We can’t afford to gamble with health sector
Health Cabinet Secretary Aden Duale (left) and the SHA Headquarters in Upper Hill, Nairobi. The authority lost Sh11 billion in six months.
The Constitution of Kenya, 2010, is categorical about the important role of health in national and global development. Article 43 guarantees every citizen “the right to the highest attainable standard of health”, including access to reproductive and emergency healthcare services.
However, recent challenges within the health system paint a bleak picture, thus raising difficult questions about whether the governance structures responsible for delivering health as a right are sufficiently protected from mismanagement.
The health sector has faced a number of setbacks, from recurrent medical workers’ strikes to concerns about hoarding medicines and irregular processes.
Health systems are often sensitive to governance failures, given the nature of how other sectors depend on it. Unlike other sectors, where inefficiency may result in financial loss or delayed service delivery, loopholes or weaknesses in health governance can translate into loss of lives. For example, expired or counterfeit medicines place patients at direct risk. Artificial shortages of essential drugs undermine the continuity and quality of care.
The disputes between health workers and governments, often rooted in unimplemented collective bargaining agreements, disrupt services for millions of Kenyans who rely on public facilities.
Most recently, a damning report by the Auditor-General exposed a series of fraudulent actions at the Social Health Insurance Fund. A weak oversight system has failed to ensure that claims are legitimate and payments are transparent, eventually causing taxpayers pain and the loss of public resources.
The national government, through the Ministry of Health, and the counties, cannot afford to gamble with the health sector. Appointments to public health leadership and regulatory roles must be firmly anchored in merit, professional competence, the rule of law and institutional integrity. A meritocratic system improves regulatory enforcement and builds confidence among both healthcare workers and the general public.
The national and county governments must safeguard public health institutions through transparent governance, professional leadership, merit-based public service, and solid accountability.
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Onyimbi Nelson, NAYA Kenya
