Leased medical equipment breath life to public hospitals

By Nzioka S. Waita

The raging debate about the cost-effectiveness of the countrywide program to equip public hospitals with modern equipment is a healthy discourse that should be encouraged.

But the discussions around the Managed Equipment Scheme (MES) should nevertheless be nourished by facts and immunized from distortions and obfuscation of truth.

Launched in 2015, the MES program that is a joint venture between the National and County governments targets the equipping of select public hospitals with modern equipment. These include cutting edge machines for dialysis, Intensive Care Units (ICUs), theater and X-rays and other imaging facilities.

Under the program, two hospitals in each county will benefit from an equipment upgrade. It is the onus of county governments to select the respective beneficiary institutions. By end of last year, 96 hospitals had received surgical and radiology equipment, 39 had dialysis machines installed while nine have brand new ICU facilities.

Critics of the MES claim the program fails to acknowledge the diversity of medical priorities and needs of each county. Others accuse the National government of forcing on county administrations equipment that they either do not need or were ill-prepared for.

What such arguments ignore are hard statistics pointing to a shared burden of the specific diseases that MES seeks to alleviate. Research data reveals that cancer, diabetes, high blood pressure and other life-threatening diseases are on an upward trajectory in virtually every corner of the country.

Before the introduction of the MES, many county hospitals that are the first port of call for majority of Kenyans, were reduced to lettering referrals for many of their patients. Often, patients were directed to Kenyatta and Moi referral hospitals. The long patients’ queues and even longer waiting lists for urgently needed medical attention at the two institutions were a continuous reminder of an unhealthy crisis.

Another fallacious argument against the MES is that health is a devolved function and therefore, the National government has no business prescribing interventions for the sector. Granted, the Constitution vests in the counties the management of the sector. But the national government is expected to midwife the relevant infrastructure to nurture a healthy citizenry.

The importance of health to the well being of a nation cannot be gainsaid. The ill-health afflicting an individual mutates to a national headache in so far as the pressure on public-funded medical facilities and diminished social-economic productivity is concerned. A nation can seldom prosper when its citizens are overrun by disease.

The significance of an efficient health services underpins President Uhuru Kenyatta’s government focus on the sector. The Universal Health Coverage, which is among the Big Four legacy projects of his administration, and the MES are among the key interventions intended to boost the sector.

Kitting public hospitals with modern medical equipment is an expensive undertaking even to advanced economies. Besides incubating economic growth to free more internally generated revenue to the public health budget, governments the world-over result to ingenious public-private sector partnerships to fund the sector.

The MES should be seen in this light. By negotiating leasing contracts with leading global medical firms, the Government has struck a win-win deal that avails, on fast-tracked terms, much-needed facilities to public hospitals.

Furthermore, tying the suppliers to routine maintenance and software upgrades also mitigates the risk of equipment obsolesce and thereby guarantees optimum utilization of leased services.

The key successes of the MES are self-evident. For instance, the number of public hospitals that are now offering dialysis has shot to 49 from five in three years. ICU and High Dependency Units (HDU) beds in public hospitals have increased to 116 and 63 up from 50 and 30 respectively in the corresponding period.

The same healthy increase has been witnessed in a rage of X-ray services and theater facilities. But the numbers only tell half of the success story. A stronger narrative rests in the relief the MES is quietly administering to hundreds of patients across the country.

Most services offered under MES are subsidized meaning they cost below prevailing market rates. In a country where virtually everybody has received appeals for medical aid for friends or relatives, cheaper health services are a much-needed respite.

A good example is the dialysis machines. Before MES, many diabetic patients had to travel to either KNH in Nairobi or MTRH in Eldoret for dialysis. Often, patients would be forced to queue for unknown days for the service at the risk of aggravating their health conditions.

It is common for patients to travel in the company of a relative or a friend. The multiplier cost on transport and other attendant expenses inadvertently heightened private financial burdens. The same applied to patients in need of cancer screening and other imaging services.

With these services now available at county hospitals, this burden has mercifully been reduced. And so are the hours expended in pursuit of medical attention. The resultant savings can now be channeled to more productive ventures for the gain of the individual and the nation.

Another important consequence of the MES is in the skills transfer. Over 750 Kenyan medical professionals have undergone extensive training in the operationalisation of the equipment. This acquired expertise will outlive the program to gift the country a critical mass of professionals who can be relied on to apprentice others.

This is not to deny that there may be a few operational challenges in the MES. But beyond the din of criticism, many are Kenyans who have found medical succor in the program.

Mr. Waita is the Chief of Staff and Head of Delivery, State House