Healthcare in Kenya

Kenya’s health care system is structured in a step-wise manner so that complicated cases are referred to a higher level. Gaps in the system are filled by private and church run units. The structure thus consists:
* Dispensaries and private clinics
* Health centres
* Sub-district hospitals and nursing homes
* District hospital and private hospitals
* Provincial hospital
* National hospital

Health units

Dispensaries

The government runs dispensaries across the country and are the lowest point of contact with the public. These are run and managed by enrolled and registered nurses who are supervised by the nursing officer at the respective health centre. They provide outpatient services for simple ailments such as common cold and flu, uncomplicated malaria and skin conditions. Those patients who cannot be managed by the nurse are referred to the health centres.

Private clinics

These may be registered by the clinical officers council, nursing council or the medical practitioners and dentists board depending on the proprietor’s qualifications. Clinical officers require ten years experience in order to open their own clinics. They are usually small units, often with a medical laboratory, which offer a wide range of services depending on the training of the proprietors.

Health centres

These are medium sized units which cater for a population of about 80,000 people. A few are owned by mission hospitals. They are managed and run by Clinical officers who are the team leaders. A typical health centre is staffed by:
* At least one Clinical officer
* Nurses
* Health administration officer
* Medical technologist
* Pharmaceutical technologist
* Health information officer
* Public health officer
* Nutritionist
* Driver
* Housekeeper
* Supporting staffAll the health centre staff report to the Clinical officer in-charge except the public health officers and technicians who are deployed to an geographical area rather than to a health unit and report to the district public health officer even though they may have an office at the health centre.

The health centre has the following departments:
* Administration block where patients register and all correspondence and resources are managed from.
* Out-patient consultation rooms where patients are seen and examined by clinical officers.
* In-patient (wards) where very sick patients can be admitted. The wards are divided into male, female and paediatric with newborn units.
* Laboratory where diagnostic tests are done. These laboratories can do the following tests- bloodslides for malaria parasites, sputum AAFB, urinalysis, full haemogram, stool ova and cysts, blood sugar, Elisa and CD4 counts in comprehensive care centres for HIV/AIDS patients.
* Pharmacy
* Minor theater where minor surgical procedures are done e.g Circumcision, stitching wounds and manual vacuum aspiration
* Maternity
* Maternal and child health
* Kitchen and catering
* Student hostels for rural health training centres where students go to get rural experience.

ub-district hospitals

These are similar to health centres with addition of a surgery unit for Caeserian section and other procedures. Many are managed by clinical officers. A good number have a medical officer and a wider range of surgical services.

Nursing home

These are owned privately by individuals or churches and offer services roughly similar to those available at a sub-district or district hospital.

District hospitals

Each district in the country has a district hospital which is the co-ordinating and referral centre for the smaller units. They usually have the resources to provide comprehensive medical and surgical services. They are managed by medical superintendents.

Provincial hospitals

Kenya has eight provinces each with a provincial hospital which is the referral point for the district hospitals. These are regional centres which provide specialized care including intensive care and life support and specialist consultations.

National Hospitals

There are two national hospitals in Kenya namely
*Moi Teaching and Referral Hospital (MTRH) and
*Kenyatta National Hospital (KNH).

Major causes of morbidity and mortality

*HIV/AIDS
*Tuberculosis
*Malaria
*Respiratory tract infections
*Road accidents
*Factory accidents
*Gastroenteritis
*Diabetes mellitus

The ministry of health

Has it's headquarters at Afya house in Nairobi.There are two ministers:
*The minister for medical services
*Minister for public healthEach minister has two assistant ministers and a permanent secretary

Director of medical services (DMS)

Provincial medical officer of health (PMOH)

*Provincial health management board (PHMB)
*Provincial health management team (PHMT)
*Provincial hospital managent team (P-HMT)

ub-district hospital management board (SD-HMB)

District medical officer of health (DMOH)

*District health management board (DHMB)
*District health management team (DHMT)
*District hospital management board (D-HMB)
*District hospital management team (D-HMT)

Health centre management commitee (HCMC)

*Health centre management board (HCMB)
*Health centre management team (HCMT)

Important institutions (acts of parliament)

Medical practitioners and dentists board

Clinical officers council

Nursing council of kenya

Kenya medical supplies agency (KEMSA)

Pharmacy and poisons board

Kenya medical laboratory technicians and technologists board (KMLTTB)

National hospital insurance fund (NHIF)

Membership is compulsory to all salaried employee with voluntary membership to those in self-employment. Contributions range from Ksh 160 to a maximum Ksh 320. However plans are underway to compute contributions as a percentage of ones salary. When members or their declared dependants fall ill and are admitted in accredited hospitals, they are only required to pay the balance of the bill after the rebate has been calculated. The rebate varies depending on the hospital status and ranges from ksh 400 to ksh 2,000 per day.

Kenya medical research institute

A state corporation that carries out medicall research in kenya. It corporates with foreign research organisations such as CDC, Wellcome trust, Walter Reed Army Institute of Research etc

Health management organisations

Private companies which offer additional health cover usually including outpatient cover which is not covered by the NHIF. They include:
*Clinix healthcare ltd
*AAR
*Resolution health
*Avenue healthcare

Careers and training

*Medical officers and Clinical officers.
*Pharmacists and Pharmaceutical technologists
*Nurses are holders of a 2 1/2year certificate (enrolled), 3 1/2year diploma (registered) or 4 year bachelors degree (BSN)
*Dentists and Dental technologists
*Medical technologists are trained by the kenya medical training college, national polytechnics, universities or private colleges.
*Radiographers
*Nutritionists
*Public health officers and technicians
*Health information officers
*Orthopedic technologists
*Medical engineers
*Hospital administrators
*Physiotherapists

References

* [http://www.health.go.ke Ministry of health website]
* [http://www.health.go.ke/moi.htm Moi Teaching and Referral Hospital]
*Clinical officer
* [http://www.kmtc.ac.ke Kenya Medical Training College (K.M.T.C)]
* [http://www.health.go.ke/knh.htm Kenyatta National Hospital]
* [http://www.health.go.ke/nhif.htm National Hospital Insurance Fund]
* [http://www.kemri.org Kenya medical research institute]
* [http://www.health.go.ke/Medical%20practitioners.htm Medical practitioners and dentists board]