Local Healthcare Systems in Kenya

The public health system in Kenya is in dire state often marred with cartels, corruption, strikes by doctors and nurses, inadequate medical supplies, high maternal and child-mortality rates, long waiting times and poor access especially in marginalized areas in northern and eastern Kenya. Despite efforts to transform the healthcare system, no significant progress is evident with the exception of a vibrant private health sector.

Although you may need to dig deeper into your pocket, you are better served in private health facilities than in public ones in Kenya. The Kenyan government needs to get its act together to not only provide universal healthcare for all, but to ensure accessible, affordable and acceptable quality healthcare in its public sector.

Structure of Health System

The structure of health systems is designed in such a way that basic primary care is offered at lower levels while complex cases are being referred on higher levels. From the lowest level, the structure includes:

Health dispensaries and privately-owned clinics – Offering outpatient services for minor ailments like colds
Health centers – Catering to cases referred by clinics and dispensaries
Nursing homes and sub-district hospitals – Offering secondary care
District and private hospitals – With resource capacity to offer comprehensive medical services
Provincial hospitals – e.g., Rift Valley Provincial Hospital, etc., with capacity to offer specialized care such as life support
National Hospitals – Such as Kenyatta National hospital and Moi Teaching and Refferal Hospital-offers third level care
Privately-run and mission hospitals – Function to fill in gaps left in the health system

The highest percentage of resources and time in the Kenyan health system is spent treating:

HIV/AIDS
Tuberculosis
Malaria
Pneumonia
Road accidents
Diabetes

Options of healthcare for locals and foreigners

Other than the public health system, varied healthcare options are open for locals and foreigners.

Herbal Medicine

Herbal medicine, a form of alternative medicine, has played an important role in promoting health among Kenyans in rural and urban areas and across the social classes. From treating flu and acne, to complex diseases such as arthritis, diabetes and high blood pressure, etc., herbal medicine is central in health promotion in Kenya. Although issues of safety and efficacy have been cited, herbal medicine remains a major healthcare option for locals and foreigners.

Private Health System

This attracts the largest percentage of patients and clients given the deplorable state of the public health systems. Despite the high charges, many even those who cannot afford prefer this system because of:

Ease in accessibility
Quality health services
Availability of adequate medical services
Limited delay and waiting times

Dental Health

Dental health in Kenya is in poor state given the limited number of dental specialists and limited public awareness about the importance of oral health.

A mere 0.0016% of the health budget is allocated to oral health
More than 90% of adults have a gum condition
Decayed, filled, broken and missing teeth is a norm among Kenyans
Less than 5% of Kenyans access dental health
Dental health is a privilege of the middle and upper classes, and the fact that dental health insurance is costly, and that a majority of dental clinics and specialists are located in urban areas, does not help matters

Cosmetic Coverage / Aesthetic Medicine

A third-world nation it may be but Kenya is not left behind in embracing aesthetic medicine. Often offered by private hospitals, procedures in aesthetic medicine are registering increased number of clientele. From BOTOX, liposuction and facial chemical peels to mesotherapy and breast implants, cosmetic coverage in Kenya is sizeable and growing.

Thinking of living or buying in Kenya?

Patients Don’t Want to (Can’t) Reform the Healthcare System

Don’t misinterpret the heading of this entry. It’s not that patients don’t want healthcare reform. It’s that patients don’t want to be the responsibility of reforming the healthcare system.

And who could blame them.

Although it appears that the federal government is working to reform the healthcare system, one will periodically hear experts talk about consumer driven healthcare. That is, give patients more financial responsibility for their health through higher deductibles and copays and health savings accounts. Seeing this increased financial burden, they will consequently make better choices about their health, shop around for the best care, and make more rational decisions about when to seek medical care much the same way they do for other services and goods.

Please.

I would note that giving the public more responsibility for reforming a benefit program occurred decades ago with retirement planning. Employers stressed by the increasing obligations from pension plans opted many years ago to move from defined benefit plans to defined contribution plans. Pension plan now becomes a 401k plan. The burden of having enough assets to comfortably retire moved from employer to employee. Theory was individuals now would take charge and do better.

Right.

We now know that this was a disaster for nearly everyone, except for the financial services industry it created. Individuals didn’t save money or invest in the right financial products. Many were in cash, which generally doesn’t keep up with inflation. As a result, employers are becoming more involved requiring people to opt out of a 401k rather than opting in, choosing a target date mutual fund account as a default rather than cash, and spending resources on educating their workers more about financial planning.

So the problem with healthcare? Patients don’t have the expertise and don’t wish to grasp the nuances of medical diagnosis and treatment. They falsely believe that the answers to their problems and ailments come from the high-tech MRIs and CT scans, blood work, and other tools at our disposal as doctors. It could be due to television shows like ER or House or doctors doing extensive work-ups with little thought on costs or relevance. Nevertheless, with increasing co-pays, patients feel that to solve their problem, forgo the doctor visit and simply order a test.

Unfortunately, these tests are merely tools and can help provide doctors clues into what is happening, but don’t provide the universal truth. In other cases, we don’t need the test because it is quite clear what the problem is. However, Dr. Scott Haig notes in a recent Time article that it is practically impossible to convince patients otherwise.