practitioners. The World Health Organization’s doctor-patient ratio is one doctor for every 1,000 people. According to the latest data from the World Bank, Kenya has a doctor-patient ratio of one doctor for 6,400 people. Interestingly, a few years ago, when our Government recruited Cuban doctors, it was reported that we have one doctor for every 16,000 people. Irrespective of the actual numbers, it is clear that we need thousands more doctors.

One sure way of increasing the number of qualified medical practitioners is through free or Government-sponsored post-graduate training for medical students. Their tuition fees, accommodation and stipend expenses should be catered for by the Government. Nowadays, the cost of a post-graduate medical degree is so prohibitive that only the rich or sponsored students can afford it. In the first three decades of independence, post-graduate medical students used to study for free, and receive a stipend and medical cover from the government. Lawmakers should craft relevant policies so that the profession can attract passionate students from poor backgrounds. This moral obligation will increase the quality and quantity of our physicians.

Secondly, I suggest that we abolish private practice from Government hospitals. The existing arrangement inevitably creates double standards in delivery of medical services. Public hospitals should cater exclusively to the medical needs of patients and not the business needs of doctors.

Thirdly, private hospitals play a critical role in the healthcare ecosystem. Since millions of Kenyans depend on them, the government should ensure their affordability. One of the steps the government can take is to revise the tax regime on medical equipment. In July, a new medical oxygen plant that Kakamega County had imported from France was stuck at the port, awaiting tax payment of Sh8 million.

The governor frustratingly stated that, “it is a shame that at this time of the Covid-19 pandemic we are being taxed on machines that are meant to save many lives.” Indeed, every medical appliance exists to save lives. All these machines should be imported either tax-free or at reduced tax rates. That way, investors will not have to pass on the cost of importing them to helpless Kenyans.

Fourth, our National Hospital Insurance Fund universal healthcare programme is the best idea ever to happen to Kenyans. However, the NHIF has become a cash cow for some players, both locally and internationally. Upsettingly, NHIF Chief Executive Officer Peter Kamunyo recently revealed that corruption robs them of Sh10 billion annually. I suggest support to the ministry of Health from relevant investigative agencies to analyze who are the recipients of these fund.

Finally, Kenyans are distressed by the high cost of prescription drugs. Time is ripe for price control in this sector. Government can also scheme to invest and produce drugs locally. In India, the National Pharmaceutical Pricing Authority ensures fair pricing of pharmaceutical products. It’s no wonder that India has some of the lowest drug prices in the world. Kenya needs to follow suit even as it learns from India’s experience.

I suggest that CS Mutahi Kagwe attracts the power of thinking and acting green by calling for a broad-minded meeting to synthesise expertise, talent and life experiences for common good. Please invite experienced practitioners, young doctors, traditional medicine practitioners, ministry officials and relevant sector representatives. The results shall be transformative.

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