• The strategic plan cites outdated equipment, low staff morale and dilapidated infrastructure as main challenges.
• The hospital is also grappling with corruption, loss of revenue due to poor record keeping and inability to pay debts.
Kenyatta National Hospital needs Sh77 billion to improve its poor-rated status in the next four years.
Currently, it cannot effectively treat the 1.3 million patients who seek medical attention annually due to outdated equipment, low staff morale and dilapidated infrastructure.
This grim picture of East and Central Africa's premier referral hospital is captured in a strategic plan signed by KNH board chairman David Kimaiyo.
"Inadequate and obsolete working tools and equipment have seen low productivity, low staff satisfaction levels and high maintenance costs,” Kimaiyo says.
"Over the years, KNH has grown to its present capacity of 1,800 beds and attends to an annual average of 700,000 inpatients and 600,000 outpatients.”
The management requires Sh19 billion to improve services. The money will be used for training medical students, digitise operations, investment in research and expansion of the private wing by 300 beds.
The strategic plan was prepared by a committee headed by Peter Masinde and 31 members.
The hospital is also grappling with corruption and dwindling revenue due to poor record keeping. It is struggling to pay debts.
“There are competing priorities in provision of resources and management of healthcare between the national and county governments. The Ministry of Health is left to deal with policy, legislation, standards and research," the committee says.
"There have been changes in government policies that bring the unpredictable cost of compliance and reduced funding."
The Masinde team says KNH faces tough competition from private hospitals, uptake of traditional and alternative medicine, resistance medicine and re-emerging diseases.
Other challenges are the upsurge of non-communicable diseases, emphasis on mother and child health, change in technology, high demand for specialisation, an increase in demand for emergency and critical care services.
“The shifting bias of the national health priorities from curative to preventive and promotive care, calls for strategies to provide a robust health infrastructure, improve quality of health service delivery to the highest standards and promoting partnerships and collaborations,” the plan notes.
The manual systems have led to operational inefficiency, poor service delivery, loss of revenue, lack of integration and continuity.
The committee also says the negative attitude of workers has led to decreased customer satisfaction.
“Resistance to change has seen the loss of business, low uptake of advances in technology and poor organisational culture,” the plan said.
“Over-dependence on the University of Nairobi personnel and low staffing levels have seen poor service delivery and an inadequate patient credit assessment system.
"The hospital is also facing poor service delivery, inefficient admission and discharge process, increased turnaround time, low customer satisfaction, nepotism, favouritism and cronyism in employment."
According to the committee, the challenges have led to low productivity, increased staff indiscipline, untargeted research, resource wastage and inadequate security surveillance system.
The report also said there is a lack of an integrated ICT system, compromised service delivery and absenteeism.
Edited by P. Wanambisi