Anti_Burglar wrote:The allegations of x number of doctors serving 10,000 number of Kenyans though often quoted with genuine concern but is very misguided. It doesn't help that doctors themselves repeat it often. It should be x number of medical health workers serving 10,000 Kenyans. That is according to the Kenya Health Sector Strategic Plan JULY 2013-JUNE 2017.
But it is good he crystalises a main issue as "job group".
Anyway, the different levels of health care delivery in the Kenya Essential Package for Health is as follows:
6 Tertiary hospitals
↑
5 Secondary hospitals
↑
4 Primary hospitals
↑
3 Health centres, maternities, nursing homes
↑
2 Dispensaries/clinics
↑
1 Community: Villages/Households/Families/Individuals
Doctors start appearing in that hierarchy at around level 4. The staff at the community health workers level, dispensaries, clinics, health centers do the donkey work within the community. They include enrolled nurses, nurses, clinical officers and such. What they cannot handle is what they refer up the chain. And that is how it should be. There is no point going to say KNH to get diagnosis for Malaria when it can be done at the health center.
So what is ailing the health sectors in Kenya? What can be done? For starters, lumping money at the top of the chain in salaries and what not is absolutely not the way to go.
Calculating the number of physicians per unit population is a pretty standard way of assessing whether a country has an optimal number of doctors to serve it's population with regard to services that only doctors provide. The more accurate way is to assess each of the clinical groups separately...So number of clinical officers/nurses/community health workers etc per unit population.
The various levels of service that you describe are excellent for a universal health care system. Doctors in such a systems get paid a living wage that is not above other civil servants.
Our problem is that we are trying to introduce a half-assed for profit component into the picture and expecting some health professionals to stay at the civil servant level, while others go into the private sector. If we do this, then market forces will come into play and health professionals (including CO's and nurses) will want in on the profit pie. Furthermore, the for-profit entities will siphon off the public monies (read NHIF) that are supposed to maintain the public health sector.
We either stay with the universal health model or the fully capitalistic model. Trying to blend them cannot end well..