THE MUSYIMI TASK FORCE REPORT

The task force consisted of 6 Union members and 6 government officers. The main purpose was to look into the non-pay related issues raised by KMPDU in December 2011 – issues that if addressed would raise the standards of health care in public institutions. (please see full report for indepth details). The next few slides summarize this report. (please see the full report for in-depth details):

1 - REFERRAL HOSPITAL IN EACH COUNTY

The identification/building and equipping of an appropriate county referral hospital in each county. Each of these should have the following units and equipment levels – addressing critical shortages in some of these such as dialysis, icus and newborn units.

SPECIALISED UNITS: THEATRES

6 fully equipped and functional theatres. Full anesthetic setup for all forms of anaesthesia, complete patient monitoring setup, working theatre lights, available operation packs and kits, state of the art sterilization sub unit. All theatres built with strict infection control in mind.

SPECIALISED UNITS: ICU

20 bed ICU with piped oxygen and suction to every bedside. Each bedside with a state of the art patient monitor and ventilator machine. Each bed to be electrical with a ripple mattress and a warmer. At least 6 of the Units should be full isolation units. The facility to be built with strict infection control in mind.

DIALYSIS/BURNS/TRANSFUSION

•DIALYSIS UNIT – 10 conventional dialysis machines plus two CRRT machines. Fully equipped dialysis centre with its own water plant and patient controlled electrical chair. The facility to be built with strict infection control in mind.

•BURNS UNIT – 20 Bed burns unit with strict infection control in mind and all units isolated

•BLOOD TRANSFUSION UNIT – Fully equipped to collect, screen, store and distribute blood.

RADIOLOGY EQUIPMENT

• One 3 Tesla MRI machine • One 64 slice Ct scan Machine • Two Ultra sound machines with Echocardiographic capabilities • One 3D Echocardiaographic machine • One portable X-ray Machine • One table top (fixed) X ray machine • One dental X-ray • One mammogram machine.

LABORATORY EQUIPMENT

• Complete hematology panel • Complete immunology panel • Complete biochemistry panel • Complete microbiology panel – cultures to include fungal and viral • Full capability for pathological examination including histology and cytology • Capacity for complete hormonal assay • PCR for wide range of illness from viral to mycobacterial • Enzyme and protein assays – complete • Basic routines.

2 - PHARMACEUTICAL SERVICES AND MEDICAL SUPPLIES

Introduce a revolving fund for KEMSA of 15.94Billion annually to procure Essential Medicines and Medical Supplies. This will ensure access to the entire Kenya Essential Medicine List (KEML) that includes anticancer drugs, antiretrovirals and anti-tuberculosis drugs, to levels of patients including the poor and vulnerable patients. This will also put an end to the perennial shortage of EMMS that have seen patients being sent to purchase drugs and supplies out of hospitals.

3 - STAFFING LEVELS AND SPECIALIST DEFICIENCIES

Increase Government Recurrent budget allocation to health Ministries from the current Kshs 20 billion to about Kshs 39.75 billion in FY 2012/13 to reduce vacancy ratio. The ministry implements strategies that promote equitable distribution of human resource for health. The task force recommended use of incentives such as hardship/rural allowance, harmonised house allowance, priority in scholarships, housing, security, etc to promote equitable distribution of health workers

4 - HEALTH SERVICE COMMISSION

Carry out a constitutional amendment to enable formation of the Health service Commission with the involvement of all stakeholders

5- UNDERFUNDING OF THE HEALTH SECTOR

Treasury to allocate additional funds for the two Ministries to implement a three year (2012/13-2014/2015) health stimulus package amounting to approximately Kshs. 217 billion. The treasury to increase progressively, at 2% per annum, the budgetary provision to the Ministries of health until we achieve the Abuja Target of 15%. For sustainable and affordable health care in the country, the Ministries of health to fast track implementation of the recently developed health financial strategy. That 1% of the total health budget is allocated to Research

6 - STRENGTHENING PERFORMANCE MANAGEMENT

If this report is implemented, with the exception of staffing levels which will remain a challenge for the next few years given the duration of training needed, there is no reason why the public sector should not be better than the private sector. The best part is that it is achievable; neither does it come with an outrageous bill. The cost is 247Billion over three years and a 2% annual increment in the health budget.

7 - IMPLEMENT IT NOW!!!

The next step is to generate political goodwill to prioritize healthcare and implement the report. However, it is currently not clear that the health of an ordinary citizen is a true concern of government and it may take no less than a concerted pressurizing effort from the Union, civil society and media, for this report to see the light of day. Else it will find a comfortable place in the graveyard of past good reports shoved under.