•The research findings say since private hospital owners are out to make money, they are less likely to operate where there is less opportunity for revenue.
•The report notes that high-end medical services are concentrated in the wealthy areas of cities, at the expense of those living in rural and marginalised urban areas.
Image: MAGDALINE SAYA
Nairobi’s Dandora estate hosts the largest dumpsite in Kenya.
Its presence has been associated with cases of respiratory illnesses such as asthma among residents.
Eye allergies are very common because of the smoke emitted when burning rubbish.
Despite this, the largest health centre in the area is a public facility but cannot treat any of the above illnesses.
Most of the public hospitals in the informal settlements have limited working hours.
Patients have to wait for hours to see a doctor, and when they finally do, they rarely get the prescribed drugs.
Clara, a resident of Mukuru Kwa Njenga, says before consulting a doctor, one has to wait in a long queue and sometimes the patient might die.
“When there is no public transport or I don't have money, I have to walk, other times I am forced not to go because I am in pain, shaking and risk falling,” Sarah (not her real name) said.
Sarah is a Dandora resident suffering from epilepsy.
These are some of the findings in the latest report, ‘patients or customers’, by the Global Initiative for Economic, Social and Cultural Rights released this week.
The impact of commercialised healthcare on the right to health in Kenya during the Covid-19 pandemic sought to assess whether the marketing of healthcare has undermined the realisation of the right to health.
Image: MAGDALINE SAYA
The focus was on individuals living in poverty in urban informal settlements.
Forty seven people were interviewed and three focus group discussions were held in Dandora, Mathare and Mukuru Kwa Njenga, the three of Nairobi’s largest informal settlements.
Data collection was conducted between September to November last year.
The report said first-class looking private health facilities are largely inaccessible to low-income individuals.
They rely on the limited availability of public medical facilities or low-cost private health services offering substandard medical services.
According to the report, a rapid increase of commercial private sector participation in healthcare has instead led to inequity in access to healthcare services by the marginalised populations who face financial hardships.
The report says there exist public policies that have encouraged more private sector engagement in healthcare but have not been accompanied by sufficient regulation and monitoring of private healthcare actors.
As a result, there has been a proliferation of ramshackle private clinics, nursing homes and laboratories.
“Partly because of insufficient regulation and monitoring several private health facilities in marginalised areas are unsafe and offer substandard services,” the report says.
“These facilities, often unlicensed, employ unqualified doctors and chemists or sell expired drugs. Registered private facilities have challenges, including episodes of misdiagnosis, unnecessary treatments or misrepresentation of medical qualification.”
According to the report, patients who have been mistreated find it hard to seek justice since such establishments are closed down immediately the news pops up, the entire place painted over and the name erased.
“The widespread proliferation of unlicensed private clinics and laboratories is problematic due to the high incidence of these providers using expired drugs and reagents, or employing unqualified and untrained health staff,” the report says.
The research findings say since private hospital owners are out to make money, they are less likely to operate where there is less opportunity for revenue, such as in rural areas.
The report notes that high-end medical services are concentrated in the wealthy areas of cities, at the expense of those living in rural and marginalised urban areas.
The wealthy have an alternative of flying out of the country for specialised care.
Image: VICTOR IMBOTO
The dominance of the private sector in the provision of healthcare has been attributed to the starving of resources towards healthcare by the government.
The current domestic spending on health stands below five per cent of the national budget, below the target of 15 per cent to which the African Union states committed in the Abuja Declaration.
Those occupying the higher echelons of society can enjoy quality healthcare as a luxury by paying for it or travelling abroad.
The report shows the Covid-19 pandemic exposed the poor and marginalised to suffering, compared to the rich.
For instance, most of the intensive care units for Covid-19 cases are concentrated in cities, while 72 per cent of the Kenyan population lives in rural areas.
The report recommends that the government increase public spending on health to ensure that everyone has access to universal, public healthcare services.
The report calls on both the national and county governments to coordinate efforts to ensure all health care providers, both public and private, comply with regulatory requirements.
Health CS Mutahi Kagwe has been on record saying the poor services in public health facilities have pushed Kenyans to seek healthcare services from private facilities, resulting in huge medical bills and retention of bodies.
“Our public hospitals must be made so good in terms of capacity in the people we deploy and the continuous training of non-clinical issues such as the reception and customer care that people get in public hospitals,” he said.
“With that, they will go to public hospitals rather than private hospitals.”
Edited by Kiilu Damaris