The majority of county governments are either not ready or ill-prepared to tackle the Covid-19 pandemic which is now in at least 21 counties, representatives of healthcare workers, unions and professional associations have said.
They include health workers unions such as the Kenya Medical Practitioners and Dentist Union, Kenya Union of Clinical Officers and the Kenya Union of Nurses.
While the professional associations are the Kenya Medical Association, the National Nurses Association of Kenya, the National Nurses Association of Kenya, the Pharmaceutical Society of Kenya and the Kenya Association of Clinical Pathologists.
A report by the Senate Committee on the Covid-19 situation reveals that the health workers’ representative groups who appeared before them disclosed that most counties either still lack adequate supplies of personal protective equipment (PPE) or have poorly equipped isolation and treatment facilities and have not facilitated adequately Covid-19 training and sensitization for their health workers.
This has led majority of the healthcare workers in the counties to be afraid as they are exposed and not adequately trained to handle the pandemic.
Kenya has a total number of 435 confirmed cases of coronavirus with the number of fatalities standing at 22.
“In our meetings, we spoke to the nurses and clinical officers in different parts of the country, not just in Nairobi, but where they are in hospitals. Many of them expressed fear. They are afraid that they are exposed and are not trained enough,” the committee chairman, Nairobi Senator Johnson Sakaja, said in the report tabled in the House on Tuesday.
According to the report, the national government has made a commitment to allocate Sh 5 billion to county governments to be disbursed over a period of three months to facilitate county response plans and purchase of necessary equipment, essential medical supplies and commodities such as PPEs.
At least 27 counties do not have a single intensive care unit (ICU) facility.
According to the Ministry of Health and other stakeholders, the country has only have a total of 518 ICU beds in both public and private facilities.
Of these, 94 percent or 448 ICU beds out of 518 are already in use by non-Covid-19 patients requiring critical care services.
“We face serious deficits as a country in the availability of ICU beds and ventilators. This is something that we seriously need to consider as a Senate. We can help each and every county to get, at least, 10 ICU beds. That will raise the number by 470,” Sakaja said
On the availability of ventilators, the country has only 297 ventilators of which only 90 are available at public health facilities.
According to submissions to the Council of Governors (CoG), an additional 30 ventilators were procured by the Ministry of Health but none of these additional ventilators have been distributed to them.
“We have written to the Ministry to establish where these ventilators are. As you know, they need personnel. Critically, what is needed is oxygen and basic oxygen equipment to the counties. The lack of this equipment threatens our ability to care for and manage Covid-19 patients who may develop mild to moderate symptoms,” he said.
However, Senator Sakaja said that some counties like Mombasa, Makueni, Marsabit, Machakos, Kisumu, Laikipia, Kiambu, Isiolo and Kisii have been singled out by the Ministry of Health for having made laudable progress in initiating and implementing their specific county response plans.
In addition, Sakaja said the national government has made commendable progress in ensuring universal access through commitments to meet the costs of treatment for Covid-19 patients at public hospitals and by demonstrating willingness to fully cover Covid-19 patients in a proposed Universal Health Coverage (UHC) scheme under the National Hospital Insurance Fund (NHIF) benefits package.
Further, the committee the Health ministry to use telehealth/telemedicine services to enhance access to specialist services, address existing disparities in access to care and promote quality affordable care.
In relation to human resources for health, the committee lauded the mass recruitment exercise by the national government which is set to increase the number of staff responding to the pandemic by 5,500 health workers under the UHC scheme.
That is 703 contracted health professionals, including 188 medical officers, 72 medical specialists, 94 clinical officers, 235 ICU nurses, 94 chest physiotherapists and 20 epidemiologists.
Other obstacles obstructing the effective fight against the pandemic include lack of material to carry out more tests for the disease, the committee said.
Only about 18,000 tests have been carried out so far, according to health ministry briefings, in a population of 47 million and against a capacity to carry out 37,000 tests daily.
The committee blamed the low testing rate on lack of skilled lab personnel, lack of adequate sample collection kits, insufficient reagents and some faulty test kits which were received as donations.
The committee also called for an additional funding allocation of Ksh.790 million to the country’s medical research institute in order to redress the testing situation’.
With regard to providing an adequate compensation package for the motivation and welfare of health workers, the committee laud a commitment to develop a comprehensive compensation package for health workers that includes medical, disability and life insurance for health workers, risk allowances and tax relief.
“During a pandemic, we can give income tax relief to all our medical personnel for that period, say, three or six months. It goes a long way in not only boosting their morale but also providing for them in these unique circumstances,” they proposed.