REVIEW OF HEALTH SERVICES IN KAKAMEGA COUNTY CIDP 2013-2017
Kakamega County’s population was estimated by the 2009 Housing Census to be 1,660,651. At that time, there were more female at 52 per cent of the total population than makes who stood at 48 per cent. The county’s population is estimated to be growing at 2.5 per cent per annum. The high population has its advantages and disadvantages. For instance, the large number is putting a lot of pressure on the available socio-economic facilities such as schools, hospitals and housing. It must also be noted that Kakamega has the second largest population in Kenya after Nairobi City County and as a result, the county receives more resources in the form of equitable share as compared to other counties. Population is one of the parameters used by the Commission on Revenue Allocation to share resources collected at the national level as required by the law.
The health Services sector is made up of: Medical Services, Public Health and Sanitation. The sector’s vision is to achieve “an efficient and high quality county health care system.”
The county health care facilities provides quality preventive, promotive, rehabilitative and curative health care services. Efforts are being made towards upgrading Kakamega County Hospital to a referral hospital as one of the priorities in the health sector.
Completion of all stalled projects was to be given priority on the advent of devolution. This means immediately the county government got into power, they were supposed to embark on completing the stalled projects in the health sector. This did not happen as planned.
Secondly, the CIDP indicates that Kakamega County was to establish a medical school in Kakamega town at a cost of Ksh. 300 million. According to civil society professionals working in the health sector, this did not materialize. There is ongoing construction of facilities at the Kakamega General Hospital in the county’s quest to upgrade the hospital to a Teaching and Referral Hospital. This facility will serve medical students from Masinde Muliro University as well as the local Kenya Medical Training Campuses.
Kenya Medical Training Colleges (KMTCs)
The Kakamega County government was planning to set up new Medical Training Colleges at a cost of Ksh. 150 Million in order to produce more health personnel to work in the county health facilities. The status on this matter is that not a single new MTC has been set up in Kakamega. It is important to note that tertiary education is a national government function. Despite that being the case, counties have allocated resources towards some national functions such as primary education, establishment of MTCs and provision of bursaries for secondary and college students. During the 2013 to 2017 period, Kakamega County government worked with other partners to open a new Medical Training College (KMTC) in Lugari. In addition to that, construction of another college is ongoing in Ikholomani Constituency where the county government of Kakamega is reported to have allocated Ksh. 500 million. On the same project the National Government CDF has expressed its commitment to contribute towards completing the KMTC facility at Ikholomani.
Kakamega County CIDP indicates that the County was supposed to construct 1 morgue in each sub-county at a total cost of Ksh. 100 million. This project was in the original CIDP and still it made its way to the revised document. This is one of the projects that the Kakamega County Health Reference Group feel was overambitious. Currently, renovations are being undertaken at Kakamega General Hospital Morgue. It’s assumed that this facility will have more capacity to handle the high demand for its services.
Kakamega County had set plans to purchase 1 ambulance for every sub-county. Kakamega County has currently purchased a total of four (4) ambulances out of the target of one ambulance for each of the 12 sub-counties.
Staffing of Healthcare Facilities
There is the problem of understaffing in Kakamega County. This is a serious problem because it leads to overworking of the existing healthcare staff. Currently, there are a number of health facilities which were constructed by the County Government but as per now, they have adequate healthcare staff. We know that a healthcare facility needs a certain number of healthcare officers to operate smoothly.
It is important for us to think about how many and type of healthcare workers are need to efficiently run a healthcare facility? A well-equipped healthcare facility requires nurses, doctors, dentists, pharmacists, medical lab technicians and support staff. It is interesting to note that the inadequate staffing is happening while there are many unemployed healthcare graduates out there. We can’t say that all nursing, medical and clinical graduates have been absorbed. I personally know friends who graduated with a medical degree or diploma and are out of work. The major issue in this case is availability of funding.
To illustrate this point, in Murhanda ward Shinyalu Makuyi and Ivichio healthcare facilities have been partly equipped but there is not staffing. This forces the residents to seek healthcare services in Shinyalu or Shamakhubu.
Questionnaire they collect data and store it. They send money to direct beneficiaries. The money never reaches the intended beneficiaries. Ksh. 50 M diverted to pay kazi mashinani workers.
Carrin, G. (2009). Health systems policy, finance, and organization. Amsterdam: Academic Press.
Kakamega County Government. County Integrated Development Plan (CIDP) 2013-2017