Kenya Health CSOs Position on the Plight of Kenyans’ Health due to the ongoing Doctors Industrial Action.
Background
The Health NGOs’ Network (HENNET) expresses deep concern over the ongoing industrial action by doctors under the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) which represents over 7,000 members. The doctors issued their strike notice on 6th March 2024 and effected it on 15th March 2024 to date. Other Health Care Workers (HCWs) issued their strike notice on 2nd April 20241 and have warned the government that they will join the doctors. This industrial action will not only affect the health outcomes in Kenya but will also affect the achievement of the Medium Term Four Plan 2023-2027 and that of Vision 2030 of providing “equitable and affordable healthcare at the highest possible standard” to all citizens and “building a just and cohesive society that enjoys equitable social development in a clean and secure environment” by the year 20303 respectively. Expresses deep concern over the ongoing industrial action by doctors under the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) which represents over 7,000 members. The doctors issued their strike notice on 6th March 2024 and effected it on 15th March 2024 to date. Other Health Care Workers (HCWs) issued their strike notice on 2nd April 20241 and have warned the government that they will join the doctors. This industrial action will not only affect the health outcomes in Kenya but will also affect the achievement of the Medium Term Four Plan 2023-2027 and that of Vision 2030 of providing “equitable and affordable healthcare at the highest possible standard” to all citizens and “building a just and cohesive society that enjoys equitable social development in a clean and secure environment” by the year 20303 respectively.
Kenya through the Constitution and government priorities, is committed to achieving Universal Health Coverage (UHC) for the improvement and well-being of its people. This commitment has been witnessed through the recent intentional and well-thought-out investment in Primary Healthcare (PHC), the delivery platform for health care and for the attainment of UHC. This has been done to ensure that the country has a robust health care system to cater for the needs of Kenyans across the different levels of health care provision. The policies that have been enacted provide a blueprint in accordance with the Constitutional provision (Article 43 (1) (a) for every person having the right to the highest attainable standard of health. The ongoing doctors industrial action risks eroding the gains made towards the journey of attaining UHC and slows the momentum on achieving other health-related goals. Human resource for health (HRH) which is one of the key components of UHC provides 50% of services needed in a health care system.
In the year 2017, doctors went on strike and the health sector experienced losses whose impact is documented in many reports4, 5 which included loss of lives, delayed treatment for many people and the volume of patients at faith based hospitals increased and exceeded the hospitals’ ability to respond to needs. The industrial action was called off 100 days later when Collective Bargaining Agreements (CBAs) were reached between County Governments, National Government and KMPDU6.
In the ongoing strike, doctors have since been joined by a coalition of health sector unions which consists of the Kenya Environmental Health and Public Health Practitioners Union (KEHPHPU); Kenya National Union of Pharmaceutical Technologists (KNUPT); Kenya Union of Nutritionists and Dieticians (KUNAD) as well as the Kenya Health Professional Society (KHPS)7
Effects of the Ongoing Industrial Action
The public hospitals and health facilities offer diagnostics, treatment and care to millions of Kenyans across the country, however health service provision in the country has been disrupted. , Many Kenyans are suffering and remain unattended in public health facilities because there are no doctors to treat them. Doctors are also not attending to emergency and critical services in all public hospitals in the country as has been documented in different platforms. Major hospitals such as Kenyatta National Hospital (KNH) and Pumwani Maternity Hospital (PMH) have stopped admitting patients for elective and maternity surgeries respectively.
The government has called various stakeholders for meetings to discuss the industrial action, but this has not borne any fruit Instead, Kenyans are not able to access their basic right to health care as envisioned in the constitution.
If the ongoing strike does not end, unfortunately, we might see many people losing lives, many people being denied their right of access to healthcare, many patients going untreated, and unfortunately, many people may lose faith in the public health facilities hence leading to an increase in low health seeking behaviors.
Health CSOs Call to Action
Civil Society in the Health Sector represents the voices of Kenyans and has a responsibility to intervene in the matter. HRH is a key pillar for the attainment of UHC whose progress has been interfered with by the ongoing strike and has also affected the overall wellbeing of Kenyans. CSOs recommend the following actions:
Call on doctors and other HCWs to resume their service to Kenyans on provision of health care as they work with the government on an amenable solution to the crises.
Interim measures to be implemented to ensure that Kenyans continue to receive essential health care services without interruption.
Stakeholders, including doctors, HCWs, the government, experts and development partners to discuss and come up with strategies for resolving the current crisis. This could include exploring the feasibility and implications of returning the health service provision to the national level as a means of addressing disparities and improving coordination.
Thoroughly investigate the root causes of the ongoing industrial action across the different cadres of HCWs. This will provide suggestions for a feasible and sustainable solution.
Ministry of Health to come up with a sustainability plan to address the concerns of doctors and other HCWs. This should include the possibility of returning health service provision to the National level to avoid disparities between counties.
The government to come up with an outline of available resources for HRH, the current gap and strategies of bridging the gaps, including soliciting support from development partners.
In all the deliberations between government and the different health care workers, the citizens who seek these services should be at the center of the conversation, negotiations, and solutions.
In an effort to intervene in the ongoing industrial action, the leadership of the Health NGOs’ Network (HENNET) is willing and open to convene relevant stakeholders to engage in constructive dialogue to understand the genesis and gist of the strike with the intention of having the parties involved to resolve the issues and call off the strike.