Counties should prioritise emergency health provision to save lives

Health is a devolved function. However, the Health Act creates a unified health approach.

In Summary

• Act provides that emergency treatment shall include pre-hospital care. 

• It is a criminal offence for a medical institution to fail to provide emergency treatment when it has the ability to do so.

Health CS Mutahi Kagwe.
Health CS Mutahi Kagwe.
Image: FILE

The Constitution of Kenya (Article 43) and the Health Act 2017 guarantee every Kenyan the right to emergency medical treatment. The 2013 Ministry of Health National Patients’ Rights Charter also provides that every patient has a right to receive emergency medical treatment in any health facility.

Access to quality emergency services is an integral part of the human right to health. While Article 45 of the Constitution protects the right of every person to the highest attainable standard of health, including the right to health care services, Article 43(2) explicitly states that no person shall be denied emergency medical treatment.

The Health Act 2017 defines emergency treatment as the necessary immediate health care that must be administered to prevent death or worsening of a medical condition.

Section 7 of the Act provides that emergency treatment shall include pre-hospital care, stabilizing the health status of the individual and arranging for referral where the health provider of first call does not have facilities or capability to stabilize the health status of the victim. 

It is a criminal offence for a medical institution to fail to provide emergency treatment when it has the ability to do so. In spite of this well-entrenched legal right, many Kenyans continue to die needlessly due to lack of access to critical care in the event of an accident, severe trauma or acute illness.

The launch of the Kenya Emergency Medical Care (EMC) Policy 2020-2030 in July was timely as it brought Kenyans closer to enjoying this right fully as provided in law.

Lack of a properly functioning national emergency care system has been blamed for the increasing number of deaths whenever the country suffers serious tragedies like floods, accidents, terrorism, fire, disease outbreaks and collapsed buildings. Also, the rising prevalence of non-communicable diseases like cancer, stroke, diabetes, hypertension and respiratory conditions like asthma calls for a stable, optimal emergency care system.

According to the Emergency Medicine Kenya Foundation, a non-profit body, other major emergency conditions include prolonged and obstructed labor, head injuries, and pediatric complications arising out of pneumonia and malaria.     

Health is a devolved function. However, the Health Act creates a unified health approach through a well-coordinated relationship between the national government and county government health systems. The EMC Policy also sets out a framework for collaboration between the national and county governments in ensuring every person has access to emergency medical care.

Counties need to work closely with the national government and the private sector in developing emergency health infrastructure at the local level. But this will require a high level of mutual trust and cooperation between the two levels of government. The feuding over allocation and transfer of funds and resources should not be allowed to derail this process.

Moreover, the debilitating impact of Covid-19 on the health system, going by the surging number of patients in need of intensive care in our hospitals, has brought home the urgency of a national emergency care system.

Spiraling infections have left county public health systems literally gasping for air due to inadequate preparedness in providing critical care. But even as the Ministry of Health moves to develop an emergency medical fund to cater for victims of accidents and disasters, we must first ensure that the appropriate infrastructure is embedded in national and county health institutions.  

This is critical in achieving universal health coverage (UHC), one of the global sustainable development goals and part of the Big Four Agenda. Sustainable funding is required to secure the long-term viability of any EMC system. This means prioritizing this item under the fiscal allocations to UHC at both national and devolved levels.

This cuts across the hardware (buildings and equipment) but also the software (human resource, standards, skills and knowledge).  

The National Steering Committee on Emergency Medical Care Policy appointed in July has its work cut out. It should urgently come up with sustainable ways of funding the emergency care system and develop strategies for seamless coordination through a one-system approach.

Equally important is eliminating red-tape and corruption that bedevil procurement in the health sector thus denying many Kenyans their right to quality emergency health interventions. This will not only save many lives but also enhance the country’s disaster response capability.  

Choto is a legal and policy analyst. [email protected]