Kitui hospitals: What can we do to make Kitui public hospitals more effective?

Well, in my view, there are three important things that we need to do, in order to make Kitui hospitals more effective.

Firstly, we need to get the healthcare workers operating in Kitui hospitals to develop a genuine respect for the people who seek their services. This should be a policy issue,  but it needs to be inculcated in the healthcare workers – so that we get to a point where they do it not because it is policy, but because they really see the need for it. This is critical, because the complaint you are likely to encounter from most of the people who seek healthcare services in Kitui is to the effect that they feel that they have been belittled/disrespected by the healthcare workers.

Secondly, we need to make investments in hospital infrastructure: wards, theaters, labs, consultation rooms and so on. It is important to ensure that we invest where the investment is likely to make the biggest impact. I mean, for instance, if in a given hospital you hire extra medical officers or clinical officers, yet you don’t increase the number of consultation rooms, the hiring of the extra personnel is unlikely to make an impact as they wouldn’t be having somewhere to operate from. It is also important to ensure that the labs and imaging facilities (x-ray, CT scan, ultrasounds etc) in various Kitui hospitals actually work. It makes no sense to have an X-ray machine if it is always out of order…

Thirdly, if Kitui hospitals are to be effective, we need to ensure that they are well staffed. An assessment has to be made, for each of the hospitals in Kitui county, to understand how many medical officers it needs, how many clinical officers it needs, how many nurses it needs, how many lab technicians it needs and so on. As things stand, whereas the Kitui county government has made lots of efforts towards improving the staffing of Kitui hospitals, there are still some gaps that need to be filled. One challenge that I think exists is that of getting the higher cadres (like the consultants or even the generalist medical officers) to move to the subcounty hospitals. Yet for an 'hospital' to be worth the name, it needs to have at least some doctors and not just clinical officers manning it. And if there aren’t enough staff, you are likely to find long queues outside the consultation rooms, leading to hurried consultations which in turn is likely to lead to all manner of other issues.