We’ve Revived Health Care Services

“Mandera people, through the County Government, are now in control of their health services, and more people have access to health services.” – Ahmed Sheikh Mohamed, CEC Health Services

At the inception of devolution in 2013, Mandera County Government exemplified the case of a region with no meaningful health care services. “We inherited a sector that was completely grounded,” said Governor Ali Roba in his address to the Mandera County Assembly in 2014, in reference to health.

The people of Mandera had little or no access to health care, safe drinking water and formal education. Diseases ranged from diarrhoea, malaria, respiratory infections, malaria, measles and Dengue fever.

Given that Mandera is semi-arid and its people pastoralists, lack of services only made an already bad situation worse. The journal of Tropical Medicine and International Health argues that given their lifestyle, systematic surveillance data on the health status of nomads are practically non-existent.

Mandera was a case study of regional differences in maternal deaths and highlighted inequities in allocation of resources necessary for the realisation of basic constitutional rights, especially, the right to health care. Mandera had the highest rate of maternal deaths in Kenya, with a MMR of 3,795 per 100,000 live births (7.6 times the national average and almost twice the NEP average). Compare this with Elgeyo-Marakwet that recorded the lowest MMR at 187 for every 100,000 live births.But this bad picture is changing very fast.

The County Government has devised strategies to deliver proper health care to areas previously profiled as remote. Hospitals and dispensaries are being rehabilitated and equipped with drugs as qualified personnel are hired to improve health services. Mandera people, through the County Government, are now in control of their health services, and access to health care is covering more women, children and men alike.

 

New Face of Mandera Hospital

Medical officer attends to a new born at Mandera Referral Hospital

“Devolution has increased resource allocation to previously forgotten and marginalised counties, thereby giving their populace a chance to improve their health and socioeconomic status,” Governor Roba says. The health sector had a vacancy rate of 93 per cent for skilled professionals, the highest in the country. To address this, the County has recruited an additional 360 health workers, pushing the numbers to about 500.

This is equivalent to a 13 per cent increase within two years of devolution. Staffing levels are still only 20 per cent of the ideal requirements based on the 2009 population census and WHO recommendations.

“In order to optimise service delivery, Mandera County requires 35 medical doctors, 400 nurses, and 100 clinical officers, among other health cadres,” Governor Roba says. “We inherited 52 health facilities out of which less than 10 were operational at less than 10 per cent capacity. This was fixed within the first year of devolution. All the existing health facilities are now functional. There are eight more, bringing the total number of health facilities that are fully operational to 60. This financial year we will be adding 30 new health facilities and 30 maternity centres, while a number of the existing ones will be upgraded with additional facilities,” says the Governor.

The County minister for health Hassan Eymoy says several milestones have been made in the sector in the two years of devolution. “To effectively do medical evacuation, we engaged seven new ambulances with an ICU medevac capability in partnership with the Kenya Red Cross Society in the first financial year. We have purchased seven new ambulances that will be run by the County Government,” Eymoy adds.

“This financial year we will be starting the construction of an ultra-modern hospital complex that will carter for all modern hospital amenities, including HDU, ICU, cancer treatment centre and accident and emergency centre with dialysis, CT-scan, and MRI machines among others. Our objective is to also have a wing that will be used by visiting specialist doctors,” says Governor Roba.

Plans are at an advanced stage to send a specialised group of medical personnel to Turkey for refresher training and on the use of these sophisticated machines, for periods of one month or less. All the hospitals at the sub-counties will also be upgraded to full Level Four facilities with all the necessary amenities befitting such status.