June 18, 2024

Ruto’s plan to take back healthcare from counties revealed

4 min read
Ruto's plan to take back healthcare from counties revealed

President Ruto accused of plans to takeover healthcare functions from the counties

President Ruto accused of plans to takeover healthcare functions from the counties

Governors are upset following a meeting between President William Ruto and representatives of a health workers’ union on February 14 to discuss taking over county-run health services.

The Health Risk Commission, an independent organization that will supervise the management of human resources for health, including recruiting, promotion, and the provision of all services within the health sector, was also proposed at the meeting, which was held at State House.

The county executives view this as a violation of the devolved authority, and they have subsequently cautioned the federal government to refrain from meddling with and aggravating the industry.

During the meeting, Kenya Medical Practitioners and Dentists Union (KMPDU) Secretary-General Davji Atellah and other health experts said the counties’ inability to manage the sector had led to the failure of the health system.

In response, the President promised to invest heavily in primary health care and employ community health promoters to provide health care for all Kenyans. 

Three days after the meeting, President Ruto made a public announcement that he was committed to ensuring access to health care for all Kenyans, regardless of socio-economic status, and that he would recruit 100,000 community health promoters to focus on primary health care.

The Ministry of Health has planned to conduct a sensitisation programme for the promoters on the use of electronic tools and procurement of kits from May 15 to June 20.

The President said the community health promoters will be jointly funded by the two levels of government, with the government paying Sh2,500 and the county paying Sh2,500. 

The Ministry of Health has already allocated Sh519 million to pay stipends to the health promoters and provide mobile devices to roll out electronic community health information systems.

The Ministry of Health has since written to development partners asking them to quickly train the health promoters. 

These are the same partners that have been working directly with counties to support CHWs’ activities.

Two months after the meeting, the President ordered the reconstitution of the Kenya Human Resource Advisory Council to address the counties’ health workforce challenges. 

He said the council was already provided for in the law and called on counties to nominate members to the board.

The governors say all these moves point to a plot by the national government to wrest health functions from the counties, which they say will be strongly resisted. 

They have since warned that the national government taking over the training, remuneration and deployment of CHWs, the backbone of primary health care, would be an illegal transfer of constitutional functions.

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Council of Governors chairperson Anne Waiguru said in a statement that several areas, including the provision of primary health care, deployment of community health workers (now called promoters), attempted establishment of primary health care networks, creation of institutions and authorities within the sector, and proposed changes and legislation by the Health ministry have severely compromised the implementation of the devolved health function.

“The Council of Governors calls on the Ministry of Health to desist from reclaiming the health function and stop interfering in the role of county governments,” said Ms Waiguru. The Kirinyaga County boss questioned why the Health ministry was interested in building the capacity of promoters without involving counties when the management of CHWs is a devolved function.

“We urge development partners to stop supporting and funding national government ministries and interventions in devolved functions. This (trend) is prevalent in the health and agriculture sectors,” Ms Waiguru said.

The uproar by the governors was triggered by a letter from Chief of Staff and Head of Public Service Felix Koskei directing the Health ministry to work with the county governments to fast-track the assessment of all county hospitals. 

The assessment, according to the April 28 letter, is to ensure that the government has up-to-date data on equipment and human resources in all facilities.

Mr Koskei also directed Health Cabinet Secretary Susan Nakhumicha to liaise with the Kenya National Bureau of Standards and other government institutions to procure 90,000 kits for community health promoters to set up primary health care networks.

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