The Kenya’s public health system remain complicated and needs more work to reap the benefits of a fully functional system. With the current system, there are many deficiencies that need to be addressed.
First, I think there is lack of adequate and effective management and preparedness to deal with emerging health issues. The system has for the longest time been reactive rather than proactive in dealing with public health issues. It is during an active outbreak that this deficiency arises and notice that there was no preparedness at all thus creating haphazard approach.
Surveillance, reporting and investigation of diseases are other big issues. There are no clear guidelines relating to reportable diseases and reporting and if so they are not followed and/or enforced as they should. These are essential core functions in public health as they help to assess and monitor health of a community as well as providing a disease prevention and control framework. Most acute communicable diseases require prompt mandated reporting in order to allow for timely intervention. All healthcare providers, laboratory personnel, etc. are integral stakeholders that need to be involved as mandated disease reporters.
Another issue is inadequate regulations to monitor and enforce rules that govern food handlers. Cholera, which has become a nuisance in Kenya is an acute bacterial illness that is easily transmitted can be challenging when food handling sector is not effectively regulated. Serious food inspections, certificate of health, training, etc. need to be in place in order to tackle the issue of foodborne illnesses that emanate from food handlers.
In addition to the above, there is lack of clear framework for collaborative efforts among stakeholder agencies. Any effective system requires identification and collaboration of all stakeholders. There is also the issue of the government not effectively collaborating with private partners who may have additional resources needed to address public health efforts. Some private hospitals may be well equipped to handle certain services especially during emergency situations thus augmenting already limited public resources.
Prevention versus treatment
It is also clear that there is more emphasis on treating diseases in Kenya than focusing on preventive efforts. Preventive measures are less expensive compared to medical interventions. Therefore, there is need to amplify the important role public health plays as well as education to change people’s attitude and behavior with regards to health. There is therefore the need for more public education in order to mitigate disease burden. Involving media is important as they can reach the bigger population.
Bad politics and corruption also play a big role in curtailing public health efforts. Some corrupt individual divert resources meant for public health interventions to their own gains. Other officials may engage in acquisition of unnecessary equipment for the sake of getting kick-backs and making a profit at the expense of fellow citizens. Nothing has clearly been put in place to deter this corrupt behavior and no wonder we see repeat of the same over and over again.
Similarly, there is the issue of staff incompetency which hinders effective delivery of public health services. Public health is a calling and should not be taken lightly. It is a positive note that we are starting to see colleges and universities offering public health courses and hopefully will produce competent professionals.
We therefore have a lot to be done within our public health system in order to have a functional system.
By Thuku Njenga: The writer is a public health professional having worked in various public health capacities in Missouri as an epidemiologist, health planner and educator.