Public health officers were critical in the British colonial settings, and early post independence Kenya in administering healthcare and disease control for both colonial staff and local populations. They were involved in policies and practices that ranged from managing epidemics to developing sanitation infrastructure.
A section of Garissa County PHOs joined by their national KEHPHPU leaders led by SG Brown Ashira, after a meeting in Garissa. Photo/ KNA.
They were once dreaded enforcers of public health regulations, with powers to issue instant fines, close businesses, or pursue legal action.
But Kenya’s environmental and public health officers (PHOs) are now
crying over their diminishing role in the health system.
They claim that doctors and nurses, who essentially deal
with curative measures in health care system, have invaded their departments
and taken leadership roles in disease prevention areas, which is their turf.
PHOs focus on the health of populations and communities
rather than individuals.
Speaking during a meeting in Garissa County, the national
General Secretary of the Kenya Environmental Health and Public Health
practitioners (KEHPHPU), Brown Ashira, said PHOs want counties to post their
qualified members to infections, prevention and control (IPC) departments.
“Infections,
prevention and control (IPC) is a reserve of public health, primary healthcare
is also a reserve of public health. We know there are colleagues in the
clinical areas who have occupied IPC and we are putting them on notice and we
are telling them to relinquish those positions,” Ashira said.
“We are
asking the Chief Officer in charge to post qualified PHOs to be in charge of
Infections, Prevention and Control and also the public health department in
Garissa. We cannot allow intruders, people who masquerade as public health
officers coming in to be in charge of public health departments,” he added.
The union
claims there has beenonly minimal replacement of PHOs and
technicians who left service through retirement, attrition and death for the
last 20 years.
The 2025
Economic Survey says Kenya has 2,186 employed PHOs and 181 public health technicians.
The union
further wants the Garissa county government to recruit enough PHOs to meet the
World Health Organization (WHO) recommended ratio to population.
“Garissa
county government has failed to employ the number of public health officers
required to fight diseases. As we speak, there is an outbreak of polio in this
county but we only have 60 public health officers serving a population of
800,000 people. The World Health Organization (WHO) ratios are very clear that
one PHO is supposed to serve around 6,500 – 7000 people,” Ashira said.
Among
other issues the PHOs are raising include alleged sidelining during promotions,
and management of the Facility Improvement Fund (FIF).
“As public
health officers, we collect and mobilise revenue. It is very sad that we
collect revenue and then the FIF act that revenue is not ring fenced. We
mobilize medical certificates, we give yellow fever vaccines, enforce food
hygiene licenses and other resources. It is very immaterial for somebody else
to say that a sub county PHO cannot access these funds,” said Juma Mahero, the
KEHPHPU’s national vice chairperson.
“We need
our officers to be signatories to the FIF just like the act says. We have curative
and prevention. We are the only people leading in prevention and we cannot miss
out on the FIF because we are generating a lot of revenue,” he added.
Public health officers were critical in the British colonial
settings, and early post independence Kenya in administering healthcare and
disease control for both colonial staff and local populations. They were
involved in policies and practices that ranged from managing epidemics to
developing sanitation infrastructure.
PHOs are governed by the Public Health Officers and
Technocians Council, a statutory body established by Act No. 12 of 2013 to
regulate the training, registration & licensing of public health officers
& technicians in Kenya. It lastly updated its X page in January 2024.
Antony
Kilonzo, the Garissa branch secretary general for KEHPHPU said that Garissa
County is faced by frequent disease outbreaks mainly as a result of cross
border migration from the neighbouring countries who may not have consistent
vaccinations for their population.
“The
biggest issue in this county is the frequent outbreak of diseases. You will
find that we have outbreaks of polio, we have outbreaks of measles, cholera in
very large numbers, currently, and we have Dengue fever and measles. We are
also currently investigating a polio case in Dadaab Sub County,” Kilonzo said.
A section of Garissa County PHOs joined by their national KEHPHPU leaders led by SG Brown Ashira, after a meeting in Garissa. Photo/ KNA.
