This archive report was first published on 17 August 2019.
On August 17, 2019, participants at the Health Forum reached a consensus on the need for a mechanism to improve the management of human resources for health. This consensus was reached in the face of a nationwide roll-out of Universal Health Coverage, which would inevitably inundate county hospitals with patients.
One of the shorter-term measures proposed to improve efficiency in the system is to have specialists based at county hospitals detailed to serve a number of sub-county facilities in a particular region. This would ensure equitable access to highly specialized services and reduce the load on county hospitals.
However, in the long term, it has become increasingly obvious that the scattered management of human resources for health is not working in the best interests of the people. A national mechanism to manage the human resource function in health must be implemented sooner rather than later, in line with best practices elsewhere.
Currently, the health human resource function is left to 'market forces', with the moral burden of ensuring equitable access placed on individual health workers. Despite disparities in working environments across counties and huge differences in remuneration, Kenyans have insisted that all health workers must bear the responsibility of ensuring access to the best quality health services.
Unfortunately, individual health workers have needs and desires, and the constitutional burden has proved too heavy to bear. The result has been unending industrial unrest in the sector, with worsening service delivery and a work ethos that is at odds with a professionally-run health service.
The proposed solution is the establishment of the Health Service Commission, which would have the overall responsibility of registering, recruiting, distributing, and disciplining health workers in the public sector. This Commission was originally included in the Constitution in 2010, but was deleted in the referendum draft.
However, we now have the opportunity to operationalize our favourite option by delegating the health human resource management function to the Kenya Health Human Resource Advisory Council, established in the Health Act of 2017. We can then take advantage of the referendum coming within the next year or so to entrench the Health Service Commission in the Constitution.
Lukoye Atwoli is Associate Professor of Psychiatry and former Dean, Moi University School of Medicine.
