By Stephen Macharia
Establishment of a Health Service Commission (HSC) will address shortages of health professionals in the country and boost Kenya’s ability to deal with the Covid-19 and future pandemics if they occur, the Kenya Medical Association has said (KMA).
Speaking in Nairobi last month, KMA President Dr. Were Onyino decried inadequate personal protective equipment for healthcare workers citing fragmented healthcare management mechanisms as a hindrance to service delivery.
Dr. Onyino called for the establishment of “a centralized mechanism for managing human resources for health”. The commission, Dr. Onyino added, will have the necessary professional competence to make decisions pertaining health services.
“Human resources for health management has proved to be the most difficult aspect of the Covid-19 pandemic. In some counties, the health workers are still unable to access quality PPEs,” he noted.
The KMA President noted Covid-19 pandemic has exposed fissures in the health service delivery and called for a speedy formation of the Kenya Health Service Commission to “ensure equitable distribution of healthcare workers”.
“For Kenya to achieve quality healthcare as envisioned in the Constitution, there is need to redefine the scope of all healthcare workers,” he added.
Since the devolution of health services in 2013, industrial strikes have frequently disrupted health services in the public health sector in Kenya. In 2017, health workers recorded about 250 strike days, disrupting health services across the country.
A doctors’ strike, for example, lasted 100 days. Nurses on the other hand went for 150 days strike even as the counties and national government promised to resolve the issue. In 2020, nurses spread across 20 counties went on strike in February citing salary delays. Proponents of the Kenya Health Service Commission have predicated it on Teachers Service Commission model.
The Building Bridges Initiative (BBI) report contains a proposal for the establishment of the commission. The proposal advocates for the transfer of the human resource for health from the county government to the specialized HSC, reflecting the TSC model.
HSC model is not a foreign concept. Uganda established a Health Commission over two decades ago. According to the the Uganda Health Service Commission, the organization seeks to “address unique Human Resources for Health issues in the health service.
“Specifically, the Commission is mandated to appoint, confirm, promote and review the terms and conditions of service, training and qualifications of health workers.
“The Commission is also mandated to foster professional and work ethics, and exercise disciplinary control over the health workers under its jurisdiction.”
“The Jurisdiction of the HSC covers Central Government Health Institutions which include: – Ministry of Health and specialized institutions under it such as the Uganda Blood Transfusion Services, Uganda Cancer Institute and Medical Professional Councils.
“Other Central Government Health Institutions include National Referral Hospitals, Regional Referral Hospitals and the Directorate of Public Health and Environment. In addition, the Commission provides technical support and support supervision to District Service Commission (DSCs) and Local Governments on matters relating to HRH management such as recruitment of health workers,” reads a note from the Uganda Health Service Commission.
KMA believes that uncoordinated implementation of health services in the counties is a source of disputes in the sector. The establishment of HSC will bring together about 90,000 healthcare workers in the country and is expected to create a conducive labour environment in the public health sector, addressing localized industrial actions in the county governments.
The Constitution pf Kenya (2010) devolved health services to the 47 counties. However, the operations of public institutions such as the National Referral facilities and research institutions were left under the National Government.
The National Government is in charge of operations at the Kenyatta National Hospital, Moi Teaching and Referral Hospital, Mathari National Teaching and Referral Hospital, National Spinal Injury Referral and Kenyatta University Teaching, Referral & Research Hospital (KUTRRH).