Healthcare providers and their roles.

 Healthcare in Kenya

Photo courtesy: Peter Caesar
MMB Laboratory

This article is about Healthcare in Kenya. For the general health issues, see Health 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.

Dispensaries and private clinics

Health centres

Sub-district hospitals and nursing homes

District hospital and private hospitals

Provincial hospital

National hospital

Health care units

See also: List of hospitals in Kenya

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

Most private clinics in the community are run by nurses. In 2011 there were 65,000 nurses on their council's register. A smaller number of private clinics, mostly in the urban areas, are run by clinical officers and doctors who numbered 8,600 and 7,100 respectively in 2011. These figures include those who have died or left the profession hence the actual number of workers is lower.[citation needed]

Health centres

All government health centres have a clinical officer as the in-charge and provide comprehensive primary care. Because of their heavy focus on preventive care such as childhood vaccination, rather than curative services, local council (municipal) and most mission, as well as many private health centres, do not have clinical officers but instead have a nurse as the in-charge.

Health centres are medium-sized units which cater for a population of about 80,000 people. A typical health centre is staffed by:

At least one Clinical officer

Nurses

Health administration officer

Medical technologist

Pharmaceutical technologist

Health records information officer

Public health officer

Nutritionist

Driver

Housekeeper

Supporting staff

All the health centre staff report to the clinical officer in-charge except the public health officers and technicians who are deployed to a 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.

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 AFB, urinalysis, full haemogram, stool ova and cysts, blood sugar, Elisa and CD4 counts in comprehensive care centres for HIV/AIDS patients.

Pharmacy

Minor theatre 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.

Sub-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. They are also believed to provide better medical services compared to public hospitals.

Sub-County or District hospitals

Each sub county formally district in the country has a subcounty or 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.

County hospitals

Kenya has 47 counties, each with a county hospital which is the referral point for the district hospitals. These are regional centres which provide specialised care including intensive care and life support and specialist consultations. It is the policy of many hospitals that those who do not pay their bills are not allowed to leave and may be prevented from doing so by armed guards. This policy was found to be illegal in September 2015 by the High Court but  was still widespread in October 2018, when the court again ruled that this “is not one of the acceptable avenues (for hospitals) to recover debt”. [1]

National hospitals

There are five national hospitals in Kenya, namely:

Moi Teaching and Referral Hospital

National Spinal Injury Referral Hospital

Kenyatta National Hospital

Mathare National Teaching and Referral Hospital

Kenyatta University Teaching and Referral Hospital

Maternal and child healthcare

The 2010 maternal mortality rate per 100,000 births for Kenya is 530. This is compared with 413.4 in 2008 and 452.3 in 1990. The under 5 mortality rate, per 1,000 births is 86 and the neonatal mortality as a percentage of under 5's mortality is 33. In Kenya the number of midwives per 1,00000 live births is unavailable and the lifetime risk of death for pregnant women 1 in 380. [2]

Ministry of Health

The Ministry of Health has its headquarters at Afya house in Nairobi. There is one minister for health, although there used to be two between 2008 and 2013 when Kenya had a coalition government.[3]

Director of medical services (DMS)

Provincial director of medical services(PDMS)

Provincial medical officer of health (PMOH)

Provincial health management board (PHMB)

Provincial health management team (PHMT)

Provincial hospital management team (P-HMT)

Sub-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 committee (HCMC)

Health centre management board (HCMB)

Health centre management team (HCMT)