Kenya: Budget Too Small to Cover Health Needs

Nairobi — Professor Anyang Nyong'o might have guessed that a trip to the United States for treatment for prostate cancer would provoke a furore: he is the Minister for Medical Services.

Health activists are outraged that high-profile politicians are able to access world class facilities, whilst ordinary Kenyans are can only dream of accessing such health care.

"We are glad that the minister is back and is exuding good health. But what choices does the ordinary Kenyan have at accessing quality treatment?" asks Nairobi resident, Milka Ondiek.

"When our politicians need treatment for serious ailments they can afford to fly abroad for quality health care but the same cannot be said of the majority of Kenyans."

Nyong'o himself has admitted that most Kenyans battling diseases such as cancer have very few choices in as far as access to treatment is concerned. Kenyatta National Hospital in Nairobi is the only public hospital with the facilities - although poor - that can diagnose and treat cancer.

According to the hospital, the cancer waiting list is stretched to September 2011.

Health Budget Decreases

In June last year, the national budget was estimated at 12.5 billion dollars, the largest in the history of the country.

Despite a significant increase over the previous year for the health sector, the share of the budget fell.

Ten years after African Union (AU) member states agreed to spend 15 percent of national budgets on health in the Abuja Declaration, the pledge remains largely unmet by most African countries, with the exception of Botswana and the Seychelles.

Yet the Abuja Declaration remains one of the most vital signs of commitment African leaders can make towards health.

"In this regard, the national budgetary allocation becomes a key indicator of strides that the government is making towards improving the health sector," explains Pauline Amollo, a policy analyst and consultant in Nairobi.

The proportion allocated to the health sector for the current financial year stands at 6.5 percent, down from 7 percent in the previous financial year.

"The national budget is a significant indicator of how public policy is to be implemented and what the government of the day deems to be of national priority," adds Amollo.

"The fact that Kenya is yet to achieve even half of the expected 15 percent allocation of the budget to the health sector is a clear indicator that the sector (health) is yet to be treated with the seriousness it deserves."

From curative to preventative care

Resources have also shifted from curative health to preventive medicine and promotive health.

"This may be due to the fact that social development and health indicators show that many lives in Kenya are lost to preventable illnesses and conditions," says Martin Owour, a public health technician in Migori County, Nyanza Region.

According to a USAID report on Maternal Health in Kenya, "approximately 14,700 women and girls die each year due to pregnancy-related complications. Additionally, another 294,000 to 441,000 women and girls will suffer from disabilities caused by complications during pregnancy and childbirth each year."

According to the medical services, 75 percent of newborn deaths occurred in the first week of life due to factors such as poor quality of antenatal care, delivery services and the nature of the care that a newborn receives soon after birth. According to Kenya's Division of Malaria Control, malaria is the leading cause of morbidity and mortality in Kenya. The Division also estimates that 170 million working days are lost to the disease each year.

Light at the end of the tunnel

This year's budget allocation enabled the recruitment of an additional 15 nurses and five public health technicians in each of the 210 constituencies in Kenya.

"This is an important measure because most public health facilities are understaffed, making it difficult to provide quality health care," explains Owour.

According to the Finance Ministry, the resources would also facilitate the expansion and upgrading of the health care facilities. This would also involve the purchase of ambulances for use in health facilities.

The Minister for Medical Services has been calling on the public to supplement the money that goes into the health sector from the treasury. This call has largely continued to be met with resistance.

"Why should anyone earning about 375 dollars [a year] pay 12 dollars to the National Health Insurance Fund, while those earning 1,250 dollars and above pay a paltry 25 dollars? It is unreasonable and the government should work out other rates which do not give the impression that the government is exploiting Kenyans," Owour concludes.

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