Kenya, a former British colony which was named after the second highest mountain in Africa, gained its independence in 1963. It has a population of approximately 38 million. Today, Kenya is a leading travel destination due to its scenery, magnificent wildlife and high year-round temperatures.
Kenya spent 5.1% of its Gross Domestic Product (GDP) on healthcare in 2002. This was well below the high-income OECD (Organization for Economic Cooperation and Development) countries’ average of 9.8% for the same period. Total health spending stands at about US$6.2 per capita, far short of the World Health Organisation’s (WHO) recommended level of US$34 per capita.
Life expectancy is also on the decline. In 2006, life-expectancy for women was 51 years and 50 years for men. This is expected to decrease further due to the rising incidence and prevalence of HIV/AIDS. In 2006, the child mortality rate was 78 per 1,000 live births.
Some 56% of the population live in poverty. Worse still, this 56% contributed 51% of the total healthcare expenditure in 2002.
The under-financing of the health sector has reduced its ability to ensure an adequate level of healthcare for the population. Thus, the provision of health and medical care services in Kenya is partly dependent on donors. In 2002, more than 16% of the total expenditure on healthcare originated from donors. There are also other factors inhibiting Kenya’s ability to provide adequate healthcare for its citizens. These include: inefficient utilisation of resources, the increasing burden of diseases and the rapid population growth.
Access to health and medical care is unequally distributed across the country, as is the fertility rate and the level of education. Generally speaking, the Central Province and Nairobi are deemed to have the best facilities, whereas the North-Eastern Province is found to be the most underdeveloped.
Poor people in rural areas who are ill and choose to seek care, usually only have the option of treatment at primary care facilities. These facilities are often under-staffed, under-equipped and have limited medicines.
Among those Kenyans who are ill and do not choose to seek care, 44% were hindered by cost. Another 18% were hindered by the long distance to the nearest health facility.
Basic primary care is provided at primary healthcare centres and dispensaries. Dispensaries are run and managed by enrolled and registered nurses who are supervised by the nursing officer at the respective health centre. They provide outpatient services for simple ailments such as the common cold and flu, uncomplicated malaria and skin conditions. Those patients who cannot be managed by the nurse are referred to the health centres.
Sub-district, district and provincial hospitals provide secondary care, i.e. integrated curative and rehabilitative care. Sub-district hospitals are similar to health centres with the addition of a surgery unit for Caesarean sections and other procedures. District hospitals usually have the resources to provide comprehensive medical and surgical services. Provincial hospitals are regional centres which provide specialised care including intensive care, life support and specialist consultations.
Third level care is provided at the general hospitals Moi and Kenyatta, both located in Nairobi. Gaps, which regularly appear in the system, are filled by private and church run facilities.
The Government of Kenya has addressed the issue of inequalities and poor performance in a number of policy documents. The efforts made under the First Health Sector Plan (1999-2004) did not contribute towards improving Kenya’s health status. In 2005, the Second Health Sector Strategic Plan was implemented. This will run until 2010.
In order to improve the funding of the healthcare system and to give more Kenyans access to better healthcare, the Ministry of Health is planning to introduce a National Social Health Insurance Fund (NSHIF). This is a social insurance scheme to which everyone will contribute, without exception.
Health services are provided through a network of over 4,700 health facilities countrywide, with the public sector system accounting for about 51% of these facilities. The best quality of care is found at national referral hospitals, which represent the apex of the healthcare system and provide diagnostic, therapeutic and rehabilitative services. The two public national referral hospitals are Kenyatta National Hospital in Nairobi and Moi Referral and Teaching Hospital in Eldoret. The equivalent private referral hospitals are the Nairobi Hospital and the Aga Khan Hospital, also in Nairobi.
In 2004 there were 16 physicians and 128 nurses per 100,000 of the population.
Travellers who come from countries where Yellow Fever is prevalent are required to carry certificates of vaccination against Yellow Fever in order to enter the country. According to the WHO, malaria is a risk which exists throughout the whole country, all year round. In 2003, malaria was the most common diagnosis in both out-patient and in-patient care. However, there is normally little risk in the city of Nairobi and in the highlands (above 2,500 m) of Central, Eastern, Nyanza, Rift Valley and the Western Provinces.
You should consult your doctor about taking additional vaccinations for polio, typhoid and hepatitis, prior to travel.