In Kenya, the healthcare system has a well-defined structure consisting of six (6) levels that are defined as follows (Francis W, Irene K, Ezra O, 2017):
Level 1 – Community Health Services,
Level 2 – Dispensaries and Clinics,
Level 3 – Health Centers, Maternity and Nursing Homes,
Level 4 – Sub-county Hospitals and Medium-sized Private Hospitals,
Level 5 – County Referral Hospitals and Large Private Hospitals
Level 6 – National Teaching and Referral Hospitals and Large Private Teaching and Referral Hospitals.
The system works in a hierarchical order or rather referral system whereby complicated medical cases are referred up the tier where the patient can have access to more sophisticated and specialized healthcare services. The healthcare system also comprises of various healthcare regulatory boards and councils such as the Pharmacy and Poisons Board (PPB), Kenya Medical Practitioners and Dentists Board (KMPDB), Nursing Council of Kenya (NCK) among others that are responsible for the training, registration, licensing, monitoring and evaluation of their designated cadres (Kenya Medical Practitioners and Dentist council, 2020). According to recent reports it is stated that the regulatory bodies due to their weak structures and the liberalization of the health market has contributed to the increase in counterfeits and substandard healthcare products and services which is now a major challenge in the country (Ministry of Health, 2014). The Ministry of Health has the mandate to regulate and create the policy framework for Health as well as manage national health facilities and offer capacity building and technical assistance to counties (Ministry of Health, 2014). You have to take note that Kenya is a devolved country divided into county governments that are responsible for delivering health services to their populations with the national government only responsible for the creation of health policies, managing national health facilities and financing the county governments. Because of this system we can all speculate that there will be differences in the level of care observed in different areas of the country and this will depend on the leadership in those particular areas, division of resources both at the national and county level, geographical factors, and level of education among other factors. In order to achieve the stipulated goal of Universal Health Coverage (UHC) as aligned to vision 2030, it is in my opinion that mandate of health service provision should be reverted to national government.
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